|
|
| 07th Jul 2008 | |||||||
 Home FEATURES What's New? Current Feature The Doctor's In Spotlight AFM Calendar of Events Be a Member About Us Contact Us RESOURCE Useful Links Archives Rheumatology Services  Exercise your arthritis pains away! 
Be a member of the Arthritis Foundation.Click here for an application form.  Tell a friend about...
|
What Happens?  AS causes inflammation
outside the joint where the ligaments and tendons are attached to the
bone. It usually affects the little joints between the vertebrae of the
spine and tends to reduce the movement which takes place at these joints,
causing stiffening.
The spine, or backbone is made up of 24 bones (vertebrae) and 110 joints. There are 3 main sections; the cervical or neck section, which is the most mobile, the thoracic or chest section and the lumbar section. Below the lumbar section is the sacrum, which fits into the pelvis. AS usually starts at the sacro-lilac joints which lie between the sacrum and the pelvis. What Causes Ankylosing Spondylitis? The cause is not yet known, but there is a hereditary factor as occasionally, more than one family member can have this condition. AS is not infectious, and neither can it be caused by athletic activity or injury. Sometimes, the initial symptoms may follow unusual exertion or strain and this may be blamed at first, but it is not the cause of AS.Who Gets Ankylosing Spondylitis? AS unusually affects young people between 13 and 35 years old, but may appear in the older age group. Typically, it affects young males, but can occur in women as well. Early Symptoms The early symptoms vary, but pain and stiffness in the lower back and around the hips are common. Back troubles however, are some of the commonest complaints seen by doctors. The most common cause of backache is "back strain," which can happen at any age. A "slipped disc' is another example. In older people, wear and tear problems often affect the back. Diagnosis is made by listening to your symptoms and examining you. Your doctor may do certain investigations. We will discuss these points a little later. Although the early symptoms commonly affect the lower spine, other areas of the spine may be affected. In a few cases, the first complaint may not be in the back at all, but in the hip or knee. The symptoms are particularly worse in the early morning and tend to wear off through the day. Unlike the common mechanical low back, which improves with rest, the pain and stiffness of AS are relieved by exercise and are worse after rest. Some patients may have other symptoms, for example, chest pain. This does not come from the heart, but from the joints between the ribs and breast bone. Breathing exercises will help maintain the mobility of the ribcage. Iritis (inflammation of the iris which forms the pupils of the eye) occasionally occurs, so if you suddenly develop a red eye, please see your doctor immediately. There are other rare complications which can affect the heart, lung and nervous system, but these affect less than one patient in a hundred. AS is a condition that waxes and wanes with time, so there will be periods when one has more pain and stiffness and other periods when they are less troublesome. AS is a systemic condition and can affect the whole body and hence, when AS is active, a person may experience fever, loss of appetite and feel constantly tired. If any of these symptoms continue for more than two months, you should see a doctor.Diagnosis AS is often very difficult to diagnose in the early stages or in mild cases. The diagnosis can be confirmed by X-rays, but because the changes may take several years to appear, it may not be possible to make a definite diagnosis initially. Your doctor may also carry out some blood tests, which may point to a diagnosis. The Outlook AS takes a different course in different people, and no two cases are the same. The symptoms may come and go over long periods, but in the end, it almost always settles down. Your lower back will probably become stiff, but the same can happen to the upper part of your back and neck as well. Therefore, it is no utmost importance to maintain a good posture. Treatment At present, there is no cure for AS, but there is a great deal each person can do to help manage the condition and to make it easier to lead a normal working and social life. Do your best to keep fit. There is no specific diet you need to keep to, but do not get overweight. Unlike other types of arthritis, people with AS do not usually become seriously disabled. The treatment is designed to minimize the amount of stiffness and rigidity which takes place in various parts of the spine (i.e. to retain mobility) and to provide as correct a posture as possible. Medication There is no drug which will cure AS, but there a wide range of drugs - mainly non-steroidal anti-inflammatory drugs (NSAIDS) to help the pain and reduce inflammation. These drugs act quickly and are not addictive, but will relieve the stiffness and pain and therefore allow the person to exercise regularly, which is very important. NSAIDS however do have side-effects, and the commonest one is indigestion. If you do experience this, make sure you let your doctor know. Always take the NSAIDS after meals or with a milky drink to avoid problems.Exercise The physiotherapist can give you a regime of exercises to do at home. In addition to this, other exercises are beneficial. Swimming is perhaps the best form of exercise because it uses all the joints and muscles. Other suitable sports include non-contact sports, including badminton, tennis and golf. Contact sports are best avoided as joints or the spine may be injured. If there is too much stiffness or pain to exercise comfortably, a hot bath or shower will help ease the pain and tension so that exercises can be done. Rest If the AS is very active and the stiffness troublesome, you may need to take time off to rest. This does not mean keeping still in bed, because this will hasten the stiffening of the spine. So even a spell of rest from work means that you need to continue to do exercises for your back, chest and limbs to keep them supple.Your bed should be firm. If you have an internally sprung mattress, get a suitable board to put between the mattress and the bed frame. Even when the painful active phase of AS is passed, it is important to keep a firm bed in order to prevent any tendency for spinal curvature. When you are in bed, it is important that you should lie quite flat on your back; some of the time you should practice lying on your front. "Prone lying", as it is called, is best done for twenty minutes before rising in the mornings, and twenty minutes before going to bed at night. At first you may not be able to tolerate more than five minutes at a time, or may need a pillow under your chest. But with practice, as the spine relaxes, it will become easier. If you make a habit of this, it will help prevent your back and hips becoming bent. It may, of course not be practical every day but it is better to devote some time to it than nothing at all.Posture A person with AS should be aware of posture at all times. It is important to keep the spine straight and to stay as erect as possible. Pay special attention to the position of your back when at work so that you do not stoop. Hardback, upright chairs are far better for your posture that low, soft, upholstered chairs. If you sit at a desk or bench, see that the seat is at proper height and do not sit in one position for too long without moving your back. Corsets and braces are hardly ever helpful, and can make the AS worse. It is better to develop your own muscles, and keep a straight back by natural means.Pregnancy Pregnancy in women with AS provides no special problem for the mother or baby. However, in contrast with some other forms of arthritis, the condition does not subside during pregnancy. The babies are usually born by the normal route, but occasionally, a caesarean operation is necessary if the hip joints become stiff. Employment AS sufferers are capable of doing a wide variety of jobs and many have very successful professional and business careers. An ideal occupation is one which allows period sitting, standing and walking. Occupations involving prolonged stooping and back strain may worsen symptoms. Summary AS is a chronic illness with no known cure as yet. The effects of AS can be controlled or minimized by regular mobilizing exercises, good posture and proper medication. By following the individualized programme, the chances of AS interfering with an active, functional life are kept to a minimum.
|
DID YOU KNOW... ...that this decade has been designated as the "Decade of the Bone and Joint"? So we can expect many new developments and a better understanding in these fields worldwide. |
|||||
|
This website is made possible with the support of MSD © 2000 - 2008 Arthritis Foundation of Malaysia Disclaimer | Contact |
|||||||
In this article:
