Ankylosing Spondylitis (AS)

What is Ankylosing Spondylitis?

Ankylosing spondylitis (AS) is severe inflammatory arthritis that affects the spine and pelvis. At least 80 bones in the head, face, ear, neck, rib cage, vertebral column, and sternum, which form part of the axial skeleton, and the sacroiliac joints are affected in this condition. The sacroiliac joints are the joints where the spine and the pelvis meet. These joints are the first joints to be affected. Gradually, the inflammation moves from these joints to the point where ligaments and tendons join the vertebrae. Deposits of calcium formed in the ligaments around the intervertebral discs, cause the spine to fuse together and prevent movement. This condition is known as ankyloses. Ankylosing Spondylitis leads to stiffness and back pain, reduced range of motion, and can cause deformity, resulting in affecting the quality of life. In severe cases of AS, spinal fusion can take place in the thoracic spine (upper back region) and cervical spine (neck).

What is the cause of Ankylosing Spondylitis?

Several factors are responsible for AS, or for increasing the likelihood of AS. Genetics, Race, Age, Gender, and Environmental factors are some of them. There is a strong hereditary factor connected with the disease. Gender: About 95% of people have the human leukocyte antigen (HLA)-B27 protein in their blood and there is a 50% risk of passing the antigen to children. Family history of AS or another spondyloarthropathy disorder like Psoriatic arthritis, Reiter’s syndrome (reactive arthritis), and Crohn’s disease and ulcerative colitis (arthritis of inflammatory bowel disease).

Race: AS is found to be more common among Caucasians or people who have Northern European ancestry.

Age: AS is found to be common in people between the ages of 17 and 45. In case AS occurs before the age of 16, it is known as juvenile-onset AS.

Gender: AS is more common among males.

Environmental factors like frequent gastrointestinal infections or bacterial infection.

What are the signs and symptoms of Ankylosing Spondylitis?

The symptoms of AS are varied. It starts gradually with mild to severe pain. The pain is often intermittent. It flares up sometimes and then decreases. There are several symptoms of AS. For example, it starts with low back pain, dull pain in the hips, and buttocks (sacroiliac joints). Gradually the pain is felt in the upper back and ribs with the progression of the disease. The pain increases in the morning or after no activity and reduces with exercise. Usually, it affects the hips and the spine which become sensitive and stiff. It also results in a reduction in the range of motion of the back, neck and hips.

About 25% of people are also affected by eye disease, like conjunctivitis (pink eye) and iritis (eye inflammation). Due to stiff rib joints and the consequently decreased range of motion in the chest, the heart and lungs can also be affected over time, making it difficult to breathe. This can lead to narrowing of the spinal canal and put pressure on the spinal cord and nerves. As a result, the nerve can get damaged due to spinal fracture or cauda equine syndrome, connected to bowel and bladder dysfunction, which requires emergency treatment.

How is Ankylosing Spondylitis treated?

Treatment for AS consists of medications, physiotherapy, and surgery. Pain and stiffness can be controlled if it is diagnosed in early stages. It also reduces the possibility of the spine fusing together and leading to deformities. Physiotherapy is considered essential in treating AS. A wide range of medications are used for AS. Non-steroidal anti-inflammatory medications (NSAIDs) used are Ibuprofen (Advil and Motrin) or naproxen (Aleve), which are available over-the-counter or prescribed. TNF inhibitors bisphosphonates, which are biologic medications, are found to be successful in slowing the progress of the disease. Antibiotics and Corticosteroid injections help in reducing inflammation. Disease modifying anti-rheumatic drugs (DMARDs) are also used for AS, even though they are found to be more effective for outer joints. Surgery is performed when less invasive treatments are not effective, and only when there is a high risk of complications. Usually, it is not required. However, if surgery is undertaken as the last resort, physiotherapy becomes important for rehabilitation.

