Ankylosing Spondylitis – Causes, Symptoms, and Management

Ankylosing Spondylitis – Causes, Symptoms, and Management

From facilitating erect posture to ensuring body structure, the spine performs numerous functions and is an indispensable part of the human body. Thus, health issues concerning the spine and back, including ankylosing spondylitis, can be debilitating, requiring early diagnosis, timely treatment, and adequate care. This article provides a detailed insight into ankylosing spondylitis, its causes and symptoms, treatment options, and some lifestyle tips to help patients cope better with the condition.

What is ankylosing spondylitis?
Belonging to a group of diseases classified as spondyloarthropathies, ankylosing spondylitis (AS) is a health condition wherein the vertebral bones fuse over time, causing severe pain and stiffness. Such pain is particularly prevalent in the lower back, buttocks, and hips. It hampers mobility considerably and is classified as a form of arthritis. Specifically, AS is the advanced stage of sacroiliitis, characterized by inflammation of the sacroiliac joints between the spinal base and the pelvis. Studies reveal that 13 in 1,000 people in the country are diagnosed with this disease.

Risk factors for ankylosing spondylitis
Although the exact cause of AS is unknown, some risk factors can contribute to the onset of this condition:
Genetic factors
Individuals with a gene known as HLA-B27, proteins classified as antigens, are at a higher risk of acquiring AS than others. However, not all individuals with this gene may develop a health condition. Further, individuals with close relatives, such as parents or siblings, diagnosed with AS are 10-20 times more susceptible to the disease than those with no such family history.

Racial predisposition
Studies suggest that AS is more prevalent among Caucasians, possibly due to the increased presence of the HLA-B27 gene in Caucasian individuals. It has been found that up to 95% of Caucasians have this gene, considerably increasing their risk of developing this disease.

Uveitis
Some studies demonstrate that uveitis, characterized by inflammation of the uvea or center of the eye, can increase one’s risk of developing AS. According to one study, 50% of individuals with AS had uveitis at least once. The inflammatory factors causing the two health conditions are the same; consequently, these diseases are commonly associated.

Inflammatory bowel disease
Inflammatory bowel disease (IBD) and AS are highly interconnected, as one of these conditions can trigger the other. In one research study, 3-4% of patients with AS were already grappling with IBD during their AS diagnosis. Conversely, AS can also increase one’s risk factor for developing IBD.

Symptoms of ankylosing spondylitis
Stiffness in the lower back and hips
A common symptom of AS is stiffness in the lower back and hip regions, particularly in the mornings or after spells of inactivity.

Fatigue
Individuals with AS often face chronic fatigue, which does not diminish with sleep and rest. The constant pain and rigidity caused by AS can significantly contribute to such fatigue.

Inflammation in other joints
Other joints, such as the knees, shoulders, and feet, are also typically affected by AS. Pain and stiffness in these joints are common AS symptoms and can worsen with time.

Curved spine
The spine often becomes curved due to the fusion of the vertebral bones. Thus the postures of patients with AS are often compromised.

Difficulty in breathing
AS can trigger the onset of lung inflammation or pulmonary fibrosis, accompanied by chest tightness. Such comorbidities can cause shortness of breath.

Flu-like symptoms
Patients with AS may develop flu-like symptoms such as fever and chills during the early stages of AS. Some individuals diagnosed with AS also report night sweats.

Sleep issues
Since pain increases with inactivity among individuals with AS, sleep issues are common AS symptoms. A study shows that up to 90% of persons with the condition were suffering from sleep issues.

Jaw inflammation
Patients with AS are likely to develop temporomandibular joint (TMJ) disorder, involving swelling and inflammation of the jaw. Jaw inflammation can cause difficulties in eating, sleeping, and talking.

Treatment options
Physical therapy
One way to alleviate the symptoms of AS is through physical therapy, which entails a range of exercises to increase strength and flexibility. These exercises can also improve posture significantly. Some activities included under PT are strengthening exercises, deep breathing, posture training, and stretching.

Surgery
Although surgery is not a recommended treatment option for most, it may be prescribed to patients with extremely severe pain or serious hip-joint damage.

Acupuncture
Acupuncture is an age-old practice that can help with pain relief, particularly among individuals suffering from lower back pain, neck pain, etc. Thus, it may be an effective technique to relieve AS symptoms.

Ways to deal with ankylosing spondylitis
Have nutritious meals
A meal plan rich in calcium sources, such as milk, yogurt, tofu, lentils, almonds, and leafy vegetables, is ideal for patients with AS. Foods rich in vitamins, minerals, and magnesium are also important for treating AS symptoms. One must incorporate plenty of fruits and vegetables and avoid foods that trigger or worsen inflammation, such as deep-fried and processed foods.

Avoid long spells of inactivity
AS symptoms typically improve with movement; therefore, patients with AS must engage in low-intensity physical activities like walking, jogging, low-impact aerobics, and stretching. A physiotherapist can guide patients with the most effective exercises for AS.

Maintain good posture
An erect posture goes a long way in preventing the worsening of AS symptoms. Thus, from the early stages of the condition, it is advisable to practice maintaining a good posture and seeking help from a physiotherapist.

Regulate your sleep schedule
Having a good sleep cycle is crucial to fighting the symptoms of AS. Although sleep is often compromised among patients with AS, following tips like regular exercise, sleeping on a firm mattress, using a thin pillow, and controlling the bedroom temperature before sleeping can facilitate better sleep among those with AS.

Get professional massages periodically
Professional back massages can help calm the body and mind in multiple ways, improving mobility and facilitating pain relief. Regular back massages are recommended for symptom relief among patients with AS.

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Known Signs of Hemophilia and Anemia

