Ankylosing Spondylitis

Ankylosing Spondylitis (AK) is a chronic rheumatic disease. (Read about "Arthritis and Rheumatic Diseases") It primarily affects the spine and back (Read about "The Spine"), but can also affect joints elsewhere in the body including the hips and the shoulders. (Read about "The Shoulder") In addition, some patients have eye inflammation, and others may have heart valve issues. (Read about "The Eye" "The Heart and Its Valves") The Spondylitis Association of America (SAA) says that at least 300,000 and maybe up to one million people in the United States suffer with AK.

In AK, the joints and ligaments that normally help us move our backs become inflamed and may even fuse together, resulting in a permanently stooped posture. The Arthritis Foundation says this primarily affects men between the ages of 16 and 35. Although the cause is unknown, genetics or family history may increase the risk of having AK. (Read about "Genetics" "Family Health History")

Treatment options

Among treatment options, weight control is very important for anyone with AK. Excess weight puts added pressure on your joints. (Read about "Losing Weight") The Arthritis Foundation also recommends proper exercise for arthritis treatment. Exercises can develop range of motion, using gentle stretching, for example, to improve joint mobility. Strengthening exercises for muscles can also help stabilize joints. In addition, there are a number of specific classes, such as water exercise or chair exercises, designed for people with arthritis. Always consult your doctor or physical therapist for information on the right type of exercise for your specific problem. (Read about "Rehabilitation")

In addition, NIAMS says there are other therapies that may work for flare-ups of swelling and pain. Moist heat, such as a warm bath or shower, or dry heat, such as a heating pad, placed on the painful areas for about 15 minutes may relieve the pain. Make sure you take all necessary precautions to avoid burning or otherwise hurting your skin (Read about "Skin"), and if you have poor circulation, do not use cold packs.

Medications

The drugs used for treating AK fall into several different categories. Among the non-steroidal anti-inflammatory drugs (NSAIDs) are aspirin, ibuprofen and naproxen sodium. Many of these drugs are available over-the-counter; however long-term use of these products should never be undertaken without a doctor's advice. NIAMS says common side effects of NSAIDs, including those available over-the-counter, can include stomach upset, heartburn, diarrhea, and fluid retention. (Read about "Heartburn" "Diarrhea" "Gastritis") Some patients also develop liver and kidney inflammation (Read about "The Liver" "Kidney Disease") while taking NSAIDs, making it especially important to stay in close contact with the doctor while taking these medications. (Read about "Medication and Digestion")

Disease-modifying anti-rheumatic drugs (DMARDS), such as methotrexate, are another type of drug used to treat people with AK who have not responded to NSAIDs. Drugs that block inflammation caused by a protein called tumor necrosis factor (TNF) may also be used in some cases. You will need to discuss potential risks and benefits of these medications with your doctor.

Corticosteroids may also be used. These are hormones that can be taken by mouth or given by injection. Prednisone is a corticosteroid that can reduce the inflammation when taken orally. A doctor also may inject a corticosteroid into the affected joint to stop pain. According to NIAMS, because frequent injections may cause damage to the cartilage, they should only be done once or twice a year. Long-term corticosteroid use has also been linked to a condition called osteonecrosis in which a portion of bone loses its blood supply and begins to die. (Read about "Osteonecrosis")

When taking medication, it's important that you never mix different types of drugs on your own. Even medications such as cold remedies may contain ingredients that can cause problems if taken in combination with other medications, so always read labels and talk with your doctor or pharmacist first. (Read about "Drug Interaction Precautions")