Constant Neck and Back Pain? It Could Be Ankylosing Spondylitis!

• In India, approximately, 30-40 lakh people suffer from ankylosing spondylitis.
• Spondylitis does not only affect the back but also shoulders, ribs, hips, knees, etc.
• It is particularly most prevalent in men than in women.
• Spondylitis is challenging to identify but has a particular pattern of pain symptoms, and changes can be seen on MRI and X-ray.

What Is Spondylitis?

Ankylosing Spondylitis, commonly known as spondylitis, is a type of arthritis that mainly affects the sacroiliac joints, spine or the lower back. This inflammatory condition causes the spine and pelvis to harden and eventually fuse together. In severe cases, this condition can also lead to spinal deformity or loss of flexibility and mobility. AS most commonly occurs in men, but can affect anyone of any age. However, it tends to be milder when it does occur in women, making it harder to diagnose. As per doctors, physical therapy and medications can help relieve the symptoms.

Symptoms of Spondylitis

The symptoms of spondylitis may vary from individual to individual. However, this condition can differ from meek to moderate outbreaks of inflammation that vary with almost no symptoms. The main symptoms of spondylitis include:

• pain
• stiffness
• loss of mobility
• loss of appetite
• low-grade fever
• weight loss
• anaemia or low iron

As pain is the main symptom of AS, it particularly affects the lower back and buttock areas during the early stages. However, pain and inflammation are not confined to the spine. It may also affect other parts of the body, including:

• the neck
• other joints
• the top of the shin bone in the lower leg
• behind the heel of the foot, in the Achilles tendon
• under the heel of the foot

Individuals with AS may also experience fatigue, tiredness, and lack of energy.

What Causes Ankylosing Spondylitis?

The precise cause of Ankylosing Spondylitis is still unclear, but the symptoms result from the inflammation in the lower spine. When new bone develops, this swelling can lead to damage and fusion. The fusion can happen as a result of the inflammation of the tissues that connect to bones. This can make everyday tasks difficult to carry out. In some cases, it can also restrict the movement of the chest and make it hard to breathe. According to a study, genetic factors provide 90% of the susceptibility to this condition. Therefore, it is safe to say that AS is majorly caused due to hereditary factors.

What Are the Possible Treatments for Spondylitis?

There is no particular treatment for AS, and the damage cannot be overturned. However, some treatment options can help in relieving the symptoms and control progression, including:

Drug and Medication Treatment

The medication prescribed for the treatment of AS is non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs can ease inflammation and reduce pain so that one can get on with the daily routine and tasks. The most common NSAIDs include naproxen, ibuprofen, and diclofenac. Besides, acetaminophen and codeine are other options if NSAIDs are inept or inadequate. Other drug options include:

• locally injected corticosteroids
• tumour necrosis factor (TNF) antagonists, such as certolizumab (Cimzia), adalimumab (Humira), golimumab (Simponi), etanercept (Enbrel), or infliximab (Remicade)
• disease-modifying anti-rheumatic drugs (DMARDs), such as sulfasalazine and methotrexate
• other biologic treatments, such as secukinumab (Cosentyx)

Physical Therapy and Exercise

Keeping an active routine can improve the posture and movement of the spine, along with preventing the spine from becoming stiff and painful. Types of therapy useful for AS include:

• a group exercise activity – for example, yoga and Zumba.
• an individual exercise programme – for example walking and swimming.
• massage – the muscles and other soft tissues are manoeuvred to relieve pain and improve movement. Massage therapy can also provide relaxation and calming effect on spinal mobility.
• hydrotherapy – similar to a hot water bath, in this therapy, shallow swimming in warm water can help ease the tension or inflammation from the muscles. Besides, the resilience of the water helps make movement easier.

Some patients prefer to play sports for agility and flexibility. This is usually fine, although some daily stretching and exercise is also important. If one is ever in doubt, consult the physiotherapist before taking up any new form of exercise or sport.

Surgery

Usually, most patients don't need surgery. However, joint replacement surgery may be suggested to improve movement in the joint that has become severely damaged. Surgery is only advised, in severe cases, to correct deformities, such as replacing a hip or other joint or in case of excessive bending of the spine. In rare cases, corrective surgery may be required if the spine is badly bent. Spondylitis can affect the whole body and patients may be recommended to consult specialists, including physical therapists, eye specialists, and gastroenterologists.

Is Spondylitis Preventable?

Although there's no particular cure for spondylitis, preventive measures can help ward off potential complications. Try these tips from doctors to prevent the condition and live a healthy, active life.

• Consume a diet rich in omega-3 fatty acids. It helps in reducing joint inflammation.
• Increase the intake of minerals in the diet. Minerals like magnesium, calcium, and sodium also help in preventing symptoms of spondylitis.
• Turn to hot baths. Probably, back pain feels worst when after waking up. Stepping into a steamy shower can relieve aches and relax up stiff muscles and joints.
• Follow an exercise regime regularly. Exercise helps in keeping the body moving and also lessens the proximity of pains and aches.
• Keep a check on the body posture.
• Try activities that involve an overall body movement, for example, walking, swimming, hiking, cross-country skiing, and tennis.
• Stay as straight as possible when sitting or standing to help improve the forward bend that often occurs as the condition progresses.
• While at work, make sure to take frequent breaks throughout the day for basic stretches and flexibility exercises.
• Never perform backbreaking exercises when having a flare-up.
• At all times begin with gentle exercises and increase the force only if it doesn't pain.

Poor living choices are causing an alarming rise in the prevalence of spondylitis. Therefore, it is important to maintain a healthy life structure in order to avoid this condition. Besides, if one witness any symptoms of spondylitis seek medical attention promptly. Follow the above tips meticulously to prevent spondylitis from affecting the quality of life.