Ankylosing spondylitis (pronounced ank-kih-low-sing spon-dill-eye-tiss), or AS, is a chronic progressive inflammatory form of arthritis that affects the spinal joints. It is in a family of spondyloathritis related diseases. It is one of the spondyloarthropathies, a group of chronic autoimmune joint diseases characterized by joint inflammation affecting the spine and pelvis, specifically the sacroiliac joint.
The disease is very painful and its course is unpredictable between patients. Some patients have episodes of transient back pain only, others have more chronic severe back pain and other related symptoms. The progression can become disabling.
Excerpt from Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain: The Mind-Body Connection by Celeste Cooper, RN and Jeff Miller, PhD
… The cause is unknown, and symptoms predominately begin to appear in a person’s twenties. Over time the spine becomes stiffer, and eventually the vertebrae (bones in your spine) may grow or fuse together….[Fusion can be seen on an MRI].
Symptoms include stiffness and pain in the lower back, buttocks, and hips upon waking in the morning or after a period of inactivity; back pain relieved by movement and exercise; difficulty bending the spine; pain in the hips and difficulty walking; pain in the heels and soles of the feet; bent-over posture (kyphosis); and straightening of the normal curvature of the spine.
Other symptoms of AS are fever, loss of appetite and weight, fatigue, eye swelling, redness and pain, sensitivity to light, difficulty taking a deep breath, and disruption in the flow of the electrical impulses that cause your heart muscle to contract. Treatment consists of physical rehabilitation and medication used to treat arthritis….
According to the CDC, http://www.cdc.gov/arthritis/basics/fibromyalgia.htm (accessed, 7/27/12), fibromyalgia co-occurs up to 25-65% with ankylosing spondylitis and some other rheumatic conditions.
As mentioned in the excerpt of our book, ankylosing spondylitis can affect more than the spine and some complications or symptoms are more common than others. For instance, inflammation of the eye, or iritis, is very common; neurological symptoms, while they can be present, are very rare; and shoulder involvement is neither common nor uncommon.
Susceptibility to AS is genetically determined, meaning most patients have a "genetic marker,” a protein called HLA-B27. However, a person can have the gene, but they never contract AS. Scientists suspect a number of other genes are associated with AS and that a triggering environmental factor, such as a bacterial infection, are needed to activate AS in susceptible people. Ankylosing spondylitis is another one of the diseases thought to occur when the intestines start breaking down, such as seen in leaky gut syndrome (LGS), and bacteria from the intestines pass into the bloodstream targeting the region where the sacroiliac joints are located. Several autoimmune diseases have been related to LGS.
Ankylosing spondylitis can affect:
Note: About 33%- 40% of people with spondylitis will experience inflammation of the eye at least once, such as seen in Iritis or Anterior Uveitis.
Note: Cauda Equina Syndrome is due to an acute loss of function of the lumbar plexus, where nerve roots branch out at the end of the spinal cord, thus causing loss of function, weakness of the muscles of the lower extremities, possible paraplegia, urinary retention, fecal incontinence, sexual dysfunction, and numbness of the pelvic floor.
The optimal treatment of ankylosing spondylitis involves medications that reduce inflammation or suppress immunity, physical therapy, and exercise. In some cases surgical intervention can improve postural deficits.
More information can be found at the Spondylosis Association of America, http://www.spondylitis.org/about/as.aspx or
If you are a patient or suspect you have AS, discuss your symptoms with your physician so that proper testing and treatments can be initiated. The information here is not intended as a substitute for medical advice.