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INJURY TITLE
| Ankylosing spondylitis ‘AS’ |
GENERAL INFORMATION
| This is a systemic based inflammatory condition that affects the skeleton. It shows in genetically predisposed individuals although environmental factors can play a role in its presentation. ‘AS’ is thought to be either inherited or derived from an infection. Although it can affect the whole skeleton, it is typically seen as inflammation of the sacroiliac joints (specifically the ligaments) at the base of the spine. This will be felt as varying combinations of stiffness and pain on movement of the spine.
It affects roughly 3/1000 in the UK population, typically starting at a young age (teens to late twenties). It was thought that it affected women more than men although the numbers seem fairly balanced now. Many studies have shown a good functional outcome for those diagnosed with ‘AS’ with some 78% of sufferers maintaining a good level of function. |
COMMON SIGNS & SYMPTOMS
| – Stiffness (particularly in the morning for usually over an hour)
– Pain (can be local to the spine but also spread throughout the limbs) an accurate description of the pain must be taken by a qualified clinician such as a physiotherapist or doctor. – fatigue – disability ( this will vary from day to day and from case to case). – sometimes a flexion deformity can be seen in the middle of the back I between the shoulder blades. However, the condition has varying levels of severity and physical signs such as this may not always be present. |
HOW IS IT ASSESSED
| -Clinical examination may reveal some of the characteristic signs and symptoms ( also regular attention to various joint ranges of motion in the back and limbs will help chart any changes in the condition)
-X-Ray is also an important diagnostic tool for this presentation. -Blood test will check for blood markers (blood marker HLA B27) indicating the presence of the pathology. -Checking through family history. -Referral to a rheumatologist quickly is desired |
GENERAL TREATMENT
| Medical management
Drug therapy falls into three categories 1) drugs to affect the process, 2) non steroidal anti-inflammatory drugs, 3) pain medication. Depending on your particular symptoms, one or more methods of medical management may be needed. This particular approach would of course be managed by your GP and rheumatologist.
Physiotherapy Physiotherapy has a role of education and advice regarding the condition. Adequate stretching and strengthening programs will help to maintain a functional level of flexibility in the spine (it will also help limit postural changes that may occur). Swimming is actively encouraged, and hydrotherapy often a useful treatment. Also the NASS run organised exercise groups and my operate in your area. |
WHICH HEALTH PROFESSIONAL TO CONSULT
| PHYSIO X | MEDIC X | PODIATRY |