Do you sometimes wake up in the morning with severe pain in your knees and hips? Does the pain subside after a while, then return? You may think that this is normal, or that it is just a sore throat caused by overexertion. But sometimes, behind such simple pain, there may be a medical condition that we need to pay attention to. Today, we are going to talk about such a condition, namely Ankylosing Spondylitis (AS).
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AS is more than just back pain.
Many people think of AS as just a disease that causes back pain and stiffness. Yes, back pain and stiffness are the main symptoms of this disease. But the truth is, AS is a condition that can affect the entire body. To be precise, it is a systemic disease , meaning it affects multiple systems in the body, not just one area.
When this occurs in young people, sometimes back pain can be preceded by pain in large joints such as the shoulders and hips. Also, a condition called enthesitis is very common in this disease.
So what is Enthesitis?
Simply put, it's an inflammation of the tendons and ligaments that attach our muscles to our bones. This is most commonly seen in the Achilles tendon in the heel and the plantar fascia in the sole of the foot. If you're experiencing severe heel pain when you first get out of bed in the morning, it could be due to this condition.
Even though I was 21 years old, I walked like a 90-year-old, with a stiff body and swaying from side to side.
This story was told by someone who has suffered from this disease. Sometimes when these symptoms come, we don't pay much attention to them. Or we forget to tell our doctor about it. That's why it can take years for some people to get an accurate diagnosis of AS. Especially if you are being treated by a general practitioner, he may not think about this kind of joint inflammation. Therefore , it is very important to talk to your doctor about every symptom you have, no matter how minor it is.
How AS affects the spine
AS is a lifelong condition. If not managed properly, it can permanently bend your spine and even affect your ability to walk. If you experience pain in other areas besides your back, it means you may have a more severe case of the disease. Let's take a look at the main areas that AS can affect besides your back.
| Affected body part | Things to know and symptoms |
|---|---|
| Hips and shoulders | About 1 in 3 people with AS experience pain in these joints. The pain may start in the groin, knees, or front of the thighs. |
| Eyes | About 40% of AS patients develop a condition called uveitis , which is inflammation of the eye. If you have symptoms such as eye redness, pain, and difficulty looking at light, see a doctor immediately. |
| Digestive system (intestines) | About 1 in 10 people with AS may develop inflammatory bowel disease (IBD) , such as Crohn's disease or ulcerative colitis . Symptoms include bloody diarrhea, weight loss, and extreme fatigue. |
| Jaw | About 10% of AS patients experience inflammation of the jaw joints, which can make it difficult to eat. It is important to see a dentist if you have this type of pain. |
| Bones | About half of AS patients are at risk for osteoporosis , a disease that causes thinning of the bones. Taking calcium and vitamin D supplements and doing exercises like walking can help keep bones strong. |
| Lungs | Sometimes, AS can cause the joints between the spine and ribs to become tight, causing the chest to not expand properly when you breathe. This can cause difficulty breathing. If you experience chest pain, see a doctor immediately. |
| Heart | AS increases the risk of heart disease. The aorta, the main artery that pumps blood throughout the body, can become swollen. The heart rate can also become fast or slow. Therefore, it is important to have an echocardiogram (ultrasound test of the heart) at least once a year. |
Let's also learn about treatment and management.
If you have these symptoms, the best thing to do is to see a rheumatologist . He or she will examine you and, if necessary, order tests like X-rays, MRIs, and blood tests to confirm the diagnosis.
As a treatment, painkillers called NSAIDs (Nonsteroidal anti-inflammatory drugs) are usually given first. However, some people may experience side effects such as stomach irritation and nausea from these medications. If that happens, you should tell your doctor about it. Then he or she may be able to change the type of medication or adjust the dosage.
If the disease is more severe, there are now modern drugs like biologics that can control the damage caused by the disease to the body.
The most important thing is to engage in physiotherapy and proper exercises , as well as medication. This will greatly help reduce joint stiffness and keep the body flexible.
Controlling your weight, blood pressure, and cholesterol levels are also very important for heart health. Also, if you smoke, you should stop immediately. Smoking makes this condition worse.
💡 Take-Home Message
- AS is not a disease limited to the spine. It can also affect the eyes, heart, lungs, intestines, and other joints.
- If you have other symptoms along with your back pain, such as red eyes, heel pain, hip pain, or difficulty breathing, tell your doctor about all of these.
- If the disease is diagnosed early, combined with the right treatment and lifestyle changes, AS can be well managed and a normal life can be lived.
- Engaging in prescribed exercise and physical therapy treatments as prescribed by a doctor is as important as taking medication.
- Educating yourself about your condition is the best way to live successfully with it.
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