Ankylosing spondylitis, also known as axial spondyloarthritis, is an inflammatory disease that gradually leads to the fusion of some of the spine’s vertebrae. This fusion reduces spinal flexibility and can result in a stooped posture. In cases where ribs are affected, it can make deep breathing difficult.
Spinal Changes in Ankylosing Spondylitis: As ankylosing spondylitis progresses, the body’s response to inflammation leads to the formation of new bone. This new bone gradually connects adjacent vertebrae, ultimately causing the fusion of vertebral sections. The fusion of vertebrae can lead to a loss of the spine’s natural curves, resulting in reduced flexibility and a stooped posture.
Types of Axial Spondyloarthritis: There are two types of axial spondyloarthritis. Ankylosing spondylitis, also known as axial spondyloarthritis, is diagnosed through X-rays that show changes in the spine. In cases where the condition cannot be observed on X-rays but is identified based on symptoms, blood tests, and other imaging tests, it is termed nonradiographic axial spondyloarthritis.
Symptoms of Ankylosing Spondylitis: Typically, symptoms of ankylosing spondylitis begin in early adulthood. These symptoms may include back pain and stiffness in the lower back and hips, especially in the morning and after inactivity. Neck pain and fatigue are also common. Symptoms can fluctuate over time, with periods of worsening, improvement, or remission.
Commonly affected areas include:
- The joint connecting the base of the spine and the pelvis.
- The vertebrae in the lower back.
- Sites where tendons and ligaments attach to bones, mainly in the spine, and sometimes at the back of the heel.
- The cartilage between the breastbone and ribs.
- The hip and shoulder joints.
When to Seek Medical Attention: If you experience slow-onset lower back or buttock pain, especially in the morning or upon waking from sleep during the second half of the night, particularly if the pain improves with exercise and worsens with rest, it is advisable to seek medical attention. If you develop a painful red eye, severe light sensitivity, or blurred vision, it’s crucial to consult an eye specialist immediately.
Causes of Ankylosing Spondylitis: The exact cause of ankylosing spondylitis is unknown, but genetic factors appear to play a role. Notably, people with the HLA-B27 gene have a significantly higher risk of developing ankylosing spondylitis. However, it’s important to note that not everyone with this gene develops the condition.
Risk Factors: Ankylosing spondylitis typically begins in late adolescence or early adulthood. Most individuals with ankylosing spondylitis possess the HLA-B27 gene, but many people with this gene never develop the condition.
Complications: In severe cases of ankylosing spondylitis, the body’s response to inflammation results in the formation of new bone. This new bone gradually bridges the gaps between vertebrae and fuses sections of the spine, causing stiffness and inflexibility. The fusion can also affect the rib cage, limiting lung capacity and function.
Other complications may include:
- Eye inflammation, known as uveitis, which is a common complication and can lead to eye pain, light sensitivity, and blurred vision.
- Compression fractures, where weakened bones may crumple, increasing the severity of a stooped posture and potentially injuring the spinal cord and nerves.
- Heart problems, as ankylosing spondylitis can affect the aorta and increase the risk of heart disease.