Ankylosing Spondylitis Treatment in Plano, TX
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At the Advanced Spine Center in Plano, TX, we offer compassionate care and cutting edge ankylosing spondylitis treatment for patients suffering with chronic inflammation and pain. Our Plano orthopedic spine specialists are dedicated to delivering personalized treatment plans that prioritize symptom relief, improve mobility, and enhance overall quality of life for individuals managing this chronic inflammatory condition.
From innovative medications to tailored physical therapy regimens, discover how our expertise and advanced techniques can help you effectively manage ankylosing spondylitis and regain control of your spine health. Call 972-499-5457 today to schedule an appointment with us.
What Is Ankylosing Spondylitis?
Ankylosing spondylitis is a type of arthritis that primarily affects the spine, causing inflammation, stiffness, and pain. Over time, this inflammation can lead to fusion of the vertebrae, resulting in a rigid spine. It can also affect other joints and tissues, such as the hips, shoulders, and ribs. Those who develop ankylosing spondylitis often suffer from very debilitating symptoms, which is why early diagnosis and treatment are so important.
Spondyloarthritis vs Ankylosing Spondylitis
Spondyloarthritis is a broader term that encompasses a group of inflammatory diseases that primarily affect the spine and other joints. Ankylosing spondylitis is a specific type of spondyloarthritis characterized by inflammation of the spine and sacroiliac joints, leading to stiffness, pain, and eventually fusion of the vertebrae.
While ankylosing spondylitis is a type of spondyloarthritis, not all spondyloarthritis cases are classified as ankylosing spondylitis. Other forms of spondyloarthritis include psoriatic arthritis, reactive arthritis, spinal arthritis, enteropathic arthritis, and undifferentiated spondyloarthritis, each with its own distinct features and manifestations.
Non-Radiographic Ankylosing Spondylitis
Non-radiographic ankylosing spondylitis (nr-axSpA) is a subtype of axial spondyloarthritis that shares many similarities with ankylosing spondylitis (AS), but it lacks the characteristic changes visible on X-rays of the sacroiliac joints. In nr-axSpA, patients typically experience symptoms such as back pain, stiffness, and fatigue similar to those of AS, but diagnostic imaging, particularly X-rays, may not show the typical signs of sacroiliitis seen in AS.
Instead, diagnosis is often made based on clinical symptoms, blood tests, and MRI findings. Nr-axSpA can progress to AS over time, and early recognition and treatment are crucial in managing symptoms and preventing disability. One common treatment option for early AS stages are non-steroidal anti-inflammatory drugs (NSAIDs).
Juvenile Ankylosing Spondylitis
It is also possible for ankylosing spondylitis to affect juveniles. When this happens, it is referred to as “juvenile ankylosing spondylitis.” It is a form of arthritis that mainly affects the spine and various sites in the body where tissues attach to bone.
Ankylosing Spondylitis Symptoms
Ankylosing spondylitis typically manifests with symptoms primarily affecting the spine. However, other joints and organs can also be involved. Common symptoms include chronic lower back pain, stiffness, radiating pain, reduced flexibility and reduced mobility, fatigue, discomfort in the neck and shoulders, and inflammation in other joints. Because AS can also affect other organs, the following symptoms are also possible.
- Eye inflammation (uveitis)
- Inflammatory bowel disease
- Appetite and weight loss
- Fever
- Anemia
Ankylosing Spondylitis Symptoms Females
In the past, many medical experts believed that ankylosing spondylitis affected male patients more than female patients. We now understand that it happens at a similar rate for both men and women. However, there are some key differences between men and women when it comes to AS. These differences are the average time it takes to get a diagnosis, the rate of misdiagnosis, symptoms, radiographic damage levels, comorbidities, pain scores, how the body responds to treatment, and quality of life.
For women, it takes an average of 9 years to receive an AS diagnosis after they first experience symptoms. The risk of misdiagnosis of AS for females is also higher than for males. One study states that around 25% of women diagnosed with axial spondyloarthritis (a category of spondyloarthritis which AS is also in) were misdiagnosed at first.
Women also tend to experience less radiographic damage from AS than men. Radiographic damage refers to joint erosion caused by AS. Some studies also found that women are more likely to experience symptoms affecting areas other than their spinal and sacroiliac joints.
Additionally, women are more likely to suffer from certain comorbidities, which are conditions that people have along with their main condition. Women are more likely to suffer from inflammatory bowel disease and psoriasis alongside AS than men.
Several studies show that women with AS experience higher pain levels, more back pain, more fatigue, and longer periods of stiffness in the morning than men. This also coincides with the fact that AS treatments tend to be less effective in women, and with women having a lower quality of life.
Ankylosing Spondylitis Symptoms Males
Ankylosing spondylitis is very similar for men and women, but there are a few distinct differences. One difference is the time that it takes for men and women to receive diagnoses. For men, it takes an average of 6.5 years to achieve a diagnosis after they first have symptoms. This is 2.5 years less than it typically takes women to receive a diagnosis. Other discrepancies between male and female experiences with AS include the following.
