Chest And Lung Problems
Inflammation in the joints of the rib cage can lead to pain and stiffness in the chest, which may feel like angina or a lung problem. Over time, it can become harder for the rib cage to expand, and this can affect breathing.
Less commonly, scarring can occur at the top of the lungs. This can affect the way the lungs work, and make it harder to recover from colds and other respiratory diseases.
How Is Ankylosing Spondylitis Diagnosed
This condition is diagnosed from your symptoms and X-ray or magnetic resonance imaging pictures. Blood tests can be helpful, but mainly to rule out other conditions.
As the disease progresses, typical changes develop on X-ray pictures of the sacroiliac joints and spine. The X-ray pictures show the bones gradually fusing together. However, these changes may take several years to become bad enough to be seen on X-ray pictures.
Until recently, the X-ray changes were the only way to confidently confirm AS. More recently, an MRI scan of the sacroiliac joints has been used to confirm the diagnosis at an earlier stage. An MRI scan can give a much more detailed view of a joint than a traditional X-ray picture and can detect inflammation in the sacroiliac joints.
What Will Happen To Me
With the right treatment, most people with AS can lead full and active lives. Many people find there are times when their symptoms worsen , and times when their symptoms get better. In most cases AS can be well controlled with treatment and the pain improves over time. However, some people may have severe, long-lasting pain. As a result of the inflammation in the spine, new bone may grow around the joints. This leads to permanent stiffness in the back or neck of some people with AS. In severe cases this extra bone can fuse the bones in the spine together, stopping the spine from moving. Fusion of the spine can lead to a bent or forward stooped posture. This used to be common but can now usually be prevented by starting proper treatment as early as possible.
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A Whole Range Of Different Factors Can Contribute To Fatigue
- The underlying inflammatory process in AS can lead to fatigue. Researchers have found that chemicals called cytokines are found in inflamed tissue. These are similar to the type of chemicals released during viral illnesses such as colds and flu, and can cause extreme fatigue
- Anaemia is often found alongside inflammation. Do get this checked out with your GP
- Pain, especially long term pain, wears you down and can wake you up at night, adding to tiredness
- Sleep disturbance due to pain and stiffness in the night
- Certain drugs used to treat arthritis can cause drowsiness and interfere with concentration, which may make fatigue worse. Medications containing codeine or other opioids and medications such as amitriptyline are most likely to cause these side effects
- Weakness of the muscles can occur. This can contribute to fatigue since more effort will be required to perform certain activities
- Any long term condition can cause distress and uncertainty about the future. This can lead to depression, which is associated not only with a low mood but also with various physical symptoms, one of which is fatigue
Get Regular Health Screenings
Up to 50 percent of people with ankylosing spondylitis will develop inflammation of the eye at least once. Known as uveitis, this complication can become serious if left untreated, according to the SAA. When its detected early, uveitis can usually be treated with prescription eye drops. Make an annual appointment during your birth month or near a favorite holiday so you remember to have your eyes checked each year. If at any point you experience symptoms of uveitis such as eye pain or redness, blurred vision, or sensitivity to light, see your eye doctor right away.
Ankylosing spondylitis can also increase your risk of other conditions, such as osteoporosis, heart disease, and inflammatory bowel disease, so its important to see your doctor regularly for screenings and to discuss ways to reduce your risk. Getting regular preventive health exams, such as your annual well-visit and any recommended cancer screenings, can reduce your risk of getting sick and help you stay healthy overall.
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How Is It Diagnosed
Many people in the early stages of AS think they have common back pain and do not seek help. However, it is important to have AS diagnosed as early as possible as there are many effective treatments available. Your doctor will diagnose AS from your symptoms, a physical examination and blood tests to measure levels of inflammation. Your doctor may also order x-rays of your spine, but these tests can all be normal in the early stages. If your doctor suspects you have AS you should be referred to a rheumatologist, a doctor who specialises in arthritis.
When To Seek Medical Advice
You should see your GP if you have persistent symptoms of AS.
If your GP thinks you may have the condition, they should refer you to a specialist in conditions affecting muscles and joints for further tests and any necessary treatment.
Further tests may include blood tests and imaging tests.
Read about diagnosing ankylosing spondylitis.
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How Humira Works Video Transcript
HUMIRA Is a prescription medicine used to reduce the signs and symptoms of ankylosing spondylitis in adults. Individual results may vary. Please see Important Safety Information in video and on this web page. Please see Full Prescribing Information including Medication Guide, on this website.
Ankylosing spondylitis, or AS, is a condition that will be with you for the rest of your life, interrupting the harmony and balance in your immune system.
When your immune system is overactive, it can contribute to inflammation in your body, creating symptoms that typically start with pain and stiffness in your neck and lower back. Over time, it could affect new areas like your hips, shoulders, and feet.
The ongoing pain and stiffness that you feel in your joints may be a sign of increased inflammation.
If left untreated, AS pain can continue to worsen over time.
