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Physiotherapy => Backache => Ankylosing Spondylitis
Ankylosing Spondylitis
INTRODUCTION
Ankylosing Spondylitis, progressive inflammatory disease of the spinal column of unknown cause, which causes stiffness or rigidity of the back and sometimes the major limb joints. The disease is usually confined to men, beginning between the ages of 16 and 25. It starts in the sacroiliac joints at the base of the spine and usually progresses upward, occasionally also affecting the hips, shoulders, or neck. In many cases, a curved deformity of the spine remains once the progress of the disease has ceased. Though sometimes loosely termed rheumatoid spine, it is distinct from rheumatoid arthritis.
SYMPTOMS
Early symptoms are pain in the lower back and increasing stiffness, later extending upward, which may lead to reduced movement of the chest. Pain radiating down one or both legs is also common. Sometimes knees or hips are also affected.
CAUSES
Although the cause remains unidentified, there is believed to be a genetic predisposition to the disease. There are 100,000 diagnosed cases of ankylosing spondylitis in the UK. There is a higher incidence in populations that carry the human leucocyte antigen HLA B27, which is present in about 90 per cent of cases. This antigen is found on the surface of white blood cells (leucocytes-seeImmune System) and is one of a number inherited from both parents. It is associated with susceptibility to certain diseases, including some autoimmune diseases.
TREATMENT AND OUTLOOK
Ankylosing spondylitis usually ceases to progress after 10 to 15 years, leaving varying levels of permanent stiffness due to bony growth (ossification) or fusion of the joints which may lead to deformity of the spine. Progress of the disease may be controlled by anti-inflammatory drugs or by X-ray therapy, though the latter carries a risk of leukaemia. In cases of severe deformity of the spine an operation to remove bone can improve posture and relieve symptoms.
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