It is not uncommon for people to think that arthritis only affects older people. Unfortunately, that is not always true. Ankylosing spondylitis is a type of inflammatory arthritis that affects young people in their 20s and 30s. It is characterised by inflammation in the back, specifically at the joint where the lower vertebra meets the pelvic bone. Other joints in the shoulders, hips, feet and knees can also be affected. AS can also lead to skin problems like psoriasis; eye problems like red eye/anterior uveitis; and chronic diarrhoea like inflammatory bowel disease. In severe cases of untreated AS, the spinal vertebrae fuse leading to poor flexibility that can be disabling and severely limits mobility.
Symptoms of AS: The most common early symptoms for AS are increasing stiffness and chronic pain in the back. Morning stiffness can last for about half an hour after waking up. Back pain worsens during the night leading to disturbed sleep. Patients may also experience pain in the hips, knees or shoulders and experience alternating buttock pain. AS symptoms are worse after inactivity and improve with exercise.
Treatment of AS: AS is diagnosed after a thorough medical examination, in addition to some blood and imaging tests, by a rheumatologist. MRI scans can help to visualise joint damage in the early stages of the disease. In addition, a genetic test to detect the presence of the HLA-B27 gene aids diagnosis because a majority of patients with AS have this gene.
A rheumatologist can choose from a number of medicines to treat AS. Nonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed to treat the swelling and relieve the pain. Steroids offer immediate relief but cannot be used over a long period. Depending on what joints are affected, a class of medicines known as disease-modifying anti-rheumatic drugs (DMARDs) can be effective. Some patients who do not respond to these treatments are prescribed “biologics” that slow down and even stop the progression of the disease.
Dietary recommendations for AS: There is no specific diet that has shown proven benefits for AS. However, those who eat healthy are more likely to be within their optimal weight range, which is very important to avoid putting excessive stress and pressure on painful joints. One must make sure that at least half the plate comprises vegetables and fruit, opt for whole grain instead of refined grain, cut back on mithai and sugary desserts and drinks, reduce the amount of sugar, salt and oil that is added to food while cooking, and stay hydrated by drinking sufficient water.
It is not uncommon for people to think that arthritis only affects older people. Unfortunately, that is not always true. Ankylosing spondylitis is a type of inflammatory arthritis that affects young people in their 20s and 30s. It is characterised by inflammation in the back, specifically at the joint where the lower vertebra meets the pelvic bone. Other joints in the shoulders, hips, feet and knees can also be affected.
AS can also lead to skin problems like psoriasis; eye problems like red eye/anterior uveitis; and chronic diarrhoea like inflammatory bowel disease. In severe cases of untreated AS, the spinal vertebrae fuse leading to poor flexibility that can be disabling and severely limits mobility.
Symptoms of AS: The most common early symptoms for AS are increasing stiffness and chronic pain in the back. Morning stiffness can last for about half an hour after waking up. Back pain worsens during the night leading to disturbed sleep. Patients may also experience pain in the hips, knees or shoulders and experience alternating buttock pain. AS symptoms are worse after inactivity and improve with exercise.
Treatment of AS: AS is diagnosed after a thorough medical examination, in addition to some blood and imaging tests, by a rheumatologist. MRI scans can help to visualise joint damage in the early stages of the disease. In addition, a genetic test to detect the presence of the HLA-B27 gene aids diagnosis because a majority of patients with AS have this gene.
A rheumatologist can choose from a number of medicines to treat AS. Nonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed to treat the swelling and relieve the pain. Steroids offer immediate relief but cannot be used over a long period. Depending on what joints are affected, a class of medicines known as disease-modifying anti-rheumatic drugs (DMARDs) can be effective. Some patients who do not respond to these treatments are prescribed “biologics” that slow down and even stop the progression of the disease.
Dietary recommendations for AS: There is no specific diet that has shown proven benefits for AS. However, those who eat healthy are more likely to be within their optimal weight range, which is very important to avoid putting excessive stress and pressure on painful joints. One must make sure that at least half the plate comprises vegetables and fruit, opt for whole grain instead of refined grain, cut back on mithai and sugary desserts and drinks, reduce the amount of sugar, salt and oil that is added to food while cooking, and stay hydrated by drinking sufficient water.
Dos and Don’ts for AS: Visit
doctor regularly, as recommended, eat a healthy diet, lose weight if not within the optimal BMI range, consult doctor if experiencing any side effects as a result of medication and exercise regularly.
Do not stop medication without consulting the doctor, do not skip any medication doses, do not stay inactive for long periods of time and do not smoke.
The writer is senior consultant physician and rheumatologist.