Ankylosing spondylitis (AS), to most people looks like a made up word or to others a really high scrabble score, but in fact it’s an arthritic condition of the lower spine.
Ankylosing spondylitis is a form of inflammatory arthritis, this is different from the more common osteoarthritis, and therefore affects a different population. AS is most commonly found in males aged between 15-25 but is still possible in women and those up to 40 years old.
It starts as inflammation in the pelvis and sacrum and works its way up the spine. As the condition worsens bony growth can occur in the inflamed segments, this can in fact cause fusion of the spine. Long term the autoimmune condition can affect body organs, skin and eyes.
There are some key points about Ankylosing Spondylitis
- It starts in the sacrum
- It ascends up the spine progressively
- It is an autoimmune condition – this means your body is actually attacking itself.
Image courtesy of MusculoSkeletal network Australia.
Signs and symptoms of Ankylosing Spondylitis
- As mentioned above, Ankylosing Sondylitis starts in the sacrum (or your tailbone), then progresses to the lower back
- This will present as pain and stiffness
- It is much worse at the beginning of the day – this is because the inflammation settles in the joint overnight.
- There can be more global pain in tendons – commonly hips, achilles and the neck
- General fatigue
- Applying ice generally helps with short term pain
- Every day might be different, fine one day and agony the next.
What is the cause of Ankylosing Spondylitis
The definitive cause of AS is actually unknown, there are some factors that have been nailed down and they are
- Seems to have an aspect of genetics, you are more likely if someone in your family has had the condition before
- Most sufferers have the gene HLA – B27, however this is concrete because some people with this gene also show no signs of AS
Diagnosis
It is important to diagnose AS early on in the disease’s presentation; however, this can be difficult as early stages mimic many other lumbar and low back conditions. A combination of case history and non-improving conditions will likely lead your practitioner to refer for imaging.
Imaging can include plain x-ray, CT scan or an MRI.
A key part of diagnosing AS is the involvement of inflammation of the sacroiliac joints; however this can be a frustrating part of diagnosis due to enough inflammation and damage can take 7 years to show up on a plain film x-ray.
Treatment of AS
The hardest part of this is knowing that at the moment there is no cure for ankylosing spondylitis.
Treatment will aim to manage pain and symptoms and trying to maintain as much range of motion as possible.
Referral to a rheumatologist to aid in medication to slow down the progression of the disease and manage pain symptoms. Depending on the severity this could be anywhere from simple anti-inflammatories, to immunosuppressing cortico-steroids and DMARDS (disease modifying anti-rheumatic drugs).
What can we do?
Our primary role will be to help diagnose the condition, assess your movement and painful motions. We will use all our skills to help improve your movement and strength to help improve the ease of daily activities.
This may involve our hands-on treatment, with soft and deep tissue massage, joint articulation, stretching and muscle energy techniques. But we also have the ability to supply you with exercises and stretches for you to do at home, we have an exercise physiologist who can also help improve your trunk stability and function.
What can you do?
- Exercise. Perhaps the most important part of managing your condition will be to stay fit and active as much as possible. Whether it be aerobics, swimming, Pilates, gym work or team sports (where tolerated), we highly recommend consulting your physician first!
- Education. Like with many conditions learn as much as you can about it. Seek help where needed, keep up to date with research and anything that may help you.
- Eat a healthy and well balanced diet
- Manage your stress
- Learn ways you can manage your pain.
If you have back pain, whether acute chronic or in between please seek professional assessment of your pain, and get your management plans started today! Book an appointment in our Albury or Wodonga office today
