Do you sometimes wake up in the morning with a stiff spine and pain that makes it impossible to straighten your spine? This type of pain, especially in the lower back and hips, can be the beginning of something much deeper than just a simple backache, especially when you're young. This isn't just a simple backache. Today we're going to talk about one such condition, ankylosing spondylitis (AS), a rare type of arthritis. Let's talk about what causes it and who is most at risk for it.
Simply put, what is Ankylosing Spondylitis (AS)?
Ankylosing Spondylitis, or AS for short, is a type of arthritis. It mainly affects the spine. It causes inflammation, which means it causes swelling and stiffness in the joints of the spine and sometimes other joints, such as the hips. This can cause stiffness and pain in the morning.
If this inflammation persists for a long time, as our body tries to heal, new bone fragments begin to form. As a side effect of this, the vertebrae can become compressed and the spine can lose its flexibility. This makes it difficult to keep the spine straight and bend.
Do doctors know the exact reason for this?
To be honest, doctors still can't say with 100% certainty what exactly causes AS. However, it is currently accepted that it is caused by a combination of two factors: our genes and environmental factors.
Think of it this way: our genes are like a gunpowder pile. But for it to ignite, it needs an external spark. The same thing happens here. Even though there is a genetic predisposition to developing AS, some kind of 'trigger' or 'spark' from the environment is needed for the disease to occur.
Genetic influence and HLA-B27
When talking about AS, one thing that definitely needs to be discussed is the gene called HLA-B27 . This is a gene that produces a special protein, or 'genetic marker', in our body. The main function of this gene is to help our immune system . That is, to help identify and fight harmful things like bacteria and viruses that enter the body.
The majority of people with AS have this HLA-B27 gene in their bodies. However, the most important thing here is:
Not everyone who has the HLA-B27 gene will develop AS. In fact, the majority of people who have this gene will never develop AS. Also, it is possible for someone who does not have this gene to develop AS.
That means HLA-B27 is only part of the story. Scientists have identified several other genes that are linked to AS. Almost all of these genes are involved in some way in the functioning of our immune system.
The Trigger
Okay, so let's say you have a genetic predisposition, or 'shotgun', to develop AS. Now you need a 'spark' to ignite it. Scientists are still researching what this spark is.
One major theory is that this flare-up is triggered by a bacterial infection . Specifically, it is thought that this may be caused by a breakdown in the natural defenses of our digestive system, namely the intestines . When this happens, certain types of bacteria from the intestines can enter the bloodstream.
When bacteria enter the bloodstream in this way, the immune system of a genetically predisposed person overreacts, going crazy. As a result, the immune system starts attacking healthy parts of the body, especially the joints in the spine. This is how AS begins.
Who is most at risk for this?
Although anyone can develop AS, some people are at a slightly higher risk. Let's take a look at who they are.
| Risk Factor | Description |
|---|---|
| Family history | If someone in your family, especially a mother, father, or sibling, has AS, you are at a higher risk of developing it than the average person. This shows the influence of genes. |
| Age | AS most often begins in young people between the ages of 17 and 45. It usually begins much earlier than other types of arthritis that develop with age. |
| Gender | Men are at least twice as likely to develop AS as women. |
| Frequent intestinal infections | This risk may be slightly increased for someone who frequently experiences stomach upsets and digestive tract infections. That's because of the 'fire spark' we talked about earlier. |
| Other autoimmune diseases | If you already have another autoimmune disease, such as psoriasis , Crohn's disease , or ulcerative colitis , you are at higher risk of developing AS. What all of these diseases have in common is a malfunctioning immune system. |
If you have back pain or stiffness like this, especially if it's worse in the morning and lasts more than half an hour, don't just ignore it. Don't just assume, 'This is what happens when you get older.' See your doctor right away and talk about it. The sooner you diagnose the condition, the better your chances are of controlling it, minimizing damage to your joints, and living a healthy life.
Take-Home Message
- Ankylosing Spondylitis (AS) is a type of arthritis that affects the spine, not just ordinary back pain.
- Although there is no specific cause for this, it is thought to be caused by a combination of genes such as HLA-B27 and environmental triggers such as bacterial infections.
- Having the HLA-B27 gene or having other risk factors does not mean you will definitely develop AS.
- This disease often begins at a young age, between the ages of 17-45.
- If you have recurring back pain and stiffness, especially in the morning, don't waste time and see a doctor.
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