If you’ve recently been diagnosed with ankylosing spondylitis, you’ll likely have a lot of questions for your doctor. These questions might include possible treatments, and other basics about your condition.
Here are the answers to some of the most common ankylosing spondylitis questions. Take this discussion guide with you to your next doctor’s appointment to use as a conversation starter.
Ankylosing spondylitis is both an autoimmune type of arthritis and a chronic inflammatory disease. An autoimmune disease develops when your body attacks its own healthy tissues.
Ankylosing spondylitis is also an inflammatory condition that involves inflamed or swollen joints. It often affects joints and bones in the spine and lower back. The spinal bones can fuse together over time.
Ankylosing spondylitis is a type of inflammatory arthritis that affects the spine and the sacroiliac joints in the pelvis. Like other types of arthritis, ankylosing spondylitis causes pain and swelling in the joints.
This condition affects the bones of the spine (vertebrae) and joints in the lower back. It also causes swelling where the tendons and ligaments attach to bones in your spine. Your doctor might call this enthesitis.
Pain and discomfort from ankylosing spondylitis can lead to symptoms in other joints, such as your shoulders and hips.
The doctor will likely start by asking about your symptoms and family history of ankylosing spondylitis. An exam can reveal symptoms like pain, tenderness and stiffness in your spine.
The doctor may send you for an X-ray or MRI scan. Both tests can show damage to bones and soft tissues in your spine. An MRI creates more detailed images, and it can show damage earlier in the disease than an X-ray.
Another way to diagnose this condition is with a blood test for the HLA-B27 gene. The prevalence of HLA-B27 varies in different ethnic populations. The genotype is seen in approximately 80% of the Caucasian patients with AS and less than 60% in the African American population. It is possible to have this gene, but not have ankylosing spondylitis.
Your primary doctor might first suspect ankylosing spondylitis or may actually diagnose you. After this point, they may refer you to a rheumatologist. This type of doctor specializes in diseases of the joints, bones, and muscles.
The rheumatologist might be your go-to doctor for treatment. You may also need to see a physical therapist, or an ophthalmologist if you have eye symptoms (uveitis).
Ankylosing spondylitis treatment involves medications, ancillary care from physical therapy or occupational therapy, and lifestyle changes. Surgery is also a possibility if your joints are very damaged.
Your rheumatologist may recommend one or more of the following ankylosing spondylitis treatments:
- nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen) to decrease pain and inflammation
- biologics, such as TNF inhibitors, which are injected or given by IV infusion if NSAIDs don’t work
- physical therapy to teach you exercises that strengthen and stretch the affected joints in your back
- disease-modifying antirheumatic drugs (DMARDs) to treat pain and inflammation in the joints
Diet hasn’t been well-studied for ankylosing spondylitis.
Avoid smoking, which drives inflammation. It can worsen joint damage from ankylosing spondylitis.
Surgery is a last resort option for people with severe joint damage. A joint replacement removes a damaged joint and replaces it with one made from metal, plastic, or ceramics.
Spinal surgery is indicated when patients are severely impaired and unable to perform daily activities. Several procedures are used based on the symptoms and imaging findings. An osteotomy involves a procedure to straighten your spine and correct your posture. A laminectomy can be performed if there is pressure on nerve roots.
Physical therapy is a recommended treatment for ankylosing spondylitis. It teaches you exercises to increase movement and flexibility, and decrease pain. A physical therapist can also show you posture exercises to improve your flexibility and range of motion.
Ankylosing spondylitis can cause complications like these:
- fusion of the spinal bones and a forward curving of the spine
- weakening of the bones (osteoporosis) and fractures
- eye inflammation called uveitis
- problems with the aorta, the largest artery in your body, secondary to inflammation
Symptoms that get worse can mean that your treatment isn’t working as well as it should, and that your ankylosing spondylitis is progressing.
For example, your spine might feel stiffer or more painful than usual. Or you might begin to experience symptoms in other joints. Excess tiredness is another sign of increased inflammation.
If you experience any new or worsening symptoms, call your doctor right away. They might recommend a change in your treatment plan to relieve your discomfort and prevent your condition from getting worse.
There’s no cure for ankylosing spondylitis. There aren’t cures for most other forms of arthritis, either.
However, a combination of ancillary care therapies, medications, and lifestyle changes can improve your symptoms and slow the rate of joint damage. Your doctor will tell you next steps based on your symptoms.
A diagnosis of ankylosing spondylitis can be confusing. That’s why it’s important to learn as much about your condition as you can.
If you still have questions, make sure you ask your doctor at your next appointment. Doing so can help you get the treatment you need to prevent your condition from getting worse.