What is Ankylosing Spondylitis?

Written by Na Hong Wei
Orthopedics
Updated on September 23, 2024
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Ankylosing Spondylitis (AS), where "A" stands for fusion and "S" for spine, refers to the condition where the bones and joints of the spine are fused together. Ankylosing Spondylitis is defined as a chronic inflammatory disease primarily affecting the axial skeleton and major limb joints. It is characterized by fibrosis and ossification of the intervertebral discs’ annulus fibrosus and nearby connective tissues, as well as ankylosis (stiffening) of the joints. It presents as a sterile inflammation occurring in the spine. However, it is not solely limited to the spine as it also involves the axial bones and major limb joints. The pathological hallmark of the disease includes inflammation mainly at the sacroiliac joints and points of attachment to the spine, leading to joint stiffness and calcification of the spinal ligaments and joints. The disease progression begins at the sacroiliac joint, spreading upwards through the entirety of the spine, and eventually stops at the cervical vertebrae. Symptoms start with pain in the early stages, followed by restricted mobility in the intermediate phase, and ultimately leading to deformities of the abdomen and back, culminating in severe hunchback. The exact cause of Ankylosing Spondylitis remains unclear, with various theories proposed but none universally accepted. Additionally, it is categorized under rheumatologic and immunologic disorders.

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Written by Na Hong Wei
Orthopedics
1min 34sec home-news-image

What is Ankylosing Spondylitis?

Ankylosing Spondylitis (AS), where "A" stands for fusion and "S" for spine, refers to the condition where the bones and joints of the spine are fused together. Ankylosing Spondylitis is defined as a chronic inflammatory disease primarily affecting the axial skeleton and major limb joints. It is characterized by fibrosis and ossification of the intervertebral discs’ annulus fibrosus and nearby connective tissues, as well as ankylosis (stiffening) of the joints. It presents as a sterile inflammation occurring in the spine. However, it is not solely limited to the spine as it also involves the axial bones and major limb joints. The pathological hallmark of the disease includes inflammation mainly at the sacroiliac joints and points of attachment to the spine, leading to joint stiffness and calcification of the spinal ligaments and joints. The disease progression begins at the sacroiliac joint, spreading upwards through the entirety of the spine, and eventually stops at the cervical vertebrae. Symptoms start with pain in the early stages, followed by restricted mobility in the intermediate phase, and ultimately leading to deformities of the abdomen and back, culminating in severe hunchback. The exact cause of Ankylosing Spondylitis remains unclear, with various theories proposed but none universally accepted. Additionally, it is categorized under rheumatologic and immunologic disorders.

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Written by Yang Ya Meng
Rheumatology
1min 7sec home-news-image

How is ankylosing spondylitis treated?

The treatment of ankylosing spondylitis mainly consists of three parts: The first part is anti-inflammatory and pain relief. For anti-inflammatory pain relief, non-steroidal pain relief medications are commonly chosen, such as slow-release diclofenac sodium tablets and celecoxib capsules. The second part involves the selection of medications to control the disease. Common drugs used to control the condition include sulfasalazine, thalidomide, and methotrexate tablets. The third part includes the most effective, yet most expensive, treatment option: biological agents. Common biological agents used are tumor necrosis factor antagonists. However, before using biological agents, strict screening for diseases such as hepatitis, tuberculosis, and cancer is required. Only after excluding these conditions can the treatment with biological agents be considered.

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Written by Li Jing
Rheumatology
52sec home-news-image

How to exercise with ankylosing spondylitis?

Once diagnosed with ankylosing spondylitis, after ruling out contraindications such as hepatitis B infection and tuberculosis, it is necessary to administer standard medications to improve rheumatic conditions. At the same time, it is necessary to develop good living habits, such as abstaining from alcohol, quitting smoking, and avoiding carbonated drinks and coffee, as these can exacerbate osteoporosis. Secondly, it is important to exercise regularly; one can walk slowly, run, or swim. Swimming is the best form of exercise for patients with ankylosing spondylitis as it can enhance the coordination of limb muscles while also delaying joint wear. Thirdly, it is important to maintain good posture and sleep on a hard bed.

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Written by Yang Ya Meng
Rheumatology
46sec home-news-image

What to do about ankylosing spondylitis pain?

The medications for treating pain in ankylosing spondylitis fall into three major categories: The first category includes non-steroidal anti-inflammatory drugs, such as sustained-release diclofenac sodium tablets. The second category consists of disease-controlling drugs, which are often immunosuppressants, such as methotrexate and sulfasalazine. Third, if patients still experience significant back pain despite using anti-inflammatory analgesics and disease-controlling drugs, biologic agents can be considered. The main biologics currently include tumor necrosis factor antagonists. (Note: The use of medications should be under the guidance of a doctor.)

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Written by Li Jing
Rheumatology
49sec home-news-image

What department should I go to for ankylosing spondylitis?

Ankylosing spondylitis is an idiopathic systemic disease primarily characterized by chronic inflammation of the axial joints, mainly involving the sacroiliac joint. The typical onset age ranges from 10 to 14 years, and it is more common in males. It is not hereditary, but there is a familial predisposition. If there is a family history, and localized pain or discomfort is present, especially if there is difficulty turning over at night, stiffness after waking or after prolonged sitting or standing, which eases with activity, it is important to be alert. This condition falls under rheumatic immune diseases, therefore, it should be managed by a rheumatology immunology department, not orthopedics.