What is Ankylosing Spondylitis?

Ankylosing spondylitis (AS) is a chronic, progressive, and potentially debilitating condition that primarily affects the joints of the spine, or vertebral column, leading to stiffness and pain. AS is an inflammatory disorder that causes the vertebrae to fuse, leading to a loss of mobility, flexibility, and function. The condition is also known as Bechterew’s disease, spondyloarthritis, or rheumatoid spondylitis.

AS primarily affects young adults and is more common in men than in women. The condition usually begins in the sacroiliac joints, which are located where the spine meets the pelvis. Symptoms typically include chronic lower back pain, stiffness, and reduced mobility. AS can also affect other parts of the body, including the hips, shoulders, and knees, and may cause fatigue and eye inflammation. In some cases, the inflammation can also affect other organs, such as the lungs, heart, and kidneys.

The exact cause of AS is unknown, but it is believed to be caused by a combination of genetic and environmental factors. Approximately 90% of people with AS have a specific genetic marker called HLA-B27, which increases the risk of developing the condition. Environmental factors, such as infections or physical trauma, may also trigger the onset of AS in susceptible individuals.

The diagnosis of AS is usually based on the symptoms, physical examination, and imaging studies, such as X-rays, magnetic resonance imaging (MRI), or computerized tomography (CT) scans. Blood tests may also be performed to look for evidence of inflammation or to check for the HLA-B27 genetic marker.

Treatment for AS aims to relieve symptoms and prevent further joint damage. Nonsteroidal anti-inflammatory drugs (NSAIDs) are usually the first-line treatment for AS, as they can reduce pain and inflammation. Disease-modifying antirheumatic drugs (DMARDs) may also be used to slow down the progression of the condition. Biologic agents, such as tumor necrosis factor (TNF) inhibitors, may be used in severe cases of AS that do not respond to other treatments.

In addition to medication, physical therapy and regular exercise can also help improve mobility, flexibility, and posture. Patients with AS are often advised to participate in low-impact exercises, such as swimming or yoga, to reduce pain and improve mobility. Surgery may be considered in severe cases of AS to correct spinal deformities and improve joint function.

Although AS is a chronic condition, it does not usually shorten life expectancy. However, it can significantly reduce a person’s quality of life, particularly if left untreated. With early diagnosis and appropriate treatment, most people with AS are able to manage their symptoms and maintain a good quality of life. Regular monitoring and follow-up with a healthcare provider are important to monitor disease activity, adjust treatment as needed, and prevent complications.

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