Physiotherapy is a non-surgical and drug-free treatment that aims at relieving pain, regaining strength, and preventing deformity. It also aids in increasing joint mobility, function, and improving quality of life. Physiotherapy is based on individual requirements. It includes stretching, strengthening, and range of motion exercises. Functional retraining and activity modification are included. In order to delay or prevent the progression of the disease, a personalized exercise routine is provided. Physiotherapy may include breathing exercises, hydrotherapy, bracing, and patient education regarding posture and sleeping. Other therapies are cross-disciplinary pain-relieving therapies, such as occupational therapy, acupuncture massage therapy, manual therapy, and interferential current therapy (IFC) or TENS therapy. At our clinic we have notice by using Simply Align Technique which includes advance physical modalities, activity modification and specific exercises we have faster, longer lasting results with reduced healing time. Please note that if you have AS you need to be under care of a rheumatologist.

If you are looking for a treatment for AS, call your physiotherapist now at #3630 Lawrence Ave E, Scarborough, ON M1G 1P6 or at 200 Marycroft Ave, Unit #6, Woodbridge, ON,  L4L 5X9.

Can Ankylosing Spondylitis go away on its own?

No. Ankylosing Spondylitis is a serious condition and needs to be treated effectively. It is important to include certain activities in the daily routine. For example, daily exercises and stretching can help prevent joint stiffness and pain. It is equally important to avoid any activity that increases the pain. Other recommendations usually include practicing pilates, switching from high intensity (jogging) to low intensity (walking and swimming) activities, and aerobic exercises that are beneficial for the lungs. Avoiding smoking is also advisable. Treatment includes applying heat and cold therapy, use of an ergonomic chair at work, and using a supportive mattress and pillow. Dietary modifications include taking fish oil supplements, which contain natural anti-inflammatory properties, and aids in conditions like rheumatoid arthritis and back pain. It is important to take care of one’s overall well-being, by taking mindfulness courses that will have a positive impact and help in managing pain, fatigue, and improvement in self-efficacy.

Can you prevent Ankylosing Spondylitis?

No. One can reduce the chances of developing AS by making certain changes in one’s lifestyle and staying active. Regular exercising, doing stretching exercises, like yoga or tai chi for 30 minutes daily, will increase the flow of blood to the spine and reduce the pressure on the intervertebral discs. It is also important to take a non-inflammatory diet (without sugar and refined, processed foods), avoid staying in one position for long periods of time, and drinking plenty of water in order to maintain a healthy weight. All these in addition to practicing good posture will help reduce the stress on the facet joints in the spine.

Are you concerned about Ankylosing Spondylitis? Consult a physiotherapist at 3630 Lawrence Ave E, Scarborough, ON M1G 1P6 or at 200 Marycroft Ave, Unit #6, Woodbridge, ON,  L4L 5X9 today!

What are the signs and symptoms of Ankylosing Spondylitis?

The symptoms of AS are varied. It starts gradually with mild to severe pain. The pain is often intermittent. It flares up sometimes and then decreases. There are several symptoms of AS. For example, it starts with low back pain, dull pain in the hips, and buttocks (sacroiliac joints). Gradually the pain is felt in the upper back and ribs with the progression of the disease. The pain increases in the morning or after no activity and reduces with exercise. Usually, it affects the hips and the spine which become sensitive and stiff. It also results in a reduction in the range of motion of the back, neck, and hips. About 25% of people are also affected by eye disease, like conjunctivitis (pink eye) and iritis (eye inflammation). Due to stiff rib joints and the consequently decreased range of motion in the chest, the heart and lungs can also be affected over time, making it difficult to breathe. This can lead to narrowing of the spinal canal and put pressure on the spinal cord and nerves. As a result the nerve can get damaged due to spinal fracture or cauda equine syndrome, connected to bowel and bladder dysfunction, which requires emergency treatment.

How is Ankylosing Spondylitis treated?

