Do you also feel pain and stiffness in your back and hips when you get out of bed in the morning? Does this pain seem to gradually decrease when you walk a little and do your daily activities? Do you sometimes wake up at night because of the pain? These are not just back pain, but could be symptoms of a condition called Ankylosing Spondylitis (AS) . This is an arthritis condition that occurs in the spine and other joints due to a problem with the immune system. So, when you go to see a specialist to talk about this, we will talk about what you need to be aware of and how to prepare yourself.
Why do we need to see a specialist for this?
Ankylosing Spondylitis (AS) is not something that will go away in a few days like a cold. It is a long-lasting condition. This means that we have to learn to live with it for the rest of our lives. So the best person to treat this condition is a rheumatologist .
Simply put, a Rheumatologist is a doctor who specializes in diseases related to the joints, muscles, and bones in our body. He has a good understanding of all types of arthritis, including AS.
The main goals of treatment are:
- Reducing your pain and stiffness .
- Helping you move better .
- Controlling the worsening of the disease as much as possible.
Therefore, after receiving initial advice from a general practitioner, it is best to definitely see a Rheumatologist and develop a treatment plan that is right for you.
Here's how to prepare before going to see the doctor
The time we have to see a doctor is limited. So to make the most of that time, we need to be well prepared. Gather information about these things. To make this easier, let's look at this table.
| What to prepare | Description (Why is it important?) |
|---|---|
| Your symptoms | Tell us exactly where the pain is (shoulder, hip, heel), what time of day it occurs (morning, night), how long it has been present, and what makes it worse/worse. These details will help a lot in making an accurate diagnosis. |
| What medicine are you using? | Tell us everything you are taking, not just for this disease, but for other diseases like diabetes, high blood pressure, and other medications, including vitamins and traditional medicines. If you have any medications that you are allergic to, don't forget to tell us about them as well. |
| Other health problems | Tell your doctor about any other medical conditions you have had or are currently suffering from (e.g. eye diseases, skin diseases, intestinal diseases). These may be associated with AS. |
| Family medical history | Tell your parents, siblings, and friends if they have joint pain, back pain, or other arthritis-related conditions. There is a genetic predisposition to AS. |
| Previous tests | If you have had previous X-rays or MRIs of your spine or hip, bring the report and film with you. Or, ask the rheumatologist's office where the tests were done to send them to you. |
Questions you should definitely ask your doctor
It's not just your doctor who makes decisions about your illness and treatment, you should also be involved. The best way to do that is to listen to everything that's on your mind. It's a good idea to get permission from your doctor and record his or her answers on your phone or in a notebook. Because you might forget some things when you get home.
Here are some important questions you can ask:
"Doctor, what is the best way to control my pain? Is it just medication, or is there exercise as well?"
"Can I reduce these symptoms if I change my diet? What are the good and bad foods to eat?"
"I can't sleep well at night because of the pain. What should I do to sleep easily?"
"Will this illness get better or worse over time? What can I expect?"
"Will I develop other health problems (e.g., heart disease, eye problems) in the future because of AS?"
"How long does it usually take to see results from the treatments you give?"
"What are the side effects of this medication? What should I do if I experience any of these?"
"Are there any activities I should avoid, such as lifting weights?"
"How soon should I come see the doctor again?"
These questions will help you gain a better understanding of your situation.
What to expect at the meeting?
Your first appointment will probably last an hour or more. The doctor will ask you questions and examine you.
Questions asked by the doctor
To get a deeper understanding of your symptoms, he or she may ask questions like:
- "When exactly did the pain start?"
- "How many times a day does the pain come?"
- "What makes the pain worse? (e.g., in the morning, when standing still)"
- "Does the pain feel less when you exercise your limbs and walk?"
Physical Exam
Next, your doctor will do a physical exam to see how well your spine and joints move. He or she may ask you to:
- Bend forward, backward, and to the sides.
- Take a deep breath (watch your chest expand).
- Move your legs and hips in different directions.
He will also check if you feel any pain at this time.
Laboratory Tests
These tests may be used to confirm the diagnosis:
- Imaging Tests: An X-ray or MRI may be ordered to look for swelling or changes in the sacroiliac joints, which are located at the lower part of the spine and hip joints. This is a key symptom of AS.
- Blood Tests: A blood test will be done to check for markers of inflammation in your blood. You may also be tested for a gene called HLA-B27 . This gene is found in more than 95% of people with AS. But remember, not everyone who has this gene will develop AS.
Take-Home Message
- Ankylosing Spondylitis (AS) is a long-term disease that affects the joints and spine. It is very important to see a rheumatologist for this.
- Before you go to see the doctor, prepare a detailed list of your symptoms, medications you are taking, and family medical history.
- Feel free to ask your doctor any questions you have about your condition and treatment. It is your right, and it will help ensure the success of your treatment.
- Follow the treatment, exercises, and instructions given by your doctor exactly. This is a disease that requires long-term management, so your commitment is very important.
- Living with this disease can be challenging at times, but remember that with the right treatment and management, you can control your pain and live an active, fulfilling life.
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