By Dr Siddharth M Shah
Ankylosing Spondylitis (AS) is an autoimmune disorder which predominantly affects the spine and the pelvic joints. It can also affect other parts of the body like the eyes, Lungs, Heart, hips, and ankles. It causes inflammation at the attachment of ligaments and tendons to the bone. Individuals carrying the HLA-B27 gene are at an increased risk of suffering from AS. However, not all individuals carrying this gene suffer from the disease. It affects people between 20-40 years of age. Traditionally, it was believed to affect males predominantly; however, recent data seems to suggest that there may not be a gender preponderance.
Recently, a 24-year-old man from Chandpur was operated for bilateral total hip replacement (THR) as he was suffering from bilateral hip Arthritis due to a condition called Ankylosing spondylitis (AS). AS had affected the patient’s lifestyle and he was wheelchair bound. He complained of pain in both the hips with stiffness for over a year. As the disease had progressed rapidly to a severe stage, he required surgery at a young age. The surgery was complex as the hips were severely damaged. Also, there was hardly any movement in the hip joints as they had become very stiff. Furthermore, his spine too was stiff, and his bones were weak. However, the surgery was a success and the patient recovered well without any complications. He is now pain free and able to move around on foot & carry on with his day-to-day activities.
As understood in this case, the key lies in early diagnose and get timely treatment in order to avoid progression of the disease. Here are the details you need to know:
Symptoms of Ankylosing Spondylitis: Patients usually complain of low back pain and stiffness, three months or longer in duration. Symptoms are usually worse in the morning. Depending upon the other parts involved, individuals may experience heel pain, ankle pain & swelling, hip pain & stiffness, redness & pain in the eyes with blurred vision, and restricted chest movements. In longstanding disease, the bones in the spine may fuse making it stiff and inflexible. These individuals usually have a hunched back posture. AS can be associated with other conditions like Psoriasis and Inflammatory Bowel Disease.
Diagnosis of the disease: Diagnosis of AS is based on the clinical symptoms and signs. Based on the history, your doctor will assess for stiffness of the spine, hips, or restricted chest movements. Scans like X-rays or MRI may be advised to check for inflammation in the spine or pelvic joints. Blood tests may be ordered to check for inflammation in the body and HLA-B27 gene.
Treatment of the chronic disease: There is no cure for Ankylosing Spondylitis. Treatment is aimed at controlling the disease, the symptoms, and to prevent its progression. Exercises and physiotherapy play an important role in the treatment. They help maintain strength and flexibility of the spine & affected joints. Your doctor may prescribe pain killers and non-steroidal anti-inflammatory drugs (NSAIDs) to ease the pain. Drugs like steroids and disease-modifying anti-rheumatic drugs (DMARDs) may be advised to control and prevent progression of the disease. In severe cases where the patient is not responding to conventional treatments, biological agents like anti-TNF alpha may be recommended. Fused spine or hips may require surgical treatment.
Hence, timely detection of the disease and astute treatment are essential in controlling the disease and preventing its progression to advanced stage of deformity & disability. Regular follow-up and strict adherence to medical advice are crucial for effective treatment of this condition which has no cure.
(The author is a Consultant Orthopaedic & Joint Replacement Surgeon, SL Raheja Hospital, Mahim. The article is for informational purposes only. Please consult medical experts and health professionals before starting any therapy, medication and/or remedy. Views expressed are personal and do not reflect the official position or policy of the FinancialExpress.com.)
