You've probably never heard of it, but ankylosing spondylitis affects many men
Pain and stiffness in your lower back that is worse at night, in the morning and after prolonged inactivity is an early sign of ankylosing spondylitis, a type of arthritis that typically affects the joints of the spine. This inflammatory condition that cannot be cured, can also affect the hips, knees, ankles and feet, causing pain and stiffness and affecting movement.
Patients may feel fatigued and find it difficult to get out of bed or even walk. In severe cases, new bone may form in the gaps between the vertebrae, causing them to fuse together and become rigid, which can lead to a twisted or severely hunched back.
Fusion of the vertebrae can also affect the functioning of the lungs and cause breathing difficulties, and increase your risk of cardiovascular disease.
Who is at risk of ankylosing spondylitis?
The exact cause of ankylosing spondylitis is unknown though heredity plays a significant role, with the gene HLA-B27 being associated with it. About 2-10 in 1,000 people in Singapore are estimated to suffer from ankylosing spondylitis which tends to begin between the ages of 20 and 40.
“Why this age group is most affected is still unknown but it may be due to the inheritance of the HLA-B27 gene,” says Dr Warren Fong, Consultant, Department of Rheumatology & Immunology, Singapore General Hospital. “Locally, a majority of our patients are males (about 75 per cent) and Chinese (about 80 per cent).”
Ankylosing spondylitis cannot be prevented but you can slow down its progression and reduce the severity of symptoms with early diagnosis and treatment. Regular physical activity and avoiding smoking can also help to improve symptoms.
“Smoking has been shown to result in greater spinal fusion, a complication of ankylosing spondylitis. Furthermore, patients with ankylosing spondylitis can have greater difficulty breathing due to reduced movements of their rib cage, and smoking can compound this problem by causing further lung injury,” says Dr Fong.
How is ankylosing spondylitis treated?
There is no cure for this condition, which is typically treated with a combination of medication and physiotherapy. Acupuncture can help with pain relief.
Medication – this can help to manage pain and reduce inflammation and damage to the joints.
Physiotherapy – this can help with range of motion, posture control, balance, and muscle strengthening, and it can also increase lung capacity and improve cardiovascular fitness.
For greater comfort, sleep on a mattress that provides adequate support, and if you have heel pain, use gel-heel cushions in your shoes when walking and exercising.
“There are no food restrictions and one should have a healthy and well-balanced diet,” says Dr Fong.
SGH is holding a public forum on ankylosing spondylitis on 16 December 2017.
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