So, in order to reduce the signs and symptoms of AS back pain, and improve daily physical function, it is important to talk to your rheumatologist when symptoms appear.
No one knows exactly what causes AS, but we do know that several proteins produced in your body are involved.
One of these proteins is called TNF-alpha. Normally, TNF-alpha helps regulate immune activity and the amount of inflammation in your body.
HUMIRA is a prescription medicine known as a TNF-alpha blocker.
In clinical studies, HUMIRA has been proven to reduce the back pain and stiffness of AS.
Ankylosing Spondylitis Key Points
- Ankylosing spondylitis is a chronic form of arthritis that eventually causes limited mobility of the spine. However, some people go into remission.
- Symptoms and their severity vary from person to person.
- There is currently no cure for ankylosing spondylitis. When ankylosing spondylitis treatment is required, it is aimed at reducing pain and stiffness as well as trying to prevent deformity and limits on your activities.
- Generally, an ankylosing spondylitis prognosis for someone who receives medical therapy and engages in regular physical activity is good. People live with and manage the disease for decades and can usually overcome the pain and mobility limitations without severe limits in their day-to-day lives.
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What Are The Causes Or Risk Factors Of Ankylosing Spondylitis
Just like all other forms of inflammatory arthritis, there’s no known cause of ASbut there is a genetic component to the disease, as well as environmental factors that can contribute.
According to Dr. Schiopu and the Arthritis Foundation, a gene called HLA-B27 may put people at a greater risk of developing AS. The disease is also more common in men, and it’s frequently diagnosed in young adulthoodearlier than age 45, according to the NIAMS.
Ankylosing Spondylitis And Cardiovascular Disease
If you have AS, you have an increased risk of developing cardiovascular disease when you get older. Cardiovascular disease is disease of the heart and blood vessels, caused by a fatty substance called atheroma. This may eventually lead to conditions such as angina, heart attack or stroke. It is not clear why the risk is increased in people with AS. It may be that the persistent inflammation of the condition is partially responsible. There is some evidence that TNF-alpha inhibitors might reduce the risk of developing cardiovascular disease but further research is needed to confirm this.
You should consider doing everything you can to reduce the risk of cardiovascular disease by other means.
For example, if possible:
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Why As Flares Happen
There are many possible causes. More inflammation is partly to blame. Other things could play a role too.
You may feel worse because of conditions you might have in addition to AS. Or you might have an injury. A weather change could even be the cause. And a flare might mean that in some way, your treatment isnât working well enough.
Youre Young And You Have Unexplained Pain In The Heels Joints Or Chest
Instead of back pain, some AS patients first experience pain in the heel or pain and stiffness in the joints of the wrists, ankles, knees, or other joints.
Some patients rib bones are affected at the point where they meet the spine or where the ribs meet the sternum . This can cause tightness in the chest that makes it hard to breathe.
Talk with your doctor if any of these conditions occur or persist.
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Ankylosing Spondylitis & Spinal Deformity
We cannot stress enough that AS can lead to spinal deformity. Not only will your vertebrae fuse together over time, but you are also more likely to develop osteoporosis. Osteoporosis means porous bones. And, excessively porous bones with low bone mineral density cannot withstand everyday forces.
Weakened vertebrae will fracture on the front side when confronted with the even slightest pressure. Even a sneeze! As more and more vertebrae shatter into this wedge shape, the spine will arc forward .
If your AS involves kyphosis, then you need a board-certified spine surgeon who specializes in spinal deformity correction, like our team of spine specialists at The Advanced Spine Center. Dont let your life be ruled by pain and stiffness. Our doctors can help!
Talk To Your Doctor About Your Treatment
Even if your ankylosing spondylitis is well-controlled, its still important to see your doctor regularly. Your doctor can suggest how frequently you should come in. In general, people with ankylosing spondylitis should see their doctor every three months or so, Azar says. Schedule these appointments for the start of each new season. If your ankylosing spondylitis is stable and responding well to treatment, the minimum for visits with your doctor should be twice a year to monitor your condition, she says.
If you feel your treatment isnt working as well as it could, or youre having trouble taking your medication as prescribed, talk to your doctor about making adjustments to your treatment plan. Never stop taking your medication without talking to your doctor first. You should also let your doctor know about any other medications or supplements youre taking to avoid any potential interactions with your ankylosing spondylitis medication.
Taking these steps to stay healthy year-round can help you get the most from your biologic treatment for ankylosing spondylitis and improve your health overall.
