How is ankylosing spondylitis treated?

Written by Yang Ya Meng
Rheumatology
Updated on December 01, 2024
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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 Yang Ya Meng
Rheumatology
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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 Na Hong Wei
Orthopedics
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Symptoms of ankylosing spondylitis

The main symptom of ankylosing spondylitis is pain, characterized by pain in the lower back and lumbar region. The pain occurs during rest and diminishes with activity; it is especially severe at night, often waking the sufferer, who then finds mild activity alleviates the pain enough to return to sleep. As the disease progresses, chest pain and restricted rib cage movement begin, due to the disease spreading to the thoracic vertebrae and eventually reaching the cervical vertebrae in later stages, resulting in difficulty moving the neck. Early physical signs include tenderness in the sacroiliac joints and paraspinal muscles. X-rays can reveal that the sacroiliac joints are often the first to be affected, usually showing sacroiliitis. Additionally, there is a particularly high positivity rate for HLA-B27, the human leukocyte antigen B27, which can reach up to 90%, whereas it is typically around 4%-9% in the general population.

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Written by Yang Ya Meng
Rheumatology
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What medicine is used for ankylosing spondylitis?

The medication for ankylosing spondylitis mainly involves three aspects. The first is non-steroidal pain-relief medications, commonly including drugs like sustained-release diclofenac sodium tablets. The second involves drugs that control the condition, commonly using medications like sulfasalazine and thalidomide. The third, which is currently the most effective, involves treatment with biologics. Common biologics include tumor necrosis factor inhibitors. However, before using biologics, it is crucial to rigorously rule out complications such as hepatitis, tuberculosis, and tumors. Only after excluding these conditions should one consider using biologics. Patients with ankylosing spondylitis should also pay attention to appropriate functional exercises in daily life to prevent the stiffening of spinal joints. (Medications should be used under the guidance of a doctor, based on the specific situation.)

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Written by Li Jing
Rheumatology
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Can people with ankylosing spondylitis have children?

Firstly, ankylosing spondylitis is an autoimmune disease and is chronic. This disease cannot be cured; rather, it is managed long-term through medications to alleviate symptoms, control the progression of the condition, and delay the onset of joint deformities, which is the main purpose of treatment. This disease is not hereditary, but there is a clear phenomenon of familial aggregation. For instance, if one or both parents have it, the incidence in their children is over 50%. Patients with ankylosing spondylitis can have children, but there is a very high probability that their children will also suffer from the disease. Additionally, it is advised not to conceive while on medication during the treatment period; one must stop taking the medication for more than three months before considering pregnancy.

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Written by Li Jing
Rheumatology
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Ankylosing Spondylitis Exercise Methods

Ankylosing spondylitis is an autoimmune disease that primarily affects the axial joints and currently has no curative treatment. Its treatment includes general measures, medication, and surgery. General measures mainly involve abstaining from alcohol, quitting smoking, avoiding carbonated drinks and coffee, which can lead to osteoporosis. In addition, it is important to focus on exercise; functional exercises are a crucial part of its treatment. Regular activities such as swimming, walking, and running are recommended, and chest-expanding exercises can improve muscle rigidity. Moreover, it is advisable to sleep on a hard bed to keep the spine level. Swimming is the best form of exercise for patients with ankylosing spondylitis as it does not overload the joints while also enhancing the coordination and flexibility of the limb muscles.