Thought I'd re-share some information from a talk given by Dr Alexander Brand, a consultant Rheumatologist which I attended in January 2012.
Ankylosing Spondylitis is a chronic inflammatory disease of the axial skeleton with variable involvement of peripheral joints and non-articular structures. It mainly affects joints in the spine and the sacroiliac joint in the pelvis, and can cause eventual fusion of the spine.
- Predominently in 35 year old males
- Always starts in the sacroiliac joint
- May suffer from some other inflammatory disorder – psorasis, iritis, IBS
- Morning stiffness that is prolonged – 60-90 minutes buttock pain and into the thighs
- Systemically unwell – continual flu symptoms
- CRP and ESR may be normal
- HLA B27+ is high in only 90% of cases. If it is high does not mead you have AS. If it is low you still may have AS. Not definitive in diagnosis.
Main diagnosis test is MRI – will show bone marrow oedema of the SIJ.
– The main aim is maintain range of movement.
– Swimming, is one of the preferred exercises since it involves all muscles and joints in a low-impact, buoyant environment.
– Moderate-to-high impact exercises like jogging are generally not recommended or recommended with restrictions due to the jarring of affected vertebrae that can worsen pain and stiffness in some patients.
– Manipulation is contraindicated and has sometimes led to spinal fractures.
- Pain relieving drugs – NSAID’s and opiod analgesics
- Disease-modifying antirheumatic drugs (DMARDs) - used to reduce the immune system response through immunosuppression.