Additional reporting by Erica Patino
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Are You Sure Its Just A Flare
I was diagnosed with ankylosing spondylitis nearly 12 years ago, and like so many of us, I dealt with this diabolical disease for years before I ever heard about AS. Ive had flares we all have. For me, the paralyzing fatigue comes first. Followed by the aches and chills that feel like the beginning of the flu. As the pain builds, theres really nothing in my arsenal to combat whats coming next. Its the worst, and my typical flare drives me to bed where Ill lay for hours, or days, completely at the mercy of my own immune system. Im now in far greater touch with my body, what sets off pain, and what doesnt. Ive developed a pretty good feel for what I need to do to keep my muscles and joints moving without inflicting damage. I see my doctors regularly, and I listen to what they tell me. After all these years I thought Id come to understand the complexities of this affliction, and what I could expect on any given day, week, or month. I can always predict a flare long before it levels me. Or so I thought.
One Friday evening, a day like any other, I fixed a salad for dinner, watched television, and then went to bed to read. I eventually switched off the light, rolled on my side and a sudden pain erupted in the left side of my chest. Startled, I moved to my back expecting relief, but my chest pain got worse. I got out of bed as the pain quickly became unrelenting. I travel with opioids that I rarely take, but I didnt hesitate a second as I took them.
Osteoporosis And Spinal Fractures
Osteoporosis is where the bones become weak and brittle. In AS osteoporosis can develop in the spine and increase your risk of fracturing the bones in your backbone. The longer you have the condition, the more this risk increases.
If you do develop osteoporosis, you’ll usually need to take medicine to help strengthen your bones.
There are a number of medicines that can be used to treat osteoporosis, which can be taken by mouth as tablets or given by injection.
Read about treating osteoporosis.
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What Are The Symptoms
Not everyone develops all of the following symptoms of ankylosing spondylitis, arthritis of the spine. What you experience depends on the severity of the condition:
- Stiffness and pain in the lower back, buttocks, and hips upon waking in the morning or after a period of inactivity
- Back pain relieved by movement and exercise
- Pain in the jaw, the temporomandibular joint
- Bent-over posture
- Straightening of the normal curvature of the spine
- Loss of appetite, weight loss
- Eye swelling, redness, and pain
- Sensitivity to light
- Difficulty taking a deep breath
- Heart failure
- Heart block
- Bowel inflammation like Crohn’s disease or ulcerative colitis
Ankylosing Spondylitis Symptoms & Treatment Options
Ankylosing Spondylitis is a rare form of arthritis that affects 0.1% to 1.4% of the population. If left untreated, AS can cause the bones of the spine to fuse together. In fact, ankylosing means just this: to stiffen or to bend.
Likewise, patients with AS will also experience inflammation of the spine, known as spondylitis. Early warning signs of AS, for example, often include pain that radiates into the buttocks from the sacrum, pelvis, or SI joint.
Inside the body, the story is a bit more complicated. Inflammation attacks the vertebrae, spinal discs, and connective tissues of the spine: your tendons and ligaments.
Swelling in these areas causes pain and makes moving the spine very difficult. As the swelling goes down, your body tries to repair the damage as if you had suffered from an injury. Scar tissue begins to form over the enthesis .
This process of scar formation, called fibrosis, can go on for quite some time. However, eventually, your body will replace the scar tissue with bone, or osseous tissue. Although the aim of this is to protect the tender tissues of your spine, the end result is the loss of a moveable joint.
If enough vertebrae in your spine fuse together, then a patient can experience spinal rigidity, or bamboo spine. On an X-ray, your spine will appear as a singular fused column, much like a stalk of bamboo. Your doctor will no longer be able to see your spinal discs or the spaces that should exist between your bones.
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Mild Or Early Ankylosing Spondylitis
Ankylosing spondylitis usually starts with dull pain in the low back and back stiffness. Some people with ankylosing spondylitis have “flares” of increased pain and stiffness that may last for several weeks before decreasing again.
- Affected bones of the low back, middle back, hips, or neck may become painful, stiff, and limited in motion. Pain tends to increase slowly over a period of weeks or months, and it is often hard to point to exactly where the pain is. Stiffness is usually worse in the morning and usually lasts for more than one hour. Pain is often noticeable in the early morning hours of sleep, such as between 3 a.m. and 6 a.m. Physical activity often helps decrease pain and stiffness.
- Some people feel tired as the disease progresses. This tiredness comes from the body fighting the inflammatory process that is part of ankylosing spondylitis and also from ongoing stiffness and pain.
- The coloured part of the eye may become inflamed. Symptoms of iritis include redness and pain in the eye and sensitivity to light.
Understanding Biologic And Biosimilar Medications
Most people are familiar with conventional medications such as pain relievers. These medications are made from chemicals .
Some of you may also have heard about biological or biologic medications which are used to treat serious illnesses, such as cancer, inflammatory bowel disease, psoriasis and rheumatoid arthritis. Biologics are special medications created using the biologic processes within living cells.
Conventional medicines and biologic medicines have important differences.
|Complex large molecules|
Some history on biologics…
It is common knowledge that when the patent expires on a conventional medication, other companies are allowed to make copies called generics. Although the active ingredient in a generic is exactly the same as the active ingredient in the original conventional medication, non-medicinal ingredients, like fillers and colouring, may be different.
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