Ankylosing spondylitis (AS) is a rare type of arthritis that causes pain and stiffness in your spine. Usually, it starts from the lower back and Bechterew disease and it can become a lifelong condition. It can spread up to your neck or damage joints in other parts of your body.
Ankylosis means fused bones or other hard tissue. “Spondylitis” means inflammation in your spinal bones or vertebrae. Severe cases can leave your spine hunched. There is no such cure for Ankylosing Spondylitis but medication and exercise can ease pain and help keep your back strong.
Ankylosing Spondylitis Symptoms and Treatment
It starts from the sacroiliac joints where spines connect to the pelvis. It can affect places where your tendons and ligaments attach to bones.
You might have pain or stiffness in your:
If you’ve had Ankylosing spondylitis for a long time or if the bones in your back have fused together, you may be at risk of bones in your back fracturing. A fractured bone in your spine can cause nerve damage. It is very important that a doctor treating you following a fall or an accident knows that you have Ankylosing spondylitis. If you are experiencing new pain or weakness in your spine, it is very important to tell a doctor.
If you have Ankylosing spondylitis or any kind of spondyloarthritis, it can make you slightly more at risk of problems such as a heart attack or a stroke. Taking drugs to reduce inflammation, as well as eating a healthy diet, not smoking and exercising regularly will reduce this risk.
Symptoms of Ankylosing spondylitis can be similar to more common back problems, especially in the early stages.
Because of this, many people put up with the pain for some time before seeking help. It’s important to see a doctor as soon as possible if you suspect yours have Ankylosing spondylitis.
These diseases are usually diagnosed by a rheumatologist, these are doctors who specialize in conditions affecting the joints, bones, and muscles.
There is no one test that can show for certain that you have Ankylosing spondylitis. A diagnosis will be made based on several things, including:
These are disease activity and pain scores that can help doctors diagnose Ankylosing spondylitis. Your doctor will ask if you have key symptoms, such as swollen and painful joints, especially around the spine, and fatigue. You will be asked if you have pain in the mornings and how long for. Your answer to these questions could help lead to a diagnosis.
Blood tests can confirm whether you have the HLA-B27 gene. Most people with Ankylosing spondylitis test positive for HLA-B27, but so do many people who do not have the condition. A positive test may point to someone having Ankylosing spondylitis, but it would not confirm the diagnosis.
Natural treatments for Ankylosing spondylitis
AS is a chronic condition. There isn’t a current cure, but treatments can relieve symptoms, like pain and stiffness. Treatment may also reduce flares.
Natural treatments may be used on their own or with traditional AS treatments.
These are some natural therapies that may help relieve symptoms:
Stretching helps build flexibility and may reduce pain. Consider adding spine stretches or lower back stretches (like the trunk rotation stretch) to your daily routine.
To reduce stiffness and pain, apply a hot-water bottle or heating pad to the affected area. You may also use moist or dry heat. A warm bath may also help, especially before exercise.
Don’t use heat therapy without consulting your doctor if you have:
Applying an ice pack, cold gel pack, or a bag of frozen vegetables to painful joints can help reduce swelling. After exercise, cold therapy may help reduce inflammation.
Don’t apply ice for more than 20 minutes at a time. If you have circulation problems, consult your doctor first before using cold therapy.
Acupuncture is a complementary therapy that involves inserting thin needles into specific points in your skin. This is thought to activate your body’s pain-relieving hormones.
The use of acupuncture has been accepted more and more in North America. Some studiesTrusted Source report acupuncture relieves AS pain.
A 2019 review of studies that examined 70 clinical trials as well as other reports found that acupuncture was generally a safe and effective intervention to reduce pain. However, the research on acupuncture and AS was deemed inconclusive, so more studies are needed.
Massage helps you relax. It may also help you feel more flexible or “loose” so you can exercise or stretch.
Massage may cause pain at tender points around your spine. If this occurs, avoid those areas, and only use light massage techniques until the pain improves.
The more you sit, the stiffer you’re likely to feel. Get up, move around, and stretch regularly. If you have a desk job, take a “get up and move” break every hour.
Gentle exercise programs such as yoga and Pilates are great for AS because they incorporate stretching. Swimming may also be beneficial because it’s easy on your joints. Strengthening exercises with weights can help build muscle, which supports joints affected by AS. Talk with your doctor or a physical therapist to determine the best exercise plan for you.
Practicing good posture is critical with AS since it can affect your back. The Alexander Technique teaches you to be aware of your posture throughout your day.
It also teaches you how to correct poor posture and may be helpful for people with AS. To find a qualified teacher, visit the official website.
Transcutaneous electrical nerve stimulation (TENS) therapy uses an electrical current to manage pain. Electrodes are usually connected to a TENS machine and applied at the site of the pain. It’s thought that when TENS stimulates nerves, it overrides pain signals in the body.
A physical therapist can teach you the TENS technique so you can continue using it at home.
Smokers, especially men, are at risk for greater spine damage from AS than nonsmokers. Quitting smoking not only helps reduce AS damage but also improves your overall health. Quitting smoking isn’t easy. Get all the support you can get. Smokefree.gov is a great place to start.
Natural ways to improve sleep
A good night’s sleep can often be an elusive goal if you have AS. Pain may be worse at night due to inadequate bedding. Your mattress should keep your spine straight when you lie on your side. Your mattress should also allow your spine to have an “S curve” when you lie on your back.
Try these tips for a good night’s sleep:
Traditional treatments can also manage pain, reduce stiffness, and help prevent flares. Several types of medications may be used.
Nonsteroidal anti-inflammatory drugs (NSAIDs)
NSAIDs help reduce pain. Some examples include:
Your doctor may prescribe corticosteroids if your AS symptoms are severe and don’t respond to other medications. Corticosteroids also help reduce inflammation and pain. Corticosteroids are usually injected into the affected joint for fast pain relief. Due to their side effects, these drugs are intended for short-term use. Examples include prednisone (Deltasone, Rayos) and prednisolone (Omnipred).
Disease-modifying antirheumatic drugs (DMARDs)
DMARDs can help slow down the inflammatory process. Examples include sulfasalazine (Azulfidine) and methotrexate (Rheumatrex, Trexall).
These drugs are used for long-term treatment.
Biologics and biosimilars
Biologic agents can block proteins that cause inflammation. Seven different biologics are approved by the Food and Drug Administration (FDA) to treat AS:
These drugs are injected or given intravenously.
Biosimilars are also available. These drugs aren’t exact copies of biologics, but they’ve been engineered to produce the same effects. The following biosimilars have been FDA-approved for AS:
However, the only two that are currently available to U.S. consumers are the Remicade biosimilars Renflexis and Inflectra. This is largely because of patents held by the biologics manufacturers.