What’s Ankylosing Spondylitis
Ankylosing Spondylitis is a form of arthritis that is thought to be an autoimmune disease. This condition is also known as Bechterew’s Disease and Marie-Strumpell Disease. It primarily affects the joints of the spine, but other joints throughout the body may also be affected. The symptoms generally begin at the SI joint causing sacroiliac dysfunction then travel up the spine. SI joint dysfunction is a hallmark symptom of this disease. The effect that it has on the spine can be mild to severe. This condition will cause the joints and surrounding structures of the spine to be chronically inflamed, leading eventually to a fusion of the entire spinal column. This occurs because of calcification of the ligaments and intervertebral discs of the spine.
What Causes Ankylosing Spondylitis
It is not concretely known what causes Ankylosing Spondylitis. Genetic factors seem to play a main role and patients are usually born with this condition. Ankylosing spondylitis seems to run in families, but not everyone that has the gene related to this, develops full blown symptoms. If symptoms are going to show up, it likely won’t be until a person is in their 20s and 30s.
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Ankylosing Spondylitis Symptoms
Unlike other forms of arthritis, when pain is usually relieved with rest, Ankylosing Spondylitis can present in the opposite way – pain worsening with rest. Symptoms include:
- Sacroiliac joint dysfunction
- Significant loss of range of motion in the spine
- Sacroiliitis which causes pain in the lower back and buttock region
- Stiffness and low back pain that is worse in the morning and decrease as the day goes on
- Pain that worsens with rest, and lessened with activity
- Pain in the chest or abdomen when Ankylosing Spondylitis symptoms affect the thoracic spine
- Difficulty breathing and an excessive kyphotic posture leading to a ‘humpback’
- Difficulty walking
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Ankylosing Spondylosis Treatment
There is no cure for Ankylosing Spondylitis, there is only management of symptoms through conservative means such as physical therapy. In physical therapy, treatments will consist of:
- Keeping moving with aerobic exercise
- Maintaining flexibility of muscles and surrounding structures of the spine
- Increasing mobility of joints using hands-on, manual techniques
- Correcting muscular imbalances, and using muscles energy techniques to decrease sacroiliac dysfunction
- Deep breathing exercises in order to maintain motion and flexibility in the chest area if the disease is affecting the thoracic spine.
- Learning diaphragmatic breathing.
- Being educated on posture, not just while sitting but sleeping as well
- Other options include pain medication, NSAIDS in an attempt to lessen the inflammation, and steroid injections
- In extremely severe cases, surgical intervention may be discussed, but this is rare
All of the above interventions besides medications and surgery, will be provided by a physical therapist. A physical therapist is especially important to seek help from for a person with this condition in order to slow down the progression of the disease and any physical deformities it may cause. Leaving it untreated and not exercising regularly will eventually lead to a total loss of independence. Physical therapy care is the key to not losing independence and maintaining mobility. A healthy spine is a flexible spine.