While we’ve learned to recognize pain as the body ringing alarm bells, it’s become easy to ignore and even normalize it as something that eventually subsides. But when that pain brings stiffness and interrupted sleep into your routine, as is the case with Ankylosing Spondylitis (AS), it’s time to investigate further before it becomes too serious to normalize and mobility is further limited.
AS, also known as Bechterew’s disease, is an incurable arthritic inflammation of the spine’s joints and ligaments. More severe cases result in gradual fusing of the spine, particularly in the lower back, and difficulty breathing if the ribs also become affected.
Symptoms of AS typically begin in early adulthood and are more commonly found in young men with sedentary lifestyles who spend extended periods sitting. Though the spine is home to the majority of AS inflammation points, this painful inflammation can also spread to the eyes in a condition called iritis.
Other affected areas to be aware of are the hip and shoulder joints, the back of the heel, and any part of the body where ligaments attach to bones. Extended periods of inactivity, and even sleeping, can exacerbate AS symptoms, causing mobility to become limited.
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If left untreated, you may develop a hunched back caused by new bone formations in the spine. Apart from chronic pain and inflammation, other symptoms to look for are gastrointestinal irregularities, weight loss, appetite loss, fatigue, and the inability to breathe fully and deeply.
It’s important to note that inactivity isn’t the only cause of AS. If you’re aware of instances of AS within your family history, a blood test is also available to confirm whether you may be a carrier of the gene marker HLA-B27, which was found in a majority of AS sufferers. It is possible to carry this gene and not develop AS. A physical exam will help your doctor accurately locate the sites of pain and stiffness, and whether an MRI or X-ray is required.
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For those suffering from chronic AS-related pain, there are over-the-counter (OTC) anti-inflammatory medications that help provide some temporary relief, such as naproxen, ibuprofen, and aspirin. Naproxen is gentler on the stomach than ibuprofen for those with more sensitive constitutions.
When OTC drugs fall short for pain management, corticosteroids may be injected into the affected joints. Janus kinase (JAK) inhibitors may also be prescribed, however, they come with increased cardiovascular risk factors such as heart attack or stroke.
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Another option is biologic therapy, the most common form of which is monoclonal antibodies we’ve seen used to combat the COVID-19 virus. Biologic therapies are proteins programmed to slow down or block the inflammation attack on your immune system, such as anti-TNF (tumor necrosis factor) therapy.
Biologic therapy can only be administered through a rheumatologist referred by your general practitioner. Any fusion damage to your spine cannot be reversed through this treatment method, but there may be improvement in managing AS symptoms.
For those with less severe cases of AS, beginning an exercise regimen that includes walking, step workouts, or light jogging in combination with deep stretching are all great places to start.
Low-impact floor exercises with a foam roller or yoga wheel to improve abdominal core strength are recommended by physical therapists. Maintaining such a routine also prevents a herniated disc from occurring in the spine, which could result in great pain, numbing, and possible surgery.
Not only do the exercises help posture and flexibility, they also relieve stress that we often store in our bodies unknowingly. Short-term commitments to better health lead to longer-term strength and peak performance.
