Does ankylosing spondylitis hurt?

Written by Li Jing
Rheumatology
Updated on September 28, 2024
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Ankylosing spondylitis primarily targets the axial joints, manifesting as a chronic autoimmune disease. The most common clinical symptoms include stiffness in the neck and pain in the lumbar and back regions, areas particularly associated with axial joint involvement, predominantly affecting the spine. Additionally, symptoms can also appear in areas outside of the joints, such as pain in the peripheral joints, heels, wrists, and shoulders. Moreover, some individuals may experience eye inflammation, including recurrent uveitis and corneal ulcers. While spinal pain, neck stiffness, and lumbar or back pain are the most commonly observed clinical manifestations, hip joint pain is also frequently noted.

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Written by Li Jing
Rheumatology
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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.

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Written by Li Jing
Rheumatology
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What causes ankylosing spondylitis?

Ankylosing spondylitis is primarily an autoimmune disease affecting the axial joints, which may also manifest with extra-articular symptoms. In severe cases, deformities and stiffening of the spine can occur. The cause of the disease is attributed to the interactive effects of genetics and environmental factors, making it a multi-gene inherited disorder. However, for some individuals, it may also be related to infections such as Ureaplasma urealyticum, Shigella, Salmonella, and Escherichia coli in the urinary and genital tracts. These pathogens trigger the body's inflammatory immune response, resulting in tissue damage and contributing to the onset and progression of the disease. There is a notable familial aggregation in the occurrence of this disease.

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Written by Yang Ya Meng
Rheumatology
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How to control ankylosing spondylitis

The treatment of ankylosing spondylitis mainly consists of three parts: The first part is the use of non-steroidal anti-inflammatory drugs, such as sustained-release diclofenac sodium tablets; the second is the choice of disease control medications, which may include sulfasalazine or methotrexate tablets, especially for patients with peripheral joint pain, immunosuppressive drugs can be chosen. The most effective for ankylosing spondylitis are biologics, but before using biologics, it is necessary to exclude hepatitis, tuberculosis, and cancerous diseases, and the cost of biologics is relatively high. (Please use medications under the guidance of a professional physician and do not self-medicate.)

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Written by Yang Ya Meng
Rheumatology
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What to check for ankylosing spondylitis?

The examination for ankylosing spondylitis mainly includes blood tests. The main components of the blood tests are erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), ANA along with CCP antibodies, and AKA antibodies, and of course, the most crucial test related to the gene - HLA-B27. Imaging exams can include the following: First, an X-ray of the pelvis, or an MRI of the sacroiliac joints. If the disease has been present for a longer time, a CT of the sacroiliac joints can be chosen. If the patient has elevated ESR and CRP, a positive B27, and lesions in the sacroiliac joints, then the diagnosis of ankylosing spondylitis can be confirmed.

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Written by Yang Ya Meng
Rheumatology
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How is ankylosing spondylitis treated?

The treatment of ankylosing spondylitis mainly consists of three types: The first is anti-inflammatory pain relief, primarily using non-steroidal pain relief medications, such as sustained-release diclofenac sodium tablets. The second is the selection of disease control medications, mainly involving drugs like sulfasalazine tablets. For ankylosing spondylitis, the most effective and economically expensive treatment is biological agents therapy. We commonly use drugs such as tumor necrosis factor antagonists. Patients with ankylosing spondylitis during acute pain periods are advised not to engage in intense exercise. However, during remission periods, appropriate functional exercises are recommended to prevent the adhesion and stiffness of spinal joints.