An Introduction to Ankylosing Spondylitis

What Is Ankylosing Spondylitis?

Ankylosing spondylitis is a form of arthritis, and it’s also known as axial spondyloarthritis or AS. If you have this chronic condition, your immune system attacks the healthy tissue in your joints. Specifically, AS affects the joints between your vertebrae, especially the joint where your spine meets your pelvis called the sacroiliac joint.

Ankylosing spondylitis is a painful condition on a day-to-day basis, but it’s a progressive condition too. Your immune system damages the tissue little by little, and it can eventually lead your vertebrae to fuse together. In the name “ankylosing spondylitis,” “spondylitis” refers to the inflammation of your spinal joints, and “ankylosing” refers to the fusion between your vertebrae.

Symptoms of Ankylosing Spondylitis

Ankylosing spondylitis can cause slightly different symptoms from person to person, and the severity and persistence of the symptoms will vary too. AS usually presents with symptoms such as:

• Pain and stiffness in the lower back and the hips, especially where the back meets the pelvis
• Back pain and stiffness that is worse in the morning and after long periods of sitting or laying
• Inflammation where the tendons and ligaments attached to the bones in the spine
• Spinal inflammation beginning in late adolescence or early adulthood
• Neck pain
• Fatigue
• Inflammation in other areas of the body, especially the eyes, the cartilage between the ribs, and the hip and shoulder joints
• Loss of appetite or unexplained weight loss

In many people with ankylosing spondylitis, symptoms ebb and flow. They might be more severe for a few weeks and fade away for a few weeks or months.

What Causes Ankylosing Spondylitis?

Researchers have linked ankylosing spondylitis to a number of certain genes. The most prominent is a specific genetic variation, a variation of the HLA-B gene called HLA-B27. However, not everyone with that genetic variation will develop ankylosing spondylitis, and researchers aren’t yet sure why.

Potential Complications of Ankylosing Spondylitis

On a daily basis, ankylosing spondylitis is an uncomfortable condition. It’s also a progressive condition, though, and it can lead to a variety of complications.

Fused Spinal Bones

As your immune system is damaging your tissue, your body starts trying to repair the damage by producing new bone tissue. Unfortunately, that bone growth can ultimately close in on the joints between your vertebrae and fuse some of your vertebrae together.

This fusing of your spinal bones is called ankylosis. When that happens, it lowers your mobility and can give you a hunched posture. Ankylosing spondylitis can also stiffen your rib cage, making it harder to take deep breaths.

Eye Inflammation

Ankylosing spondylitis primarily causes inflammation in your spinal joints, but it can cause inflammation elsewhere too. Most often, it sparks inflammation in your eyes, causing a condition called uveitis. This gives you eye pain, as well as sensitivity to light and blurred vision.

Compression Fractures

Ankylosing spondylitis makes your spinal bones more prone to fractures, especially in the earlier stages of AS. You can develop compression fractures of your vertebrae from simple everyday actions like lifting moderately heavy items. These compression fractures can also contribute to the hunched posture that is common in people with ankylosing spondylitis.

Heart Disease

People with ankylosing spondylitis often develop inflammation in their aorta, the largest artery in the body. That inflammation can be severe enough to distort the shape of your important aortic valve in your heart, making your heart function poorly.

Treatments for Ankylosing Spondylitis

While ankylosing spondylitis has no known cure, there is hope. There are numerous treatments that can reduce your symptoms and slow the progression of AS so you have fewer complications and effects of the condition. Your doctor will determine which of these best fit your specific needs and medical history.

Anti-Inflammatory Medications

The inflammation caused by ankylosing spondylitis is a core part of the problem, so medications that reduce inflammation can help greatly. Your doctor may start with something as simple as over-the-counter NSAIDs (non-steroidal anti-inflammatory drugs). These will reduce your pain and stiffness.

Specialized Prescription Medications

While it’s the inflammation that causes AS symptoms, ankylosing spondylitis truly comes back to your immune system, which is causing the inflammation in the first place. There are medications that can reduce this unwarranted immune response.

This class of drugs is called disease-modifying anti-rheumatic drugs (DMARDs). These medications, including biologics like certain inhibitors, will suppress your immune system or shift your immune response so your immune system isn’t able to cause as much damage to the tissue in your spinal joints. These medications are also often used for other immune-related inflammatory conditions like rheumatoid arthritis and Crohn’s disease.

Physical Therapy

As ankylosing spondylitis progresses, it can limit your mobility more and more. Physical therapy can help you to maintain your range of motion as much as possible so ankylosing spondylitis has less of an impact on your life. A knowledgeable therapist will guide you through targeted exercises for strength and flexibility.

How to Lower Your Risk for Complications of Ankylosing Spondylitis

Because we don’t know why some people develop ankylosing spondylitis other than uncontrollable genetic factors, there’s no way to lower your risk of developing ankylosing spondylitis. There are, however, plenty of ways to reduce your risk for complications from ankylosing spondylitis.

Stay Active

For many people with ankylosing spondylitis, the problem that impacts their life most is the progressive limits to their mobility. If you exercise regularly, it can limit the effects of AS and keep you more mobile and active for longer.

Be Conscious of Your Posture

Many people with AS eventually develop a hunched posture as their vertebrae fuse. If you work to maintain good posture, it will not necessarily slow the progression of your ankylosis, but it will make it less likely for you to have a hunched posture when those vertebrae fuse.

Avoid Smoking

Along with being generally bad for your health, smoking has a negative impact on ankylosing spondylitis. It accelerates the damage to your spine and intensifies the pain from AS. Because AS can hinder your breathing already, smoking can also make that problem more pronounced by limiting your lung capacity.

Eat a Healthy Diet

What you eat can have a significant impact on your ankylosing spondylitis symptoms because food can make inflammation better or worse. Focus on a balanced diet of nutrient-rich whole foods. Most notably, stay away from foods that tend to spike inflammation, like sugar, foods fried in oil, and saturated fats.

What to Do if You Suspect Ankylosing Spondylitis

When it comes to ankylosing spondylitis, time is of the essence. This is a progressive condition, so the sooner you can get a diagnosis and start treating your AS, the sooner you can start slowing its progression, and the better you’ll be able to minimize complications.

If you believe you may have ankylosing spondylitis, schedule an appointment with SRx Health. Your provider can then take advantage of our integrated healthcare system to conduct testing, assess your condition, and develop a holistic treatment plan.