Ankylosing Spondylitis: an autoimmune disease
What is it?
Ankylosing spondylitis (AS) is chronic inflammation of the skeleton mainly affecting the spine and sacroiliac joints (SIJ). It is a painful condition, marked by progressive losses in spinal flexibility, and a hunched forward posture. This is due to the fusion of bones in the spine which as you can image create symptoms of back pain and spinal rigidity. Seen in men more so than women at a 3:1 ratio, it tends to be diagnosed in middle age. Some co-morbidities include inflammatory skin conditions like eczema, inflammatory bowel disease and uveitis.
How is it diagnosed?
We diagnose AS using a combination of clinical signs and symptoms such as early morning stiffness, unrelenting pain, non-mechanical pain patterns and a blood test for the human leukocyte antigen HLA-B27 which your doctor can organise. Sometimes scans are helpful to gauge the extent of the wear and tear and also to rule out other pathology, but in some patients who are diagnosed early, there may be no changes to their imaging at all.
Can it be cured?
Sadly no, there is no cure for AS as it is considered an autoimmune disease that will require good management for the rest of your life. Treatment for AS is a combination of medication provided by a Rheumatologist who will generally manage your condition along with your general practitioner. From a physiotherapy point of view, maintaining spinal flexibility with a heavy emphasis on strength training and general fitness is a big part of what we do. The effectiveness of any exercise program is dependent on an individual’s adherence to the prescribed exercise. A physiotherapist can monitor and upgrade your strength regime alongside manual therapy as needed, and rejig your therapy based on the dose-response relationship between exercise and the health benefits.
Physios play a crucial role in managing AS. Patient training and exercise programs under physiotherapist supervision may improve symptoms and enable patients to manage AS throughout their lives.