What are the ways to treat ankylosing spondylitis?

Question

Hello doctor,

My husband is 40 years old. He has increased pain and stiffness in his joints. He was diagnosed with ankylosing spondylitis after consulting the doctor. May I know the common causes of this condition? What are the common risk factors responsible for developing this condition? How do we treat this condition? Can taking medications alone will help? Does physiotherapy help in this condition? Does this condition require surgery?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Ankylosing spondylitis (AS) is a complex condition, and understanding its causes, risk factors, and management options is crucial.

Common causes include:

The exact cause of ankylosing spondylitis is not fully understood, but several factors are believed to contribute:

Genetics: The majority of individuals with AS have the HLA-B27 antigen (human leukocyte antigen), which is associated with the disease.
Immune system dysfunction: An abnormal immune response may lead to inflammation in the joints.
Environmental triggers: Some infections or environmental factors may trigger the onset in genetically predisposed individuals.

Common risk factors are,

Family history: Having a close relative with AS increases risk.
Gender: AS is more common in men than in women.
Age: It typically develops in late teens to early adulthood, but it can appear later.
Other autoimmune diseases: Having other inflammatory or autoimmune conditions may increase the risk.

Ankylosing spondylitis can be treated through medications, physiotherapy, lifestyle changes, and surgery.

Medications -

NSAIDs ( nonsteroidal anti-inflammatory drugs): (example: Ibuprofen, Naproxen) help reduce pain and inflammation.
DMARDs (Disease-modifying antirheumatic drugs) can help in some cases.
Biologic medications: TNF (tumor necrosis factor) inhibitors (for example: Etanercept, Adalimumab) may be prescribed for severe cases.
Corticosteroids: Occasionally used for short-term symptom relief.

Physiotherapy -

Exercise: A structured exercise program is vital for maintaining flexibility and reducing stiffness. Physical therapists can tailor exercises to his needs.
Stretching and strengthening: Focus on improving posture and spinal mobility.

Lifestyle changes -

Regular physical activity: Engaging in activities like swimming or walking can help.
Good posture: Encouraging good posture can alleviate strain on the spine.

While medications can significantly reduce symptoms and inflammation, they are usually most effective when combined with physiotherapy and lifestyle changes. Medications alone may not fully address mobility issues and stiffness.

Need for surgery

Surgery is not commonly required for ankylosing spondylitis. However, in severe cases where joint damage occurs (for example, hip replacement) or if there are complications, surgical options may be considered.

Management of ankylosing spondylitis typically involves a combination of medications, physiotherapy, and lifestyle modifications. Regular follow-ups with a healthcare provider are essential for monitoring the condition and adjusting treatment as necessary. Encourage your husband to stay active and engaged in his treatment plan, as this can significantly enhance his quality of life.

I hope this has helped you. Please feel free to reach me again, in case of further queries.

Thank you.