- Lower risk of misdiagnosis for men
- Higher levels of radiographic damage (joint erosion) for men
- Men are less likely to experience certain comorbidities
- Men tend to experience less pain
- Treatments for AS tend to be more effective for men
- Men with AS tend to have higher qualities of life
What Does Ankylosing Spondylitis Feel Like?
While AS primarily affects the lower back and sacroiliac joint, it can also lead to other symptoms, such as the following.
- Chronic back pain and stiffness in the morning
- Gradual onset of pain
- Pain that may improve with exercise
- Fatigue and tiredness
- Reduced flexibility and mobility
- Pain in other joints, such as the shoulders, hips, and knees
- Tenderness in the ligaments and tendons
- Eye inflammation
- Difficulty breathing, in severe cases
Stages of Ankylosing Spondylitis
Ankylosing spondylitis (AS) typically progresses through several stages, each characterized by distinct symptoms and changes in the spine and joints. The three distinct stages are the early stage, the progressive stage, and the advanced stage, which we describe in the following sections.
Early Stage
In the early stage of AS, symptoms often begin with intermittent pain and stiffness in the lower back and buttocks, particularly in the mornings or after periods of inactivity. These symptoms may be mild and sporadic, sometimes mistaken for common back pain or strain. During this stage, inflammation starts at the sacroiliac joints where the spine connects to the pelvis, but X-ray images may not yet show significant changes. MRI scans, however, can detect early signs of inflammation.
Progressive Stage
As AS progresses, the pain and stiffness become more persistent and severe, affecting the entire spine and sometimes spreading to other joints such as the hips, shoulders, and knees. The inflammation may cause more noticeable symptoms, such as fatigue and reduced range of motion.
Over time, chronic inflammation leads to the formation of new bone, causing the vertebrae to gradually fuse together, a process called ankylosis. This results in decreased flexibility and can lead to a characteristic stooped posture. Radiographic changes, such as the appearance of syndesmophytes (bony growths in the spine), become more evident during this stage.
Advanced Stage
In advanced ankylosing spondylitis, significant spinal fusion can occur, leading to severe stiffness and a loss of spinal mobility. The spine may become completely rigid, making it difficult to perform daily activities and leading to a permanent hunched posture. In this stage, complications such as spinal fractures, respiratory issues due to reduced chest expansion, and cardiovascular problems may arise.
Other joints and organs, such as the eyes (uveitis) and intestines (inflammatory bowel disease), may also be affected. Management at this stage focuses on relieving symptoms, preventing further damage, and maintaining as much mobility and function as possible.
Ankylosing Spondylitis Causes
The exact cause of ankylosing spondylitis (AS) is not fully understood, but it is believed to result from a combination of genetic, environmental, and immunological factors. We explain these factors in more detail below.
- Genetic factors: The most significant genetic factor associated with AS is the presence of the HLA-B27 gene. While not everyone with this gene develops AS, it significantly increases the risk. Approximately 90-95% of people with AS have the HLA-B27 gene. Other genetic factors and variations in genes related to the immune system may also contribute to the risk.
- Immune system dysfunction: AS is an autoimmune disease, meaning the immune system mistakenly attacks the body’s own tissues. In AS, this leads to inflammation in the spine and other joints. The exact mechanisms triggering this immune response are not fully known but may involve abnormal immune system regulation and response.
- Environmental factors: Certain environmental factors, such as infections, may play a role in triggering AS in genetically predisposed individuals. However, no specific infectious agents have been conclusively linked to the development of AS.
Ankylosing Spondylitis Diagnosis
To diagnose ankylosing spondylitis, we often opt for a combination of clinical evaluation, medical history, physical examination, imaging studies, and laboratory tests. We may use any of the following forms of testing to diagnose AS.
- Detailed medical history
- Physical examination
- X-Rays
- MRIs (magnetic resonance imaging)
- HLA-B27 gene blood test
- Blood tests for inflammatory markers
Ankylosing Spondylitis Test
There is no one test that can, on its own, determine a diagnosis of AS. However, certain blood tests, such as the HLA-B27 gene blood test, are helpful in achieving a diagnosis. This blood test can determine the presence of the HLA-B27 gene, which is present in most people with AS. However, not all individuals with this gene develop AS, and its absence does not rule out the disease.
Other blood tests to measure levels of inflammatory markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) can indicate the presence of inflammation in the body, although these markers are not specific to AS.
Ankylosing Spondylitis Treatments in Plano, TX
To treat ankylosing spondylitis, we typically design a plan based around a patient’s specific symptoms and the severity of their condition. Some of the treatments and recommendations we may have include the following.
Ankylosing Spondylitis Self-Care
Self-care is incredibly important for patients with AS not only to relieve pain, but also for slowing or preventing the progression of the disease. It can also help improve a patient’s quality of life. Some AS self-care tips to remember include the following.
