Spondylitis is also known as ankylosing spondylitis, rheumatoid spondylitis or Spondylarthropathy. This causes joint inflammation, especially the large joints, of the spinal bones, and between the pelvis and spine. This disease is long term and invariably results in the affected spinal bones fusing together.
Who are at risk ?
There are no specific causes for people getting affected by spondylitis although genes do play a role. Those between the ages of 20-40 are the high risk group although children below 10 can get spondylitis. It is likely that 3 times more men than women get affected by spondylitis and those with siblings or parents with this disease are more likely to have it.
Symptoms of Spondylitis
Be aware of personal risk factors. Then you can identify spondylitis symptoms. Early detection can lead to prompt treatment and easing of the problems. If left untreated, spondylitis can cause physical deformities at an early age.
Low back pain: This is the earliest spondylitis symptom. The pain is centered in the lower back and it comes and goes. Stiffness and pain are severe early morning, at night or when you are inactive. Sometimes the pain is so severe that it prevents a good nights rest. Appropriate exercises and other activities help you manage the pain. The back pain originates between the spine and pelvis (the sacroiliac joints). Slowly it spreads to the entire spine or a large portion of it.
The stiffness that patients feel early morning is relieved by morning activities and the muscle spasms are relieved by bending forward. Hence, spondylitis patients often stoop forward to relieve pain and slowly assume a bent posture.
Uveitis: Uveitis causes irritation and inflammation of the middle eye layer called uvea. The retina receives most of its blood supply from the uvea. Uveitis causes blurred vision, eye pain, sensitivity to light, redness of the eye and the patient seeing floating, dark spots.
Joint pain: This affects most of the joints of the body and is very bothersome. There are many causes for joint pain and one of them is spondylitis. Swelling of the joint happens when there is fluid retention in the soft tissues of any joint. Joint pain occurs usually along with swelling. The joints appear larger than normal. They feel stiff and painful. Those affected by spondylitis find that the swelling occurs at the knee, shoulder and ankle joints. If the joints that connect the spine and ribs are inflamed, it can restrict the ability of the chest wall to expand.
Damage to the heart valve: Some patients experience spondylitis symptoms like an inflamed heart valve. This can permanently damage the valve and affect the aorta and heart muscles.
Compression fractures: The bones of some people can begin to thin causing weakened vertebrae. This causes patients to assume an extremely bent posture. The thinning of bones also causes compression fractures of the vertebral column.
Other symptoms: Along with the low back pain, patients suffer from low-grade fever, loss of appetite, weight loss, fatigue or excessive tiredness, hip pain that causes stiffness of movements and anemia.
Two complications of spondylitis are Achilles tendinitis or Cauda Equina Syndrome. Cauda Equina syndrome is a surgical emergency that is caused due to compression of the spinal nerve roots. One cause is the pressing of inflamed spondylitis joints on these nerves. Achilles tendinitis occurs when the tendons located at the heel bone tear. This causes heel pain in some patients.
What to do?
Those who suffer from spondylitis symptoms must consult their family doctor who may ask them to see a specialist in inflammatory disorders. Before your appointment, make a list of all symptoms. The doctor performs a physical exam and recommend various tests based on his findings.
Treatment of Spondylitis
After a series of tests like pelvic and spinal X-rays, spinal MRI (magnetic resonance imaging), HLA-B27 antigen (to get protein count on white blood cells), ESR (erythrocyte sedimentation rate) or CBC (complete blood count), the doctor will be able to pinpoint the causes of spondylitis symptoms. NSAIDs (non-steroidal anti-inflammatory drugs) are the most common medication given to ease the pain and inflammation. Stronger medications or therapies may be given to suppress the immune system. Surgery could be performed if the joints are badly damaged or the pain is unbearable.
Those with uveitis will be given appropriate eye drops. Sometimes doctors will inject medication to relieve joint pain. Long-range goals are to help patients manage the pain and maintain proper posture in the form of exercises. Physiotherapy will also be recommended.
Spondylitis : Prevention and Precaution
There is no cure for spondylitis. Since it is usually hereditary, there are no preventive measures but just ways to prevent complications. The condition can be managed with physiotherapy and medication to relieve the pain. Physiotherapy uses physical treatment like manipulation and massage to provide spinal flexibility and increase comfort levels. During physiotherapy, only the soft tissues and muscles will be manipulated and never the spinal bones or vertebrae – for this can cause permanent injury.
It is recommended that patients use a firm mattress and not use a pillow. This prevents spinal curvature. Patients must do the exercises diligently to enable them to maintain an erect posture and improve joint mobility. Breathing exercises are taught to expand the lung capacity and ease breathing. Swimming and aerobics are two preferred exercise regimes. Those with spondylitis can take part in athletics.
The progression of spondylitis varies among patients. 70-90% patients are only slightly disabled and lead normal lives. In some, after 10 years, the back and neck become rigid – ankylosis. Long term ankylosis causes the rib cage to become inflexible and stiff.
People who smoke are strongly advised to discontinue since motion of the chest wall is restricted due to spondylitis that in turn impairs lung function.
Since spondylitis cannot be cured, the condition of patients could worsen over time. Most people can live productive lives. See if you can find an online or local support group to share experiences and get emotional support from patients with the same condition.