Is your back stiff in the morning and sore all day? Let's learn about Ankylosing Spondylitis (AS)

Back pain is common for many people. But do you also feel stiff and in pain when you wake up in the morning? Does the pain subside as you work through the day, and then return when you sit for too long? This may not just be a simple backache. Today we are talking about a rare but well-managed condition that causes similar symptoms. That is Ankylosing Spondylitis .

What exactly is Ankylosing Spondylitis (AS)?

Simply put, Ankylosing Spondylitis (AS) is a rare type of arthritis that affects your spine. It is an autoimmune disease . This means that our body's defense system starts attacking our own cells for no reason. This disease is lifelong. It usually starts in the lower back. From there, it can spread to the neck and affect other joints in the body.

As the name suggests, "Ankylosis" means the fusing of bones together. "Spondylitis" means inflammation of the vertebrae of the spine. If the disease is severe, the spine may bend forward and become like a dome.

What are the symptoms of this disease?

AS symptoms vary from person to person. It usually starts with inflammation of the sacroiliac joints, where your spine connects to your hip bones. At first, you may feel pain and stiffness in your lower back and hips. As the disease progresses, it can also affect the tendons and ligaments that connect your bones to your spine. In severe cases, your spine can fuse together.

Let's see what other common symptoms are in the table below.

These symptoms are not the same for everyone. Symptoms may increase at times (flare-ups) and decrease at other times.

Why does this happen? Who is at higher risk?

AS is an ``autoimmune'' disease, meaning the body's immune system attacks its own cells. Doctors still don't know exactly why this happens. However, it has been found to have a genetic link that runs in families .

Many people with AS have a gene called `HLA-B27`. Not everyone who has this gene will develop AS, but people who have this gene are at higher risk of developing the disease.

Who is at higher risk ?

• For men: This disease is more common in men than in women.
• For people under 40 years of age: The disease usually begins around the age of 30.
• Family history : If a close relative in your family has AS, you are also at higher risk.
• People with other autoimmune diseases such as Crohn's disease, psoriasis, and ulcerative colitis are also at increased risk of developing AS.

How does a doctor find this?

Back pain is a common symptom, so it can be difficult to diagnose AS in the early stages. Your doctor will listen carefully to your symptoms. In addition, they may do the following tests:

• Physical examination : Your back, joint movements, and areas of pain will be checked.
• Blood tests: Blood tests are done to check for the presence of the `HLA-B27` gene and to measure the level of inflammation in the body.
• Imaging tests: An X-ray or MRI scan may be done to look for changes in the spine and joints.

In many cases, your family doctor will refer you to a rheumatologist, a doctor who specializes in diseases like arthritis.

What are the treatments for this?

There are several treatment options for AS. The main goals of these treatments are to reduce pain and stiffness, preserve spinal mobility, and control disease progression.

Exercise and Physical Therapy

This is the most important part of managing AS. The more active you are, the better you will feel.

• Exercise: Helps keep the spine straight, joints flexible, and reduces pain. Exercise in water (aqua therapy) is beneficial for many people.
• Physical therapy: A physical therapist can teach you how to maintain proper posture, stretch tight muscles, and reduce pain.

Medications

Your doctor may prescribe different medications depending on the condition of your condition.

Surgeries

Most people with AS do not need surgery. But for those with very severe disease,

• Joint replacement surgery: Replace a severely damaged joint, such as the hip joint.
• Spinal osteotomy: Straighten a severely curved spine .

Things to consider when living with AS

Living with AS can be challenging at times, but taking good care of your physical and mental health can make everyday life easier.

• Diet: While there is no specific diet for AS, maintaining a healthy weight is important. This is because extra weight puts more pressure on the joints. It is best to focus on a diet that reduces inflammation, such as fish, fruits, and vegetables rich in omega-3 fatty acids.
• Avoid smoking: It has been shown that AS symptoms in smokers worsen over time.
• Mental health: It is common to experience feelings of frustration, sadness, anxiety, and depression when living with chronic pain. If you are experiencing these feelings, seeking counseling or joining a support group with people like you can be very helpful.
• Sleep well: Pain can disrupt sleep. But getting a good night's sleep is essential for the body to heal and maintain energy. Use pillows that reduce pressure on your back and neck.

Ankylosing Spondylitis, back pain, arthritis, autoimmune, HLA-B27, spine, joint diseases