Ankylosing spondylitis (AS) is an inflammatory disease that causes pain and stiffness in the spine, pelvis, and other joints, like the hips, knees, feet, and shoulders. AS is a chronic (lifelong) disease, and it is hereditary. Although a majority of people who have AS carry a gene called HLA-B27, about 80% of people who have inherited the gene from a parent with AS do not develop the disease. The onset of AS is usually diagnosed in individuals between 17 and 45 years of age. Males are diagnosed 2 to 3 times more often than females, and tend to have more severe disease symptoms than females. Physical therapists help people with AS maintain productive lives by working with them to increase their strength, muscle flexibility, and joint mobility, and to improve their posture.

What is Ankylosing Spondylitis?

Ankylosing spondylitis (AS) is an inflammatory disease affecting the spine, pelvis, and joints throughout the body. AS causes abnormal bone growth, and causes joints to fuse (grow together) in the spine and in the sacroiliac joints (located between each hip and the pelvis). Vital organs like the heart, lungs, and eyes may also be affected. Rare complications include inflammation of the heart, scarring of the nerves of the spine, and kidney problems related to the long-term use of medication.

Although there is currently no cure for AS, proper treatment can help decrease the pain and stiffness associated with the disease. Medications decrease inflammation and localized swelling. If the hip joint becomes stiff and painful, total hip replacement may be performed.

Symptoms of Ankylosing Sppondylitis?

The first and most common symptom experienced with the onset of AS is pain in the sacroiliac joints and the low back. You may also gradually experience hip and shoulder pain. Pain is often accompanied by morning stiffness or stiffness after periods of prolonged inactivity, and usually improves after exercise or activity. Other common symptoms are fever, generalized fatigue, and loss of appetite.

Bony fusion or ankylosis typical of AS in the joints of the neck, spine, and hips causes progressive stiffness and can reduce your ability to turn your head, stand upright, or bend. AS can make maintaining good posture difficult, and can cause you to stoop forward. Poor posture makes it easier to lose your balance, and causes difficulty in walking, increasing the risk of falling. In advanced cases, osteoporosis (thinning of the bones) may occur, which increases the risk of fractures.

Inflammation is very common in AS. The inflammation usually is felt at the sites where ligaments and tendons attach to the bone. These sites are tender to touch and sometimes called “hot spots.” The heel and the back of the foot are common sites for tender spots, which can cause difficulty in standing and walking.

People with AS may develop difficulty breathing because the lungs and the joints where the ribs and spine attach become stiff, limiting chest expansion and causing shortness of breath, and increasing the risk of chest infections.

AS can also affect the soft tissues of the eye (in about 40% of cases), resulting in swelling in the eye (uveitis). Individuals may also experience eye redness, pain, "floaters," and an increased sensitivity to light.

How can a B2LCARE'S Physiotherapist help you?

Physical therapy will help improve your posture and joint mobility, reduce pain, and help you perform your everyday functional activities more easily. Your physical therapist may teach you:

Posture Training to improve your posture and help you avoid slouching or forward bending. This training is important to ensure that you maintain an upright posture.

Strengthening Exercises to strengthen your back and abdominal muscles and help you maintain proper posture and walking, and perform your activities of daily living.

Flexibility Exercises to maintain and improve joint mobility. Exercises for your leg and chest muscles, and gentle range-of-motion exercises help keep the spine and other joints from getting stiff. Aquatic exercises have been shown to decrease joint pain and improve movement in patients with AS.

Stretching Exercises for the trunk muscles to improve chest expansion.

Deep-Breathing Exercises to improve chest expansion and help you breathe better. Improved breathing increases oxygen and blood flow in the body, which can help decrease stiffness, pain, and fatigue.

Pain Management Techniques, such as using ice or heat packs to manage inflammation and pain in the joints. Your physical therapist may prescribe a TENS unit, which is an electrical stimulation treatment used to alleviate pain.

Individual Activities to improve your functional ability and energy, and help reduce fatigue. Your physical therapist will teach you how to move your body efficiently when performing daily activities to avoid strain. Your physical therapist may recommend using an assistive device, such as a cane or walker to improve your walking, lessen pain, and lower your risk of falling.

Your physical therapist will partner with you to ensure that you maintain your best posture, flexibility, joint mobility, and muscle strength, so you can lead a productive, fulfilling life. We are here to help!