1. Myth or Fact? Ankylosing Spondylitis (AS) Only Affects the Back
This is a big myth. Ankylosing Spondylitis (AS) is a form of inflammatory, painful arthritis that mainly affects the lower back and spinal joints (vertebrae). However, other joints such as the knee, shoulders, hips, ribs, heels and small joints of the hands and feet can be involved, too.
Even the eyes can be affected with a condition known as uveitis, and rarely, the lungs and heart, too.
- The word spondylitis refers to inflammation of the spine; ankylosis means fusion of two bones into one.
- The joints between the vertebrae, and the joints between the spine and the pelvis eventually grow together (fuse).
- This can limit movement and cause severe pain.
People with severe AS may stoop over due to the fixed position of the spine – this is termed kyphosis.
2. Myth or Fact? Ankylosing Spondylitis Only Affects the Elderly
This is also a myth. Ankylosing Spondylitis (AS) is uncommon and rarely begins after the age of 45.
- It occurs most frequently in white males 20 to 40 years old, although it can occur in children, too.
- Even though ankylosing spondylitis is a type of arthritis, it only affects about 1 in 1000 people.
The exact cause of AS is not known, but there does appear to be a genetic link as it does run in families. About 90% of people with AS also have a gene that produces a “genetic marker” – a protein called HLA-B27. However, having the gene doesn’t mean you will absolutely get AS – fewer than 5% of people with HLA-B27 get AS.
3. Myth or Fact? Ankylosing Spondylitis is Easily Curable
This is a myth, too. There is not a cure for Ankylosing Spondylitis (AS); however, there are FDA-approved medications that can reduce AS symptoms and help to manage the pain.
- AS is characterized by acute, painful relapses of back pain followed by periods of remission where symptoms subside.
- In some patients, pain may occur elsewhere – for example in the shoulders, hips, ribs, and small joints of the hands and feet.
- Pain may be worse in the morning and decrease during the day and with exercise.
AS is an autoimmune disorder, which is an illness that occurs when the immune system wrongly attacks tissues in the body. NSAIDs are helpful for pain and studies show TNF blockers can slow or halt AS disease progression.
Secukinumab (Consentyx), the first in a new class of medicines called interleukin-17A (IL-17A) inhibitors was FDA approved in 2016 to treat AS. Consentyx significantly reduces signs and symptoms of AS and increases overall mobility.
4. Myth or Fact? Diagnosis of Ankylosing Spondylitis Requires Many Tests
Not really, this is a myth. Usually the diagnosis is fairly straightforward. A rheumatologist, a specialized arthritis doctor, will usually make the initial diagnosis.
An X-ray or MRI can show if there is inflammation of the sacroiliac joints (the sacroiliac joints link your pelvis and lower spine). The doctor may also run a blood test for the presence of genetic markers, and symptoms and history help to make the diagnosis. They also look for:
- Evidence of low back pain and stiffness for a period of 3 months, which improves with exercise, but is not relieved by rest.
- Limits of lumbar spine motion while bending
- Limits of chest expansion when breathing.
5. Myth or Fact? Drugs Are the Only Way to Treat Ankylosing Spondylitis
This statement is a myth.
While medications are one component, they aren’t used alone. The goals of treatment with AS are fourfold:
- Lessen joint pain and stiffness
- Slow disease progression
- Prevent joint deformity, such as kyphosis
- Maintain posture and daily work and life function
Treatment for AS involves a multi-stepped approach: medication, exercise and/or physical therapy, applying heat / cold for muscle relaxation and to relieve joint pain.
Joining an ankylosing spondylitis support group may provide benefits, as well, like discussion among your peers and keeping up with the latest news. However, support or chat groups should never replace the advice of your physician.
6. Myth or Fact? People with Ankylosing Spondylitis Should Avoid Exercise
Absolutely not, another myth. A defined plan of physical therapy and individualized exercise is important for everyone with AS.
Back stiffness, especially in the morning, is one feature of AS that often improves with activity. People who have this disorder may get worse if they do not exercise regularly. The physician may send the patient to the physical therapist who can develop a plan of stretching, deep breathing and range-of-motion exercises. Hydrotherapy (pools, whirlpool spas, hot tubs, and physiotherapy tanks) may be used as well.
Physical therapy can help to keep the back flexible, prevent stooping, make daily activities easier, and lower the chances of severe pain or further injury.