Information From Your Health Care Provider

SPONDYLITIS, ANKYLOSING

(Marie-Strümpell Disease)

Basic information

description

Ankylosing spondylitis is a chronic, progressive, rheumatic disease of the joints. Ankylosing means "fusing together." Spondylitis means "inflammation of the vertebrae" (bones in the spine). Males are affected more often than females. The onset is usually in the late teens or early twenties. It often starts where the lowest part of the spine (sacrum) joins the ilium bone of the pelvis.

FREQUENT SIGNS & SYMPTOMS

Early stages:
- Recurrent episodes of low back ache. Pain can also occur along the sciatic nerve (along the leg).
- Stiffness in the spine (especially in the morning).
- The symptoms can be mild and a person may think it is just a common back ache.
Later stages:
- Symptoms gradually become worse. Pain often spreads from the lower back to the middle back, or higher in the neck. Joints in the arms, legs, feet, and hands may be affected.
- It can bring about a "bent forward" posture caused by stiffening of the spine and support structures.
- Muscle stiffness.
- Fatigue; weight loss.
- Iritis (eye redness and soreness).

causes

Unknown. Genetic factors appear to play a role. The disorder causes some or all the bones of the spine to fuse together.

risk increases with

Family history of ankylosing spondylitis.
Having a certain gene called HLA-B27.

PREVENTIVE MEASURES

No specific preventive measures. Consult your health care provider if you have a family history of the disorder and have ongoing back or joint pain.

expected outcomes

There is no cure for this disorder. Symptoms change with mild or moderate flare-ups and they may stop for periods of time. With treatment, symptoms can be relieved or controlled. Most patients can lead normal, productive lives. For some, the disease is severe and incapacitating due to deformities.

possible complications

Heart and lung problems.
Eye inflammation.
Difficulty walking and standing.
Osteoporosis and fractures of the spine.
Anemia.
Permanent disability.

diagnosis & treatment

general measures

Your health care provider will do a physical exam and ask questions about your symptoms. Medical tests may include blood studies and x-rays of the spine.
Physical therapy, exercise, and drugs can help delay or prevent deformity, ease pain, and maintain function.
Physical therapy includes exercises for breathing techniques, to maintain proper posture, and to build up muscle groups (to oppose the direction of possible deformities).
Sleep on your back on a firm mattress. Use a small pillow or none at all.
Take hot baths or use heat compresses before exercising or to relieve pain. Get regular massages, if possible.
Quit smoking. Find a way to stop that works for you.
See your eye care provider for regular exams.
Surgery to replace a damaged hip or to insert bone grafts in the spine (advanced stages only).
To learn more: Spondylitis Association of America, PO Box 5872, Sherman Oaks, CA 91413; (800) 777-8189; website: www.spondylitis.org.

medications

Use nonprescription, nonsteroidal anti-inflammatory drugs to help ease discomfort.
Drugs to treat arthritis symptoms, stronger pain drugs, and muscle relaxants may be prescribed.

activity

Exercise to maintain good posture and retain as much upright carriage as possible.
Swim regularly, if possible. Your buoyancy in water will allow you to move stiff, painful areas more easily.
Avoid activity that puts stress on the back. Avoid contact sports (too much risk of spinal injury).