Ankylosing spondylitis belongs to the family of spondyloarthropathies, which are chronic inflammatory rheumatisms. Spondylarthropathies cause pain and stiffness in multiple joints, with ankylosing spondylitis affecting almost exclusively those of the spine and pelvis. It is a chronic, progressive and debilitating disease, which usually strikes young people, men more so than women. Ankylosing spondylitis is manifested in the form of painful flare interrupted by periods when symptoms are absent or at least less pronounced.
Ankylosing spondylitis often begins in young adulthood and progresses. Symptoms include:
- pain in the spine, namely the thoracic and lumbar vertebrae, which increases during rest and decreases during exercise. This pain is inflammatory, and may cause the patient to wake up at night and is often at its worst in the morning before gradually decreasing over the course of the day;
- pain in the buttocks;
- stiffness of the joints;
- other joints may be affected inconsistently, especially in the heel;
- In some cases, the eye may suffer from uveitis with decreased visual acuity or pain.
Ankylosing spondylitis develops in spurts. In times of crisis, the patient becomes incapacitated. Outside of these crises, quality of life is improved significantly.
To diagnose ankylosing spondylitis, the doctor will perform a medical questionnaire and a clinical examination. The goal is to determine the origin of pain. To confirm the diagnosis, radiographs of the affected areas will initially be performed, particularly of the spine and pelvis. They are sometimes supplemented by an MRI or a bone scan. A blood analysis with markers of inflammation is also needed.
A cure for ankylosing spondylitis does not exist. Patients' symptoms are relieved with anti-inflammatory drugs
and pain medication during outbreaks. Local corticosteroid injections are also possible if pain in the joints becomes too severe. In case of insufficient relief by these treatments, drugs can be given in permanence such as methotrexate or anti-TNF-alpha. Meanwhile, physical therapy may also improve symptoms and help fight against the stiffness.