Ankylosing Spondylitis (pronounced “ank-kie-low-sing spun-dye-lie-tis”) is actually part of a family of similar inflammatory diseases (called Spondyloarthropathies) that involve the spine. Effecting about 1% of the population, Ankylosing Spondylitis (also called, “AS”) is the most predominant form of this group and generally affects younger (< 40 years old), male patients who usually have some family history of chronic back pain.
What are the treatments for Ankylosing Spondylitis?
Symptoms of AS generally have an insidious onset and almost always include morning stiffness and moderate to severe back pain. What really differentiates this type of back pain from others (for example, people who were in a car accident) is that the pain actually gets better with movement and activity (and “resting” will make the symptoms & pain worse).
How can you make a definitive diagnosis?
Diagnosis of AS is what’s called a “clinical diagnosis.” What this means is that there is no single symptom, blood test, or X-Ray which will definitely prove you have AS. That said, Rheumatologists are specially trained in looking at the multiple factors needed to establish that you have this particular disease. Those factors include taking a thorough medical/family history and complete physical examination. Additionally, your ARBDA Rheumatologist may wish to obtain certain medical imaging tests (for example, X-Ray or CT/MRI) as well as blood tests. Blood tests are generally used to assess how much inflammation is occurring as well as ensuring that your other organs are healthy.
What are the available treatments?
Depending on your particular symptoms – treatment for AS can vary widely. As you might expect – nearly ALL patients with AS should undergo physical therapy to improve how the spine moves and your daily functioning. Non-steroidal anti-inflammatory drugs (called NSAIDs) are nearly always used in conjunction with physical therapy to reduce back pain. Specific NSAID choice will be based on what, if any, has worked for you in the past as well as other risk factors – as nearly all have been shown effective in reducing pain. If NSAIDs or steroids (like prednisone) fail to improve symptoms – second line therapies (such as newer biological medicines) can effectively help patients suffering from AS.
The prognosis for many patients with AS is highly variable based on their particular disease presentation. The long-term goal in the treatment of AS is to preserve as much physical functioning, decrease work absenteeism, and maintain a high quality of life.