Ankylosing spondylitis is a disease of the spine, which is characterized by inflammation and results in fusion of the vertebrae. As a result, the spine loses flexibility, and the patient will lose the normal spinal curvature, resulting in a “hunched” posture. Some patients with ankylosing spondylitis are unable to lift their heads as the disease progresses.
How Does Ankylosing Spondylitis Occur?
Ankylosing spondylitis may be related to a genetic component, but there is no specific cause identified. The condition may begin with simple pain and stiffness in the low back and hips, occurring more frequently in the morning or after periods of inactivity. A sedentary career may lead to more complications.
Ankylosing Spondylitis Symptoms:
Patients who develop this condition tend to experience initial symptoms as young adults. There are often associated symptoms of inflammation in the eyes or bowels.
Eye inflammation is known as uveitis, and causes acute eye pain with light sensitivity and blurred vision. You should consult your physician if you develop symptoms of uveitis.
Cartilage between the sternum (breastbone) and ribs may also be affected. This can result in chest pain with deep inspiration. If your ribs are affected, your respirations may be inadequate due to bone fusion.
Some patients have associated problems with the aorta, resulting in enlargement of the aortic valve and the potential of heart failure as a result.
As the disease progresses, the areas that are primarily affected include:
- The vertebrae in the lower back
- Hip joints
- Shoulder joints
- The joint between the base of the spine and the pelvis
- Tendons and ligaments to bones, normally in the spine
A particular danger with the progression of ankylosing spondylitis is occurrence of compression fractures that result in crumbling of the vertebrae. In some cases, this may cause damage to the spinal cord, resulting in neurologic problems.
Ankylosing Spondylitis Treatments:
Ankylosing spondylitis is known as “bamboo spine” and is diagnosed through imaging studies. This may result in a late diagnosis, long after you begin to experience back or hip pain. Treatments are not curative, but are targeted to relief of pain and stiffness, with a goal of delay or prevention of complications and severe spinal deformity.
Initial treatments include non-steroidal anti-inflammatory drugs like naproxen and ibuprofen, or indomethacin.
In addition, more aggressive treatment may involve drugs known as TNF (tumor necrosis factor) blockers. Tumor necrosis factor is a protein that contributes to inflammation in rheumatoid arthritis, and drugs like Humira or Enbrel target this protein.
Physical therapy can be helpful to decrease pain and stiffness while improving strength and flexibility. Moreover, a routine of range of motion and stretching exercises will assist in maintenance of joint flexibility and posture.
Respiratory therapy may be required if your thoracic region is affected, in order to maintain lung capacity.
As the disease progresses, if you continue to utilize exercises to strengthen the muscles of the abdomen and back, then when your spine fuses, your position will remain upright. It is important to be consistent with exercises to maintain your posture.
Regenerative Medicine for Ankylosing Spondylitis:
Surgery is not usually required or useful in patients with ankylosing spondylitis, unless your condition results in a severely damaged joint that may be replaced. Thankfully, we have a couple of nonsurgical options that may be helpful.
Platelet-Rich Plasma (PRP) and Bone Marrow Concentrate (BMC) are two regenerative medicine options. Both are most effective when used in the early stages of ankylosing spondylitis. These treatments may be effective prior to the disease causing irreversible joint damage.
If spinal fusion has already occurred, PRP and BMC can alleviate pain by reducing inflammation and regenerating soft tissue.
Spinal Cord Stimulation:
Both traditional spinal cord stimulation (SCS) and BurstDR stimulation offer chronic pain relief from conditions like ankylosing spondylitis. For over 40 years, stimulators have managed chronic pain in the back, neck, and limbs.
Both stimulators involve a doctor implanting a small device that powers thin wires along the spinal cord. Through the use of low level electrical currents, the device interrupts pain signals being transmitted to the brain. However, where they differ is in the way they do so. BurstDR, a St. Jude Medical device, is the only stimulator on the market to replicate the way the brain perceives pain. Making the treatment more natural than traditional stimulators.
Finally, if you are suffering from ankylosing spondylitis and experiencing the pain symptoms listed above, you should contact us immediately to meet with one of our pain specialists and start treatment to relieve your pain. We offer weekday and weekend appointments. You can find us at our conveniently located clinics in West Orange, Aberdeen, and Lyndhurst.