Have you ever had back pain, stiffness in the morning, or joint pain since you were a teenager? You may think that it's just a bad cold, something that comes from being tired, or something that comes from sleeping poorly. That's often the case. But sometimes it can be something more serious. Today we're talking about a condition that many people don't know about, but it's important to know about. That's
Ankylosing Spondylitis , or
AS for short.
Simply put, what is Ankylosing Spondylitis (AS)?
This is also a type of arthritis. But it mainly affects your spine. To be precise, it is an "inflammatory arthritis" condition. This means that your body's own immune system mistakenly attacks the joints in your spine. This causes inflammation, which means swelling and pain, in the joints of your spine. This condition usually begins at a young age, between the ages of 20 and 40. Over time, this ongoing inflammation causes the vertebrae in your spine to fuse together, becoming like a single bone. This is called "ankylosis" in medical terms. Think of it as if your spine's vertebrae were cemented together. This can cause stiffness and a hunched posture. This is the main problem with AS.
Does AS affect everyone the same?
No. This disease does not affect everyone the same. Some people only experience mild pain that comes and goes. Others may experience severe pain and stiffness that lasts a lifetime. Research has found that the severity of the disease can vary from person to person. For example, studies have shown that some groups of people are more likely to develop the disease than others. This may be due to genetic influences, environmental factors, and differences in access to health care.
Sometimes, due to lack of awareness about this disease, a person with symptoms may delay seeing a doctor. In that case, the disease may be a little more severe by the time it is diagnosed.
Additionally, some people with AS are at increased risk of developing other medical conditions, such as high blood pressure, diabetes, depression, and heart disease.
Do genes play a role in developing AS?
No one knows exactly what causes this. But it tends to run in families, so it is believed to be a genetic link. If your mother, father, or sibling has AS, you are more likely to develop it. There is a lot of talk about the
HLA-B27 gene in particular. People with this gene are at higher risk of developing AS. But the important thing here is that
just because you have the HLA-B27 gene doesn't mean you will develop AS . Even in Sri Lanka, there are many people who have this gene but don't have any disease. Also, people who don't have this gene can also develop AS. That means that doctors now believe that not only genes but also other environmental factors that we don't know exactly are the cause of this disease.
What are the main symptoms of AS?
In addition to back pain, AS can cause a number of other symptoms. Let's take a look at the main symptoms.
| Symptom | The way you can feel |
|---|
| Pain and stiffness in the back and buttocks area | My back feels stiff, especially when I wake up in the morning, or after standing up after being in the same position for a long time. This pain decreases when I walk a little or do something useful. The pain increases at night and can even wake me up from sleep. |
| Pain in other joints | Swelling and pain can occur in areas such as the hips, shoulders, knees, ankles, and heels. |
| Difficulty breathing | If this inflammation spreads to the ribs in the chest, chest expansion may be limited and chest pain may be felt when taking a deep breath. |
| Eye problems (Uveitis) | About a third of AS patients develop an eye infection, called uveitis. Symptoms include sudden redness, eye pain, difficulty seeing, and blurred vision. This is an emergency and requires immediate medical attention . |
| Other common features | Unexplained fatigue, fever, weight loss, skin rashes, and in some people, intestinal diseases such as Crohn's disease may occur. |
What do you do if you have these symptoms?
If you, especially if you are young, have had back pain that is worse in the morning and better during the day for more than 3 months, you should definitely
see your family doctor .
It's important to be honest about your pain. If you don't describe it properly, thinking, "It's just a little ache," it can be difficult for the doctor to diagnose the underlying condition. So be open about all your discomfort.
The doctor will examine you and, if necessary, order several tests, such as:
- X-ray tests: Look for changes in the spine and hips.
- MRI scan : In the early stages of the disease, inflammatory conditions that are not detected by X-rays can be detected.
- Blood tests : Tests like ESR and CRP that measure inflammation in the body.
- Genetic testing: If necessary, check for the HLA-B27 gene.
What are the treatments?
Although AS cannot be completely cured, there are now many good treatments that can help control symptoms, prevent back stiffness, and lead a normal life.
Active lifestyle
One of the best treatments for this is
to stay active . Regular exercise, especially exercises that strengthen the back and core muscles and stretching, can help reduce pain and maintain flexibility in the back. A physiotherapist can help you find a suitable exercise program.
Medicines
Your doctor may prescribe medications such as these depending on the condition of your condition:
- Nonsteroidal anti-inflammatory drugs ( NSAIDs ): These are the first-line medications given to reduce pain and inflammation.
- Tumor necrosis factor (TNF) blockers: These are a type of biologic drug. They target a substance that causes inflammation and control the disease if NSAIDs do not control it.
- Disease-modifying antirheumatic drugs (DMARDs): Drugs like Sulfasalazine are also sometimes used.
- Corticosteroids : Given short-term when inflammation is high.
In some severe cases, surgery may be necessary to replace a damaged joint or correct changes in the spine.
Take-Home Message
- Ankylosing Spondylitis (AS) is a type of arthritis that mainly affects the spine and begins at a young age.
- Morning back stiffness and pain (which decreases with exercise) are a major symptom.
- This disease can affect not only the spine, but also other parts of the body, such as the eyes, shoulders, and hips.
- If you have persistent back pain, don't ignore it and see a doctor. Early diagnosis can lead to successful treatment.
- By staying active, exercising regularly, and taking medications as prescribed, you can live a normal, healthy life.
ankylosing spondylitis, as, back pain, back pain, joint inflammation, hla-b27, back pain, arthritis, back pain, sri lanka
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