- Regular exercise: Regular physical activity is essential for people with AS. Exercise helps to reduce stiffness, improve flexibility, and maintain spinal mobility. Stretching exercises, swimming, and yoga are particularly beneficial. A consistent routine that includes both aerobic and strengthening exercises can help manage pain and improve posture.
- Posture management: Maintaining good posture is important to prevent or minimize spinal deformities. Practices such as standing and sitting upright, using supportive chairs, and avoiding prolonged periods of inactivity can help maintain proper alignment of the spine. Ergonomic adjustments at work and home, such as using a standing desk or supportive mattress, can also be beneficial.
- Lifestyle adjustments: Managing stress and ensuring adequate rest are important for overall well-being. Techniques such as meditation, deep breathing exercises, and mindfulness can help manage stress levels. A healthy diet rich in anti-inflammatory foods, such as fruits, vegetables, whole grains, and omega-3 fatty acids, can also support overall health and reduce inflammation. Avoiding smoking and excessive alcohol consumption is recommended, as these can exacerbate symptoms and impact overall health.
Ankylosing Spondylitis Medication
The primary medications for ankylosing spondylitis (AS) aim to reduce inflammation, manage pain, and slow disease progression. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, are commonly prescribed to relieve pain and reduce inflammation.
For those with more severe symptoms, disease-modifying antirheumatic drugs (DMARDs) like sulfasalazine or biologic medications such as tumor necrosis factor alpha inhibitors and interleukin-17 (IL-17) inhibitors may be used. These biologics target specific components of the immune system to control inflammation more effectively. Corticosteroids may also be used for short-term relief of acute symptoms.
Ankylosing Spondylitis Physical Therapy
Physical therapy is a cornerstone of AS treatment, focusing on maintaining flexibility, improving posture, and reducing pain. A physical therapist can develop a tailored exercise program that includes stretching, strengthening, and range-of-motion exercises. Therapy often involves techniques to improve posture and prevent spinal deformities.
Manual therapy, hydrotherapy, and other modalities may also be employed to alleviate pain and improve function. Physical therapy can also be beneficial for a patient’s mental health, as it can restore mobility and provide pain relief.
Ankylosing Spondylitis Exercises
Regular exercise is crucial for managing AS symptoms and maintaining mobility. Exercises should include a combination of stretching, strengthening, and aerobic activities. Stretching exercises help maintain flexibility, particularly in the spine and hips. Strengthening exercises support the muscles around the spine, improving posture and stability. Aerobic activities, such as walking, swimming, or cycling, enhance overall fitness and reduce stiffness.
Low-impact exercises like yoga and Pilates are also beneficial for improving flexibility and core strength. It is important to perform these exercises regularly and correctly, often under the guidance of a healthcare professional, to maximize benefits and avoid injury. Exercise also helps patients maintain a healthy weight, which is beneficial for many conditions affecting the spine.
Ankylosing Spondylitis FAQs
Is Ankylosing Spondylitis an Autoimmune Disease?
Yes, ankylosing spondylitis (AS) is considered an autoimmune disease. Within the body, autoimmune diseases make the immune system mistakenly attack the body’s own tissues. AS particularly targets the joints and spine. In AS, this autoimmune response leads to chronic inflammation, primarily in the sacroiliac joints and spine.
Can Ankylosing Spondylitis Cause Headaches?
People with ankylosing spondylitis can experience headaches as a potential side effect of the disease. Cervicogenic headaches are particularly common types of headaches in patients with AS.
Is Ankylosing Spondylitis a Disability?
Ankylosing spondylitis can progress enough to become a severe disease that prevents people from working. Depending on the condition’s severity and whether or not the patient meets certain requirements, AS could qualify as a disability. However, it is not inherently considered a disability, as the level to which it impairs individuals varies widely.
Is Ankylosing Spondylitis Genetic?
Ankylosing spondylitis has a significant genetic component. The most notable genetic marker associated with AS is the HLA-B27 gene. Approximately 90-95% of individuals with AS possess this gene, indicating a strong genetic predisposition. However, not everyone with the HLA-B27 gene develops AS, suggesting that other genetic and environmental factors also play a role in the disease’s onset. Genetic testing for the HLA-B27 gene can, however, help play a role in early diagnosis and treatment of the disease.
What Is the Ankylosing Spondylitis Life Expectancy?
Generally, ankylosing spondylitis does not usually affect life expectancy, except in very severe cases. It does not directly shorten life expectancy. However, it is also not curable, which means treatment tends to focus on treating symptoms rather than eliminating the disease.
Contact an Ankylosing Spondylitis Doctor in Plano at the Advanced Spine Center
At the Advanced Spine Center, we are committed to empowering you with comprehensive care and support throughout your journey with ankylosing spondylitis. Our team of experienced specialists utilizes the latest advancements in medical and therapeutic treatments to tailor a plan that meets your unique needs.
Whether you’re seeking relief from pain and stiffness or looking to preserve spinal mobility, we are here to guide you with expertise and compassion. Contact us today to schedule a consultation and take the next step towards managing your ankylosing spondylitis effectively, ensuring a more active and fulfilling life.
