Arthritis Australia is playing an important part in raising the awareness of a condition that causes back pain in 2% of Australians. It is called ankylosing spondylitis. It is a form of inflammatory arthritis that mostly occurs in the spine and where the spine and the pelvis meet. “It is a disease which causes inflammation and pain in the spine and other joints…and is three times more common in men than women.”

The precise cause is unknown, however, it is suspected to be a hereditary disease that is carried on the HLA-B27 IL23R and ARTS1 genes but not all people who have the genes end up getting an AS diagnosis. Clearly, a lot more research is needed before solid conclusions about the cause can be made.

ankylosing sponylitis

The onset of AS generally occurs between adolescence and middle age at 15 – 45 years. Even if you have maintained perfect posture, don’t work in a desk job and eat a balanced diet and exercise, the genetic nature of the condition will not prevent AS from affecting you.  Early onset symptoms include “deep aching in or across the buttocks” and “pain in the front of the chest or between the shoulder blades.”

Although the spine is the part that is likely to suffer most it can and does affect other parts of the body too in some people. The shoulders, hips and legs where the muscles and bones bend are especially susceptible to AS. Stiffness and swelling appear in these areas and you might be surprised to learn that even vision can be affected!

Red, sore eyes with blurry vision might last for short periods but needs the attention of an ophthalmologist to prevent long term damage. The common IBS symptoms of diarrhoea and bloating can also appear with AS, but not with everyone.

There is a high degree of unpredictability with the disease. Some people get flare ups while other people find it simply disappears for years. A small amount are less fortunate, and may find they actually deteriorate over time. In a worst case scenario, the inflammation can cause bone growth at the joints and fuses them together if not treated. Rest assured that with sufficient medical intervention received early AS can be controlled so that the vast majority of those diagnosed live normal lives.

If a doctor suspects a patient might have AS they will make an examination, enquire after family history to see if arthritis and AS specifically have affected relatives, X-rays and MRI scans will be ordered, and send blood samples will be sent off for genetic testing.

Anyone diagnosed with AS will need to engage a team of specialists to manage the symptoms. A GP is always your first point of call. He or She will put you in touch with a trusted physiotherapist who can give you practical exercises designed for your body requirements to manage the symptoms – such as activities in a warm water pool.

A rheumatologist is a specialist in arthritis. They may prescribe medication from pain relief, to anti-inflammatory drugs, anti rheumatic drugs.

If surgery is required for mobility you may see an orthopaedic surgeon. Whatever their specialism, all medical personnel will remind you to eat healthy and stay active! This is essential if you want a mobile and flexible spine for the rest of your life.

Resources and further reading:
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/ankylosing-spondylitis
http://www.arthritisaustralia.com.au/images/stories/Michael_Slater/Pg_2_What_is_AS.pdf
https://www.theshedonline.org.au/health-lifestyle/article/exercise-with-michael-slater