Ankylosing spondylitis (AS) is a form of arthritis that affects the joints in the spine and is a chronic condition. Its name comes from the Greek words ankylos, meaning stiffening of a joint, and spondylo, meaning vertebra. It causes painful inflammation of the joints between the vertebrae in the spine and between the spine and pelvis. Occasionally it can involve other joints or organs in the body as well. The shoulders, ribs, hips, knees, and feet can be affected. It can also affect places where the tendons and ligaments attach to the bones. Sometimes it can affect other organs such as the eyes, bowel, and very rarely, the heart and lungs.
Many people who have AS have mild back pain that comes and goes. Others have severe, ongoing pain. Sometimes they lose flexibility in the spine. In the most severe cases, the swelling can cause two or more bones of the spine to fuse. This may stiffen the rib cage, restricting lung capacity.
AS usually begins in the teen or young adult years. Most people who have the disease get symptoms before age 30. Only five percent get symptoms after age 45. It affects people for the rest of their lives and it affects about twice as many men as women.
The cause of AS is unknown, however, doctors believe that AS is an autoimmune disease. People with a gene called HLA-B27 are at increased risk of developing the condition. However, being born with this gene doesn't necessarily lead to AS and scientists are currently researching other suspected triggers.
Often, a rheumatologist will diagnose and treat AS. This is a doctor trained to treat arthritis and related conditions. Since AS can affect different parts of the body, people with AS often need to see more than one doctor.
There is no cure for AS. Some treatments relieve symptoms and may keep the disease from getting worse. In most cases, treatment involves medicine, exercise, and self-help measures. In some cases, surgery can repair some joint damage.
Several types of medicines are used to treat AS. It is important to work with doctors to find the safest and most effective medication.
Some current medications for AS include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs relieve pain and swelling. Aspirin, ibuprofen, and naproxen are examples of NSAIDs.
- Corticosteroids. These strong drugs are similar to the cortisone made by your body. They fight inflammation.
- Disease-modifying antirheumatic drugs (DMARDs). These drugs work in different ways to reduce inflammation in AS.
- Biologic agents. These are relatively new types of medicine. They block proteins involved with inflammation in the body.
There is no specific diet for people with AS, but keeping a healthy weight is important. It reduces stress on painful joints. Omega-3 fatty acids, found in coldwater fish (such as tuna and salmon), flax seeds, and walnuts, might reduce disease activity. This is still being studied.