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Back pain early in the morning?  Could be AS

Ahead of World Ankylosing Spondylitis Day on May 4, Dr Sarath Chandra Mouli Veeravalli tells Kakoli Mukherjee what we need to know about the disease. 

Published: 02nd May 2019 04:38 AM  |   Last Updated: 02nd May 2019 06:55 AM   |  A+A-

By Express News Service

HYDERABAD: Ahead of World Ankylosing Spondylitis Day on May 4, Dr Sarath Chandra Mouli Veeravalli tells Kakoli Mukherjee what we need to know about the disease. 

What is Ankylosing Spondylitis?
Ankylosing Spondylitis (AS) is a chronic, inflammatory and autoimmune disease that mainly affects the joints of the spine. 
Also known as ‘arthritis of the spine,’ it occurs when an overgrowth in the spine’s bones causes them to fuse together to form a rigid spine. This condition is found among males and females in the ratio of 9:1. It commonly affects young men in their teenage years and in their early twenties or thirties.
The condition which affects men during the most active and productive years of their lives, can lead to ‘structural damage progression’.  
This means, if the condition is left untreated and undiagnosed, it can severely disrupt mobility, cause damage to posture, which can bend the spine and neck to such an extent that it may become impossible for one to lift their head high enough to see forward. In some severe cases of Ankylosing Spondylitis,  patients can become wheelchair bound.

Key symptom
Pain in the back during early mornings, especially 30-45 minutes after waking up which can last up to several weeks or more, despite taking painkillers.
Causes and diagnosis
Most people with AS have a gene called HLA-B27 which can be detected by a blood test. 
While this gene is not the absolute cause of Ankylosing Spondylitis, it can contribute to it. Also, if one has this gene, it does not necessarily mean that the person would definitely be affected by AS. 
In addition, environmental factors and a sedentary lifestyle can also contribute to this condition. Ankylosing Spondylitis can cause further damage if smoking, drinking and sedentary lifestyle continues after diagnosis of the condition.
AS is generally diagnosed through physical examination, X-Ray, MRI and a series of blood tests.

Treatment
Painkillers, anti-inflammatory drugs, low dose steroids and disease modifying drugs are prescribed by consulting doctors to ease inflammation and accompanying pain. While commonly used painkillers help reduce pain and inflammation, they provide short-term relief. 
Regular physiotherapy exercises play a crucial role in the management of AS. 
Medical experts also recommend newer and advanced treatment options like biologics, that help slow down structural damage progression and aim at preventing bone fusion, which could be disabling. 
Biologics have dramatically transformed the lives of millions of people with AS worldwide and are now also available in India. 
If patients have been diagnosed with AS, it is advised that they make a timely visit to a rheumatologist with necessary blood reports.
Precautions
AS is an auto-immune condition that occurs when immune cells (antibodies) of the body mistakenly attack the healthy cells of the vertebrae causing the spinal fusion. Due to the auto-immune nature and the genetic makeup that comes with this disease, one may not completely restrict it from happening as it occurs from within the body. However, when diagnosed on time, it can be effectively managed with the consultation of a rheumatologist to decrease the chances of further structural damage and progression.
 AS is an auto-immune disease while spondylosis is a degenerative one. 

Is there a cure? 
AS cannot be completely cured. However, effective treatment options such as biological therapy can help manage the structural damage progression to a large extent. The time taken for the treatment largely depends on the severity of this condition and pre-medical history of patients which is different from patient to patient. 



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