Bleeding disorders refer to a group of conditions like hemophilia or anemia that interfere with normal blood functions in the body. Hemophilia affects the ability of the blood cells to clot naturally, while anemia lowers hemoglobin count in the red blood cells. These conditions exhibit a unique set of symptoms that can be identified. Early diagnosis helps doctors form a viable healthcare plan. So, it pays to know and identify the following symptoms. Hemophilia and Anemia: Understanding the difference Both conditions are common bleeding disorders. However, anemia & hemophilia signs are distinctly different from each other when it comes to the disease progression. The latter is a genetic disorder that affects the red blood cell’s ability to clot and close wounds. Certain clotting factors in the blood bind with the red blood cells to prevent uncontrolled bleeding. Anemia is a condition where the body lacks sufficient healthy red blood cells in the first place. Also, a low hemoglobin count affects the red blood cell’s ability to carry oxygen to vital organs and extremities via the circulatory system. Genetic mutation triggers most known types of hemophilia, while certain nutritional deficiencies in the body trigger common forms of anemia. Symptoms of hemophilia The absence of essential clotting factors in the blood can trigger a variety of noticeable and unusual symptoms. Uncontrolled bleeding Bleeding is one of the primary symptoms of hemophilia. It can happen under the skin or in the joints. As the red blood cells are unable to bind and clot, this pool of blood can trigger swelling, pain, and tightness in the joints. This symptom is most commonly noticeable in the knees, elbows, and ankles. Blood collecting under the skin can lead to buildups under the muscle and soft tissue to cause more painful bruising. This symptom is called hematoma in medical terminology. Frequent nosebleeds When the bleeding is triggered externally, it can result in frequent nosebleeds that can be difficult to stop. Note that external environmental factors and physical injuries generally cause nosebleeds. So, any unexplained bleeding could indicate a developing condition. Bleeding caused due to cuts, bruises, and vaccinations Lack of essential clotting factor VIII can trigger bleeding from the lightest of impacts, cuts, bruises, or even after losing a tooth. Some people experience sudden bleeding after taking a vaccination. This could be the body’s reaction to producing antibodies, but the strain could be too much to bear, resulting in bleeding from the extremities. Blood in urine or stool Excess blood in the urine or stool is a clear sign of disease progression. The urine and stools appear dark red or even blackish due to the presence of red blood cells mixed with the excreta. Immediate medical assistance is advisable for visual symptoms. Bleeding in infants Complicated pregnancies can be physically taxing for both the mother and the child leading to possible symptoms of hemophilia at birth. But in some rare cases, infants may experience internal bleeding in the head. Symptoms of anemia The most common types of anemia, including iron deficiency anemia and vitamin deficiency anemia, develop due to the lack of nutrients in the body. Therefore, anemia exhibits more physically taxing symptoms as the condition worsens. Tiredness Increased fatigue and weakness for no apparent reason is one of the main indicators of nutritional deficiencies. An unexplained decrease in overall stamina with no physical exertion or any activity during the day could mean low iron in the blood. Without iron, the body cannot produce enough red blood cells. And low hemoglobin means not enough oxygen is being circulated around vital organs in the body, thus resulting in fatigue induced by low energy levels. Respiratory symptoms Experiencing shortness of breath, chest pains, and even noticing an irregular heartbeat could indicate a possible anemic condition. An iron deficiency lowers hemoglobin count, and this means not enough oxygen is being circulated by the blood. Low hemoglobin affects the breathing rate as the body struggles to extract more oxygen resulting in shortness of breath. The heart must also put in extra efforts to pump the low hemoglobin blood forcefully, thus resulting in irregular heartbeats. Doctors refer to this condition as heart palpitations. These symptoms can also induce chest pains due to the sheer stress being put on the organ. Pale skin and damaged hair Skin and hair symptoms are visible indicators of a developing anemia condition. An iron deficiency results in low red blood cell production and indirectly affects the shade of the skin. Pale skin is noticeably visible around the face, gums, lower lips, lower eyelids, and even on the nails. This symptom is more visually obvious among people who flaunt a lighter skin tone. Also, hair thinning, hair fall, and a damaged scalp is a clear sign of iron deficiency. Treatment options Note that anemia & hemophilia signs never overlap. Once the primary indicators are confirmed, doctors quickly suggest blood tests to identify the leading causes or triggers. Knowing the differences can help with prompt diagnosis even though both the conditions are bleeding disorders. It is even possible to recover from common forms of anemia within 2 to 3 months. Hemophilia is a more serious bleeding disorder that is treated by introducing the missing clotting factors. Doctors also suggest prescriptions that help stimulate the body to release more clotting factors. However, a transfusion offers more promising results for moderate to severe progression. Effective preventive measures and home remedies can help lower the risk of bleeding. These conditions cannot be completely cured. But it is possible to improve the quality of life by incorporating healthy lifestyle habits. Prescriptions and treatments only help slow down the disease progression.

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Signs and Remedies for Ankylosing Spondylitis

