World Ankylosing Spondylitis Day: Understanding the chronic lifestyle condition
World Ankylosing Spondylitis Day: Understanding the chronic lifestyle condition
Ankylosing Spondylitis is a type of inflammatory arthritis that predominantly affects the spine and sacroiliac joints (where the spine connects to the pelvis), causing lower back, hip, and pelvic pain. In India around 1.65 million people are currently diagnosed with the condition, that is estimated to grow at an annual growth rate of 2.95% as per Global data’s recent study[1]. With the lack of understanding around this disease, 69% patients are either misdiagnosed[2] or remain unaware, which further worsens their condition.
Dr Ramesh Jois, Consultant Rheumatologist, Manipal Hospital, Bangalore, said, “AS is a chronic painful debilitating arthritis which affects the spine and other joints such as hips, knees, and ankles. It can be characterized by severe pain, stiffness, and loss of function in the spine which makes the condition a life-long one. Inadequate treatment or no treatment of AS can result in permanent joint damage. 40% of the patients end up with spine fusion, loss of spinal movements and ensuing spinal deformity if the condition is treated inadequately.”
This World Ankylosing Spondylitis Day, here are important facts about AS you need to know to help you better understand the disease and treatment.
- Ankylosing spondylitis is an inflammatory disease
AS isn’t a result of the joints’ natural wear and tear but develops because of chronic inflammation in the body. The pain that comes with the disease tends to get worse when you’re not moving the joints and this inflammatory pain gets wore in in the morning. It occurs because the immune system is mistakenly attacking the joints in the spine.
- Over time, the spine could fuse together
In some people, the extent of AS joint damage might be signs of inflammation, bone erosion, or bone thickening. But in others, calcification of the discs and ligaments between back bones could make the vertebrae fuse together. As this progresses into “bamboo spine,” patients can lose mobility in their back. However, earlier diagnosis and aggressive treatment of AS can help prevent or delay this.
- Treating Ankylosing Spondylitis:
By carefully tracking the symptoms and consulting a specialist, a Rheumatologist at the onset, one can ensure accurate and timely treatment. A Rheumatologist helps identify treatment options that work best for them, with a balance of medication such as the biologic therapies, and lifestyle changes
“With recent advancements in medical science, we now have medications such as biologic drugs, which now can effectively control inflammation in the spine & joints, in turn preventing progression of the disease and joint damage. In addition to treatment adherence, regular consultation with the Rheumatologist is important. Early diagnosis and treatment adherence are key to managing the condition. The idea is to control the inflammation as best as possible, which will in turn prevent bone fusion. Building a lifestyle that is healthy and balanced with good food and an exercise routine (especially swimming) can be truly beneficial.” added, Dr Jois.
- AS strikes the young
While we tend to associate arthritis with middle age, inflammatory arthritis tends to first occur at younger ages. And of those, AS hits particularly young — about 80 percent of patients will experience their first symptoms before age 30; a mere 5 percent will notice the signs at 45 or older, according to Johns Hopkins Arthritis Center. Owing to improper posture, sedentary lifestyle, and stress, Young Indians are at a higher risk.
Dr B. G. Dharmanand, Consultant Rheumatologist, Vikram Hospitals, Bangalore, said, “Sometimes patients and even general doctors find it difficult to distinguish the most common initial symptom of Ankylosing Spondylitis (AS) which is back pain from other common causes for back pain. This usually leads to a delay in diagnosis. Numerous youngsters suffer from AS and it is an important cause of disability in this population. So, it is very important that treatment for this condition is taken seriously. Around 10 patients are diagnosed with AS each week in a rheumatology clinic, with a male to female ratio of about three to one.”
- AS can affect men and women differently
In men with AS, the spine and pelvis are the most common sites the disease shows up and where the symptoms are the most serious. Whereas for women pain is usually experienced in the joints of arms, legs, or neck. Inflammatory markers in the blood also differ between men and women with AS. One study found that men with AS have higher levels of inflammatory markers in their blood. These elevations were not seen in women with AS.
- Genes can play a role in AS
In particular, the genetic variant HLA-B27 is associated with an increased risk of developing AS. That said, testing for the HLA-B27 gene doesn’t rule out a diagnosis. About 2% of people who carry the HLA-B27 gene will go on to develop the disease, according to the Spondylitis Association of America, and not everyone with AS has the HLA-B27 gene.