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Ankylosing Spondylitis


What is ankylosing spondylitis?

Ankylosing spondylitis is a type of arthritis that affects your spine. Inflammation in the vertebrae causes them to become fused (joined). This makes your spine less flexible than it should be. Signs and symptoms begin in your tailbone area and move up your back and into your neck over time. Other joints that may be affected include the shoulder, hip, and knee. You may also have inflammation in your eyes, bowels, heart, or lungs.

What are the signs and symptoms of ankylosing spondylitis?

  • Pain in the lower back that is worst after no activity and gets better with movement (adults)
  • Pain or inflammation in the hips, or where tendons or ligaments attach to bone
  • A fever or fatigue
  • Redness or pain in one or both eyes
  • Loss of appetite, or weight loss without trying
  • A bent over posture to help relieve back pain
  • Trouble breathing, or pain with deep breathing

How is ankylosing spondylitis diagnosed?

Your healthcare provider will ask about your symptoms and when they began. Tell him if you have a family history of ankylosing spondylitis or arthritis. He may ask you to move and bend in different ways to see if movement causes pain. This also helps him measure the flexibility in your spine. He may also check how well you can take a deep breath. Your healthcare provider may know you have ankylosing spondylitis from your signs and symptoms. The following tests may be used to confirm the diagnosis or to help plan treatment:

  • Blood tests may be used to measure the amount of inflammation in your blood. The tests may also be used to check for kidney damage.
  • X-ray or MRI pictures may show damage or deterioration caused by years of inflammation. Do not enter the MRI room with anything metal. Metal can cause serious damage. Tell the healthcare provider if you have any metal in or on your body.

How is ankylosing spondylitis treated?

Treatment depends on your symptoms and how severe they are. You may need any of the following:

  • Medicines may be given to prevent inflammation or to control your immune system. Some medicines are given only in the hospital, through an IV. Steroids or other medicines may be prescribed for you to take at home. You can also take NSAIDs, such as ibuprofen, to help reduce pain and inflammation. NSAIDs are available without a prescription. Ask your healthcare provider which medicine is right for you. Ask how much to take and how often to take it. Follow directions. NSAIDs can cause stomach bleeding or kidney problems if not taken correctly. If you are taking blood thinning medicine, always ask if NSAIDs are safe for you.
  • Surgery may be used if your symptoms are severe or other treatments do not work. You may also need to have your spine straightened. Your hip or other joints may need to be replaced if they are damaged.

What can I do to manage ankylosing spondylitis?

  • Avoid activities that strain your back. Do not lift heavy objects. Ask your healthcare provider if it is safe for you to play sports. Some sports may be too rough for you to play safely.
  • Maintain good posture. Sit and stand up straight. Only sit in straight-backed chairs, with your back pressed against the back of the chair. Do not lean forward when you are working at a computer or at a desk. An occupational therapist can show you ways to work at a desk without harming your spine. Sleep on your back, on a hard mattress. Do not put pillows under your neck or knees.
  • Move often during the day. Try not to stay in one position for long periods of time. For example, do not stand for long periods. Do not go for long car rides. Your healthcare provider may recommend that you swim for exercise. Swimming will keep stress off your back and prevent you from moving your back awkwardly. Exercise helps keep your spine flexible. Exercise can also help build muscle. Muscle helps protect your bones.
  • Go to physical therapy as directed. A physical therapist can teach you exercises to keep your back and other joints flexible. Therapy can also help reduce pain and make it easier for you to do your daily activities. You may also learn deep breathing exercises to help your chest expand fully when you breathe.
  • Do deep breathing exercises as directed. Ankylosing spondylitis can make it difficult for you to breathe if your posture becomes bent over. Your healthcare provider may recommend breathing exercises.
  • Do not smoke. Nicotine in cigarettes and cigars can cause lung damage and make it more difficult for you to breathe. Nicotine can also increase bone loss. Ask your healthcare provider for information if you need help quitting. E-cigarettes or smokeless tobacco products still contain nicotine. Talk to your healthcare provider before you use these products.

What can I do to manage my symptoms?

  • Apply heat as directed. Heat helps decrease pain. Use a heat pack, or soak a small towel in warm water. Wring out the extra water and apply the towel to the sore area. Do this for 15 minutes every hour, or as directed.
  • Apply ice as directed. Ice helps decrease pain and swelling, and helps prevent tissue damage. Use an ice pack, or put crushed ice in a bag. Cover the bag with a small towel and apply the bag to the area for 20 minutes every hour, or as directed.
  • Reach or maintain a healthy weight. Extra weight puts pressure on your spine and other joints. This can increase your symptoms and make ankylosing spondylitis worse. Ask your healthcare provider how much you should weigh. He can help you create a healthy weight loss plan if you are overweight.
  • Eat a variety of healthy foods. Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, lean meats, fish, and legumes, such as lentils. Your healthcare provider may recommend you increase the amount of calcium and vitamin D you get. Calcium and vitamin D work together to help create or maintain bone.
  • Protect yourself from falls. Make sure paths in your home are clear. Tape down ends of throw rugs and electric cords. Keep paths well lit so you can see where you are going. These steps will help prevent you from tripping as you walk around your house. Your healthcare provider may also recommend that you use a walker, cane, or other supportive device. These can help you keep your balance.

When should I call 911 or seek immediate care?

  • You cannot move your legs.
  • You fall and think you have broken a bone.

When should I contact my healthcare provider?

  • You have eye pain or redness, become sensitive to light, or have blurred vision.
  • You have new or worsening symptoms.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2016 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.