Ankylosing spondylitis is a chronic inflammatory condition that primarily affects one’s spine. The symptoms of the disease usually begin in adolescence or early adulthood and can affect one’s flexibility and mobility, leading to stiffness, pain, and a hunched posture. If the disease affects the ribs, one may have difficulty breathing. Although there is no known cure, various treatments and ways can help manage the symptoms and slow down its progress. What is ankylosing spondylitis? Ankylosing spondylitis (AS) is a type of arthritis that typically begins in the area where the spine meets the pelvis. It can cause some of the bones in the spine to fuse. This fusing is a process where small bones of the spine interlock together and affect the flexibility of one's back, AS is one of six illnesses in the spondylitis family that have some of the same symptoms. 12 signs of ankylosing spondylitis Back pain Since AS primarily causes inflammation in one's joints of the vertebrae, it leads to dull pain in the back. The pain can also be felt in one's buttocks, thighs, and can turn sharp or unbearable if left untreated. The pain may initially alternate between one's left and right side, upper spine, neck, and even chest, eventually affecting one's overall movement. Soreness in one's heel or the foot arch and tenderness at the base of one's pelvis may cause pain and affect one's ability to sit or walk comfortably. Stiffness Individuals may experience stiffness in the lower back, especially after long periods of no activity, like after getting up in the morning. The stiffness may last for about half an hour and improve with physical movement. Doing light yoga or recommended exercises in the morning can also help alleviate the symptom. Changed posture Left untreated, AS may lead to a stooped back or curvature over a period of time. Chronic inflammation AS may lead to joint inflammation in one’s shoulders, knees, hips, ankles, and back. Inflammation in a patient's aorta, which is the largest artery in one’s body, may lead to blocked blood flow. Tightness in chest If AS inflammation fuses the joints where ribs meet the spine, it may lead to tightness and pain in the chest. The inflamed chest wall may also hamper one’s breathing and cause pain during coughing or sneezing. Stomach problems If inflammation spreads to an individual's gastrointestinal tract, it may lead to bloating, diarrhea, and other gastrointestinal infections, which pose a major risk factor for AS. Some symptoms like diarrhea, abdominal cramps, fatigue, and loss of appetite overlap between AS and inflammatory bowel disease (IBD), like Crohn’s disease and ulcerative colitis, which is why about 10% of AS patients have both conditions. Loss of appetite Inflammation may lead to a false sense of a full stomach even after eating a small meal. One also runs the risk of developing a fever without any infection or trigger. Anemia The condition limits the body’s ability to use iron to make red blood cells. This leads to a higher risk of anemia, which impacts a person’s quality of life. Vision problems Approximately 1 in 3 patients suffering from AS face eye inflammation and vision problems due to the disease. AS can lead to acute eye inflammation between the cornea, at the front of the eye, and the lens. Inflamed eyes can cause redness and pain, which can intensify in harsh sunlight or bright light if left untreated. If one experiences sudden sensitivity to light, sore eyes, and blurred vision, they are advised to immediately consult a doctor to avoid any permanent damage. Fatigue Some people with AS commonly report mild to unexplained chronic fatigue as a symptom. Fatigue can be caused due to fever, loss of appetite and lowered food intake or a deficiency of red blood cells. The body may expend energy to fight inflammation and blood loss from inflammation in the intestine. To manage fatigue, try eating balanced meals, getting enough sleep, and living a healthy lifestyle. Psoriasis In rare cases, people with AS may also develop psoriasis. Psoriasis is an autoimmune skin disease that leads to red, scaly patches anywhere on one's skin, especially on one's scalp, elbows, and knees. The condition may cause itchiness, soreness, and stinging. Blood pressure According to the Spondylitis Association of America, about 2 to 10 percent of Ankylosing Spondylitis patients run the risk of developing high blood pressure or other other cardiovascular conditions. This is due to the inflammation around one’s heart. Diagnosis Ankylosing spondylitis can be diagnosed via blood tests and physical examination to check one’s flexibility, breathing capacity, stiffness in the joints, and pain in the back, pelvic bones, chest, and heels. The examination also includes asking about an individual's family history and any active symptoms of the disease. Magnetic resonance imaging (MRI) and X-ray imaging can also help a doctor to track inflammation and suggest suitable treatment options. Natural remedies for ankylosing spondylitis Treatment revolves around easing pain, reducing inflammation, preventing permanent joint damage, and slowing down the progress of the disease. Some of the natural remedies to prevent AS are as follows: Stretching Stretching boosts one's flexibility and releases pain. Patients can try yogic postures for lower back or rotations or stretches for the spine after waking up or during any time of the day. Maintaining good posture A good, erect posture is a key to maintaining good spine health. One is advised to use a hard mattress while sleeping so there’s less pressure on the spine. Concerned persons can also avoid using thick pillows. Sleeping straight on one’s back and avoiding slouching while standing, walking, or sitting can be beneficial. Swimming Swimming is one the most efficient and natural full-body exercises that can relieve soreness and maintain optimal health. A hot bath is also highly recommended for AS patients. It’s best to take doctor’s advice on the best exercises for those suffering from AS. Acupuncture Acupuncture, performed by trained professionals, involves inserting needles into predetermined areas on the skin that trigger the body's natural pain-relieving hormones. According to some studies, acupuncture can aid with AS pain relief. Apart from this, one can also consider TENS therapy and massage therapy for improved movement and sleep. It’s best to consult a doctor before opting for any remedies to avoid complications.

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