As of 2009, according to the Centers for Disease Control and Prevention, ankylosing spondylitis is one of the top three types of arthritic diseases in the U.S., even though it has not received much attention. They estimate that as many as 15 percent of American adults have low back pain in general, and 2 percent have back pain because they are suffering from ankylosing spondylitis.
Identification
Spondylitis is the inflammation of the vertebrae of the spine. Ankylosing is the term used to describe a joint becoming stiff because of a disease. Thus, ankylosing spondylitis is a disease that involves the inflammation of the spine and pelvis. According to David Hellmann, M.D., Chairman of the Department of Medicine at John Hopkins Bayview Medical Center in "Current Medical Diagnosis & Treatment," the spine gradually becomes stiffer. Eventually, the whole spine will fuse and people suffering from this disease will not be able to move their spine in any direction.
Symptoms
People experiencing ankylosing spondylitis have lower back pain and stiffness. It may be worse in the morning but will decrease with activity. In "The Merck Manual for Healthcare Professionals," Roy Altman, M.D., Professor of Medicine at the University of California, explains that the pain also decreases upon bending over. In ankylosing spondylitis, people may develop arthritis in the hips as well. As the disease develops, it will become harder to move, so many people stay in a bent-over position. It will even become hard for those suffering with this disorder to expand the chest and breathe deeply.
Possible Complications
Dr. Altman writes in "The Merck Manual for Healthcare Professionals," that 33 percent of people with ankylosing spondylitis have additional complications. They may develop anterior uveitis, an inflammation of the uveal tract of the eye (which includes the iris, ciliary body and choroid). Symptoms include pain, blurry vision and sensitivity to light. People experiencing ankylosing spondylitis can develop a heart problem, called third-degree heart block, where one section of the heart cannot pass electrical signals to another section. People who have this heart block may not have any symptoms or may feel dizzy and pass out.
Diagnosis
X-rays of the spine and pelvis may show a fusion of some of the joints. The appearance of the fusion gives it the nickname of "bamboo spine." Dr. Hellmann writes in "Current Medical Diagnosis & Treatment," that the erythrocyte sedimentation rate (ESR) will be increased. ESR is the speed that red blood cells settle. Their speed increases when there is inflammation. The rheumatoid factor (RF) will be negative. This would be positive in rheumatoid arthritis.
Treatment
According to Dr. Hellmann in "Current Medical Diagnosis & Treatment," the first treatment used should be NSAIDs (nonsteroidal anti-inflammatory drugs). They may slow the progression of the disease, and decrease the inflammation and pain. Medications called TNF inhibitors are used if the NSAIDs are not giving a desirable response. Daily exercise is also important to increase breathing and improve posture. People with ankylosing spondylitis should stop if they smoke.
References
- Centers for Disease Control and Prevention: Mobile Exam Center Components Descriptions
- "Current Medical Diagnosis & Treatment 2009"; Stephen McPhee, M.D., Maxine Papadakis, M.D.; 2009
- The Merck Manual for Healthcare Professionals: Seronegative Spondyloarthropathies
