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Ankylosing spondylitis


Ankylosing spondylitis is a hereditary back condition that cripples tens of thousands of people in the UK. It affects approximately one in 100 males and one in 250 females and occurs most commonly between the ages of 15 and 35 years. High profile sufferers include the former England cricket captain Michael Atherton. What is Ankylosing spondylitis? Ankylosing spondylitis is a painful, progressive rheumatic disease, mainly of the spine. It can also affect other joints, tendons and ligaments and other areas, such as the eyes and heart. If left untreated, the disease can cause progressive stiffening of the spine, leading to immobility. It is caused by inflammation in the joints between the vertebrae, and of the sacroiliac joints in the pelvis. As a reaction to the inflammation, a small amount of bone erosion occurs. After the inflammation has subsided, new bone is created as part of the healing process. After repeated attacks, this additional bone growth can surround the disc. Effectively this means that the bones begin to fuse together, although most sufferers will only experience partial fusion, usually in the pelvic area. Sufferers initially experience stiffness and mild back pain, which is worse first thing in the morning. The initial symptoms can be prevented and relieved by regular movement of the areas involved. If this is not done, the formation of new bone can lead to increased stiffness, and to deformity with stooping posture in the spine. Eventually the stiffness and deformity become irreversible. Treating the condition The best way to stop the progression of ankylosing spondylitis is to regularly exercise all parts of the spine and the chest area. If started early and continued regularly - every day - the result is excellent with little restriction of movement or deformity. These exercises are very specialised and have to be done irrespective of the patient's lifestyle. Additional exercises may also be needed for the shoulders and the hips which are the most frequently affected joints other than the spine. Swimming is a good sport for patients with spondylitis as it moves the shoulders and hips. Anti-inflammatory medication may be prescribed to relieve the pain and inflammation, but it is not a substitute for a regular exercise programme. What causes Ankylosing Spondylitis? The cause is not yet known. However, it has been discovered that almost all the 80,000 clinically diagnosed people in the UK share the same genetic cell marker HLA B27 (Human Leucocyte Antigen B27). There is evidence that a normally quite harmless micro-organism, which would be dealt with by our immune system, sets up an adverse reaction after coming into contact with the B27 individual, triggering the condition and causing flare-ups.