By Kaycee Reyes
Have you had back pain and stiffness for quite some time? Experiencing fatigue? Neck pain? These symptoms are indeed common, that most of us may assume that it is temporary or stress related. But have you ever heard of ankylosing spondylitis (AS)? This chronic disease is a debilitating one if not detected early, and yes, the initial symptoms are as common as mentioned above. The lack of awareness of this disease has led to the formation of the Ankylosing Spondylitis International Federation (ASIF) and its annual World Ankylosing Spondylitis Day that is held every month of May. Its aim is to unite patients from around the world and provide awareness about the condition to the public. In the Philippines, Novartis Healthcare Philippines has partnered with the Philippine Rheumatology Association (PRA) and patient group Ankylosing Spondylitis Association of the Philippines (ASAP) as it celebrated World Ankylosing Spondylitis (WAS) Day 2019 last May 5 in Pasay City with the theme “Move as One Versus Back Attack.” The forum invited patients and their families to share their experiences, and also physicians to discuss AS, from symptoms to treatment.
Ankylosing spondilitis, according to ASIF, is a “rheumatic inflammatory disease primarily affecting the spine and sacroiliac joints” (left and right joints found in the base of the spine that connects to the pelvic bone). It is a debilitating disease that may cause chronic, intense pain and discomfort that can ultimately affect one’s quality of life. Initial symptoms appear as early as late adolescence to early adulthood. In fact, as high as eighty percent of AS patients get the diagnosis before age 30, according to the Spondylitis Association of America. These symptoms start as back pain and stiffness especially when immobile or at rest, arthritis, and/or fatigue. AS can also cause pain and stiffness in other areas of the body such as the shoulders, hips, jaw, and joints of the hands and feet, among others. AS may also be related with psoriasis, inflammatory bowel disease (Crohn’s disease or ulcerative colitis), or eye conditions uveitis or iritis, according to ASIF. Over time, AS can cause the vertebrae, or bones that form the spine, to join together as new bones form, making physical movement more difficult, the posture hunched, and sometimes, even breathing is affected. AS has no known cause, but the presence of a certain gene, HLA-B27, increases the risk. Men are also twice or three times more likely to develop AS than women. Symptoms take time to develop, and sometimes they come and go, which is why early diagnosis and treatment is challenging yet crucial. The physician may ask for symptoms, its duration, and when they started to appear. If the symptoms happened at the usual age AS is diagnosed, experiencing back pain and discomfort for at least three months, and physical movement has become limited, the patient may have a higher possibility that he/she has AS. Other tests will be conducted, including MRI, a blood exam, an x-ray, and an ultrasound to confirm the diagnosis. Treatment for AS includes a combination of medication, exercise, physical therapy, and pain management. Sometimes, surgery may be required to manage pain or to correct the posture if the condition is severe.
AS has no known cause, but the presence of a certain gene, HLA-B27, increases the risk. Symptoms take time to develop, and sometimes they come and go, which is why early diagnosis and treatment is challenging yet crucial.
It may sound rare and unheard of, but ankylosing spondylitis is one of the most common types of chronic inflammatory arthritis. In diagnosing AS, timing is important, as those that are detected early may have a higher chance to live a normal life as long as possible. Luckily, medical advancements have helped AS patients in reducing the pain and managing the symptoms of AS. If you are experiencing long-term back pain, and other of the symptoms mentioned above, it is best to consult immediately with your doctor, who may refer you to a rheumatologist. Do not self-medicate, nor dismiss any symptom that you have been experiencing for quite some time. As with AS patients, support from family, friends, and other individuals with the condition help as much as medications can. With or ganizations such as ASAP, PRA,and medicine companies like Novartis that all promote and lead AS awareness in the country, we can all spread the information about AS and, hopefully, find a cure in the years to come.