Have you also been experiencing frequent pain in your back and hip area since you were young? Especially when you wake up in the morning, does your back feel stiff and it feels difficult to bend or do any work for a while? We often forget about such things, thinking that "it might be a sprain" or "it might be due to fatigue from work." However, this may be a condition that requires a little more attention. Today we are talking about a disease that is similar to this, and which many people do not know exactly, but is very important to be aware of. That is Ankylosing Spondylitis .
What is Ankylosing Spondylitis (AS) simply?
Simply put, it is a type of arthritis that affects the joints of the spine. It mainly affects your spine and the sacroiliac joints, where the lower part of your spine connects to your hip bones. This disease causes your body's immune system to mistakenly attack these joints, causing chronic inflammation .
As this inflammation persists over time, it can cause back and hip pain, reduce flexibility in the spine, and limit movement . Some people may even develop a stiff neck over time.
It is said that about one in 1,000 people worldwide may have this condition. There is no cure for this yet. But don't worry , if the disease is diagnosed correctly and treated under the advice of a qualified doctor, you can control this disease well and live a normal life.
Who is at higher risk of developing this disease?
Why do some people develop this disease? Although the exact cause has not been found, scientists have identified several factors that increase the risk.
Genetic influence (Genes)
It has been found that genetic influences are the main cause of this disease.
- HLA-B27 gene: This is the gene most associated with this disease. This gene helps our body's immune system recognize 'these are our own cells' and 'a foreign virus or bacteria'. People with a certain variant of this gene (the `HLA-B27` variant) are at higher risk of developing AS.
- The most important thing: But the most important thing here is that just because you have this `HLA-B27` gene in your body, you cannot say that you will develop this disease. Most people who have this gene will never develop this disease. Also, people who do not have this gene can also develop this disease.
- Other genes: In addition, several other genes related to the immune system, such as `ERAP1`, `IL1A`, and `IL23R`, have been found to be associated with this disease.
Other Inflammatory Conditions
Some people with AS may also have other inflammatory conditions. For example:
- Psoriasis
- Ulcerative Colitis
- Crohn's disease
Therefore, if someone in your family has these conditions, or Ankylosing Spondylitis, you may also be at risk.
How gender and age affect
Symptoms of AS usually begin before the age of 40. Sometimes, symptoms can appear as early as 16 years old, which is called `juvenile-onset ankylosing spondylitis`.
The way this disease behaves differs depending on gender. Being aware of these differences will greatly help in diagnosing the disease early.
| Characteristic | Male side | Women's side |
|---|---|---|
| The prevalence of the disease | More abundant | Comparatively low |
| Main symptoms | Spinal cord damage (clearly visible on X-rays) | Joint pain in the hands and feet (peripheral arthritis) |
| Diagnostic delay | Usually low | It could be longer (perhaps many years) |
One reason women are often delayed in receiving a diagnosis is the misconception among society and perhaps even doctors that this is a 'male disease'. Also, because women's symptoms are different from men's (even MRI scans may show less spinal damage), it can take time to diagnose the disease.
Does race and ethnicity also play a role?
Yes, race plays a role to some extent. Studies have shown that this disease is more common in white people, especially in northern European countries. It is less common in black Africans.
But there's an important point here. Although the risk of developing the disease is low, studies show that if a black person develops AS, the severity of the disease can be increased .
Also, nearly 90% of white people with AS have the HLA-B27 gene. However, only 50%-60% of black people with AS have this gene. Therefore, it is important to consider race and genetic background when making a diagnosis.
Delayed diagnosis and its impact
For many people, it takes about 8 to 10 years for the disease to be properly diagnosed after symptoms begin. This delay can be even longer for women, especially.
This delay results in delayed treatment. This increases the damage that the disease can cause. Over time, the bones in the spine can fuse together (fusion), and the movement of the spine can be completely lost.
Early diagnosis and treatment are essential for maintaining good health and managing the disease.
So, if you have persistent back pain, morning stiffness, or other symptoms, especially if you are a woman , please don't ignore it. See a qualified doctor and talk about your symptoms clearly. Don't be afraid to ask for an X-ray or MRI scan if necessary. You have the right to speak up for yourself.
Take-Home Message
- Ankylosing Spondylitis (AS) is not just a simple back sprain, but a serious arthritis condition that affects the spine.
- This may be influenced by genetic factors (HLA-B27), family history of disease, and other inflammatory conditions.
- The disease affects women and men differently. Women may have different symptoms, which can delay diagnosis.
- Never ignore long-term back pain and morning stiffness that begins at a young age.
- By diagnosing the disease early and starting treatment under the advice of a qualified doctor, you can control the disease well and live a normal life.
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