Ankylosing spondylitis (AS) 

Ankylosing spondylitis is a type of arthritis that affects parts of the spine. In this video, an expert describes the long-term effects of the condition, its most common symptoms and the different treatments available.

Causes of ankylosing spondylitis

Transcript of Ankylosing spondylitis (AS)

Ankylosing spondylitis is a condition in which the spine becomes inflamed.

Inflammation infects the joints between the vertebrae,

causing pain and stiffness,

and goes on usually from a young adult age lifelong.

So pain and stiffness is often accompanied

by a progressive reduction in movement or flexibility of the back.

In fact, a minority of people with ankylosing spondylitis

also have involvement of other tissues.

They may have inflammation of other joints, often the knees or the hips,

they may have inflammation episodically in the eyes,

iritis or uveitis,

but can also develop psoriasis, a flaky skin rash,

or inflammatory bowel disease.

There are no completely accurate figures for just how common this disease is,

but it probably affects between two and five adults per thousand.

We calculate there are probably about 200,000 people

in the UK with this disease.

Anyone can be affected by ankylosing spondylitis,

both men and women.

In practice, it is most common in people aged between 18 and 30.

It does occur later in life.

More often we detect it later in life

in people who have probably had it for a long time and put up with it.

When ankylosing spondylitis begins,

the commonest symptom that people experience

is pain and stiffness in the low back.

The more people rest, the stiffer the back becomes.

Spondylitis can affect the chest.

If the thoracic spine is involved the ribs may feel tight

and that produces a sense of tightness in the chest,

discomfort on twisting or taking a deep breath.

People often experience buttock pain,

which may radiate down the back of the thigh.

Sometimes people get discomfort in the neck as well.

That often occurs later rather than earlier in the disease.

In fact, because people may also have involvement

of joints or sites outside the spine,

it's not unusual for people to have pain at the heel,

either under the heel or at the attachment of the Achilles tendon,

swollen knees, which may be painful, of course,

or even painful hips.

There are a lot of treatments available for ankylosing spondylitis,

though none of them cure it.

Occasionally the disease becomes quietened and seems to settle down,

but for most people it goes on more or less lifelong.

Most people need some sort of painkilling drugs.

There are, of course, the over-the-counter drugs,

paracetamol, codeine, which are often helpful.

Many need to take anti-inflammatory drugs,

and there's a wide range of non-steroid anti-inflammatory drugs,

which are often helpful.

If the disease is particularly severe

and in spite of these medicines life is very difficult,

there is a newer range of drugs called TNF blocker drugs,

which are also widely used now.

Generally speaking, this is the kind of thing that you need to discuss

with a rheumatologist.

The key to all of the treatment is physical activity.

Some people need regular physiotherapy for that,

other people prefer to do sport or to exercise regularly themselves.

Everyone, however, with this condition

should stretch the spine every day

and take up some form of regular physical activity.

It's also important to maintain posture.

Many people sit for long periods of time during the day

and there is a tendency for the spine to stiffen

in a rather bent-forward position.

That can be prevented completely by taking care of posture.

For the majority of people, life can be absolutely normal.

There is a good range of treatments where necessary.

Not everybody needs them.

An active life is an important part of this.

So somebody developing this condition now

really should look forward to a normal length of life

and a life in which they can do normal activities

and live fulfilling lives.

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