Treatment for AS consists of medications, physiotherapy, and surgery. Pain and stiffness can be controlled if it is diagnosed in early stages. It also reduces the possibility of the spine fusing together and leading to deformities. Physiotherapy is considered essential in treating AS. A wide range of medications are used for AS. Non-steroidal anti-inflammatory medications (NSAIDs) used are Ibuprofen (Advil and Motrin) or naproxen (Aleve), which are available over-the-counter or prescribed. TNF inhibitors bisphosphonates, which are biologic medications, are found to be successful in slowing the progress of the disease. Antibiotics and Corticosteroid injections help in reducing inflammation. Disease modifying anti-rheumatic drugs (DMARDs) are also used for AS even though they are found to be more effective for outer joints.

Surgery is performed when less invasive treatments are not effective, and only when there is a high risk of complications. Usually, it is not required. However, if surgery is undertaken as the last resort, physiotherapy becomes important for rehabilitation. Physiotherapy is a non-surgical and drug-free treatment that aims at relieving pain, regaining strength, and preventing deformity. It also aids in increasing joint mobility, function, and improving quality of life. Physiotherapy is based on individual requirements. It includes stretching, strengthening, and range of motion exercises. Functional retraining and activity modification are included. In order to delay or prevent the progression of the disease, a personalized exercise routine is provided.

Physiotherapy may include breathing exercises, hydrotherapy, bracing and patient education regarding posture and sleeping. Other therapies are cross-disciplinary pain-relieving therapies, such as occupational therapy, acupuncture massage therapy, manual therapy, nd interferential current therapy (IFC) or TENS therapy.

If you are looking for a treatment for AS, visit our physiotherapist now at 3630 Lawrence Ave E, Scarborough, ON M1G 1P6 or at 200 Marycroft Ave, Unit #6, Woodbridge, ON,  L4L 5X9

Can Ankylosing Spondylitis go away on its own?

No. Ankylosing Spondylitis is a serious condition and needs to be treated effectively. It is important to include certain activities in the daily routine. For example, daily exercises and stretching can help prevent joint stiffness and pain. It is equally important to avoid any activity that increases the pain. Other recommendations usually include practicing pilates, switching from high intensity (jogging) to low intensity (walking and swimming) activities,and aerobic exercises that are beneficial for the lungs. Avoiding smoking is also advisable. Treatment includes applying heat and cold therapy, use of an ergonomic chair at work, nd using a supportive mattress and pillow. Dietary modifications include taking fish oil supplements, which contain natural anti-inflammatory properties, and aids in conditions like rheumatoid arthritis and back pain. It is important to take care of one’s overall well-being, by taking mindfulness courses that will have a positive impact and help in managing pain, fatigue,and improvement in self-efficacy.

Can you prevent Ankylosing Spondylitis?

No. One can reduce the chances of developing AS by making certain changes in one’s lifestyle and staying active. Regular exercising, doing stretching exercises, like yoga or tai chi for 30 minutes daily, will increase the flow of blood to the spine and reduce the pressure on the intervertebral discs. It is also important to take a non-inflammatory diet (without sugar and refined, processed foods), avoid staying in one position for long periods of time and drinking plenty of water in order to maintain a healthy weight. All these in addition to practicing good posture will help reduce the stress on the facet joints in the spine.

Are you looking for physiotherapy or a Chiropractor? If Yes, then visit Simply Align Rehab Physio in Scarborough/Toronto or Woodbridge/Vaughan or you can always call or text us for your Physiotherapy or Chiropractor needs in Toronto at (416) 438-3230 or For Physiotherapy or Chiropractor need in Vaughan (Woodbridge) at (905) 638-9840.

Also Read

Adult Degenerative Scoliosis Ankle Osteoarthritis
Ankle Osteoarthritis Ankylosing Spondylitis (AS)
Base of Thumb Arthritis Bouchard’s Nodes
BursitisCarpal Tunnel Syndrome
Cervical Osteoarthritis / Neck ArthritisElbow Bursitis
Elbow Osteoarthritis Facet Joint (Spinal) Osteoarthritis
Finger Arthritis Foot Bursitis
Gout Heberden’s Nodes
Hip Bursitis Hip Osteoarthritis
Juvenile Scoliosis

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