Ankylosing Spondylitis

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KEY POINTS

• Ankylosing spondylitis is a type of arthritis that mostly affects the bones in your spine.
• It is a lifelong condition, but symptoms come and go.
• Treatment may include medicines, exercise, and sometimes surgery.

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What is ankylosing spondylitis?

Ankylosing spondylitis (AS) is a type of arthritis that mostly affects the bones in your spine and the joint where the spine is attached to the pelvic bone. It can affect other joints in your body, or your eyes, heart, lungs, or intestines.

What is the cause?

The exact cause of ankylosing spondylitis is not known. It appears to be an autoimmune disease. This means that your body's defenses against infection mistakenly attack your body's own tissue.

AS may be related to genes that you inherit from your parents. You are at greater risk if you have a family member who has the disease.

AS is more common in young men under 45 years old, however women or children may also have it.

What are the symptoms?

Symptoms include pain and stiffness in your back or hip that is usually worse at night, and improves with movement or exercise. Over time, you may not be able to move your spine and it may cause your back to bend forward.

Usually the symptoms come and go. The times when you are having symptoms are called flares. The flares may last a few days or weeks at a time.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

• Blood tests
• X-rays
• CT scan, which uses X-rays and a computer to show detailed pictures of your spine and hips
• MRI, which uses a strong magnetic field and radio waves to show detailed pictures of your spine and hips.

How is it treated?

There is no cure for ankylosing spondylitis. Treatment may include:

• Medicine to slow bone damage and lessen pain and inflammation
• Physical therapy to help keep your muscles strong, help you move better, and improve your posture
• Spinal fusion surgery to join together two or more bones in your spine. This can help stabilize the bones in your spine, and ease back pain.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Use moist heat to help relieve pain and relax your muscles. Put moist heat on the sore area for up to 30 minutes to relieve pain. Moist heat includes heat patches or moist heating pads that you can buy at most drugstores, a warm wet washcloth, or a hot shower. To prevent burns to your skin, follow directions on the package and do not lie on any type of hot pad. Don’t use heat if you have swelling.
• Take nonprescription pain medicine, such as acetaminophen, ibuprofen, or naproxen Read the label and take as directed. Unless recommended by your healthcare provider, you should not take these medicines for more than 10 days.
  • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age.
  • Acetaminophen may cause liver damage or other problems. Unless recommended by your provider, don't take more than 3000 milligrams (mg) in 24 hours. To make sure you don’t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine.
• Practice good posture to avoid hunching forward.
  • Stand with your head up, shoulders straight, chest forward, weight balanced evenly on both feet, and pelvis tucked in.
  • Whenever you sit, sit in a straight-backed chair and hold your spine against the back of the chair.
  • Use a footrest for one foot when you stand or sit in one spot for a long time.
• Sleep on a firm mattress.
• Exercise is very important to keep your bones strong, your weight under control, and your joints flexible. Talk to your healthcare provider or physical therapist about the right exercise program for you. Deep breathing exercises may also be helpful.
• Take care of your health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet and try to keep a healthy weight. If you smoke, try to quit. If you want to drink alcohol, ask your healthcare provider how much is safe for you to drink. Learn ways to manage stress.
• Try to make your home safe from accidents to prevent falls and injury. For example, install handrails in the bathroom and remove loose rugs. Keep items you could trip over, like electric cords, children’s toys, and clothing off the floor.
• Ask your provider:
  • How and when you will get your test results
  • If there are activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.