Ankylosing spondylitis

Diagnosis

The doctor will perform a physical examination and also evaluate the range of motion of the spine by instructing the patient to move in certain direction. Your doctor may apply pressure on your pelvis and move your legs into specific positions to reproduce the pain while testing. The doctor will also ask you to take a deep breath to assess any difficulties in chest expansion.

Imaging tests

• X-rays. Shows any changes in bones and joints but if you have just started to develop the disease, it might not be visible.
• Magnetic resonance imaging (MRI). Views a more detailed soft tissues and bone images using a strong magnetic fields and sound waves.  This test can also show ankylosing spondylitis at an early stage.

Laboratory tests

There are no specific lab tests to diagnose the disease. Certain blood tests can check for inflammation markers although inflammation can also be caused by other conditions.   HLA-B27 gene can be detected in your blood but many people may have this gene but they don’t have ankylosing spondylitis.

Treatment

Treatments are done for pain and stiffness relief, delay or prevent complications and spinal deformity. It is better to treat it at its early stage in order to avoid permanent impairment.

Medications

• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs). Doctors mostly prescribe naproxen, and ibuprofen for pain and stiffness relief but their side effect is bleeding of the gastrointestinal tract.
• Injection. The drugs are injected on the skin or intravenously. On the other hand, the side effect can be reactivation of tuberculosis that was left untreated and makes you immunocompromised.
  • Tumor Necrosis Factor (TNF) blocker. Such as Adalimumab, Certolizumab pegol, Etanercept, Golimumab, and Infliximab
  • Interleukin-17 (IL-17) inhibitor. Such as secukinumab and ixekizumab

Physical therapy

Physical therapy can regain muscle strength and elasticity and it is an important aspect of the treatment with various advantages. It can be customized for each patient by the physical therapist.

The following will be instructed for better posture:

• Stretching and range-of-motion exercises
• Exercises to make the abdomen and back muscles stronger
• Correct walking posture and sleeping position.

Surgery

Ankylosing spondylitis usually don’t need surgery but if there is severe damage on the joint of the hip and the pain is getting worse, surgery which is joint replacement surgery implant will be recommended.