1. Myth or Fact? Ankylosing Spondylitis (AS) Only Affects the Back
This is a myth. Ankylosing Spondylitis (AS) is a form of inflammatory, painful arthritis that mainly affects the lower back and spinal joints (vertebrae). However, other joints such as the knee, shoulders, hips, ribs, heels and small joints of the hands and feet can be involved, too. Even the eyes can be affected (uveitis), and rarely, the lungs and heart.
The word spondylitis refers to inflammation of the spine; ankylosis means fusion of two bones into one. The joints between the vertebrae, and the joints between the spine and the pelvis eventually grow together (fuse). This can limit movement and cause severe pain. People with severe AS may stoop over due to the fixed position of the spine – this is termed kyphosis.
2. Myth or Fact? Ankylosing Spondylitis Only Affects the Elderly
This is also a myth. Ankylosing Spondylitis (AS) is uncommon and rarely begins after the age of 45. It occurs most frequently in white males 20 to 40 years old, although it can occur in children, too. Even though ankylosing spondylitis is a type of arthritis, it only affects about 1 in 1000 people.
The exact cause of AS is not known, but there does appear to be a genetic link as it does run in families. About 90% of people with AS also have a gene that produces a “genetic marker” – a protein called HLA-B27.
However, having the gene doesn’t mean you will absolutely get AS – fewer than 5% of people with HLA-B27 get AS. Two new genes, IL23R and ERAP1, have recently been discovered and may also carry a genetic risk for AS.
3. Myth or Fact? Ankylosing Spondylitis is Easily Curable
Myth here. There is not a cure for Ankylosing Spondylitis (AS); however, there are FDA-approved medications that can reduce AS symptoms and help to manage the pain. AS is characterized by acute, painful relapses of back pain followed by periods of remission where symptoms subside. In some patients, pain may occur elsewhere – for example in the shoulders, hips, ribs, and small joints of the hands and feet. Pain may be worse in the morning and decrease during the day and with exercise.
AS is an autoimmune disorder – an illness that occurs when the immune system wrongly attacks tissues in the body. NSAIDs are helpful for pain and studies show TNF blockers can slow or halt AS disease progression.
In 2016, secukinumab (Consentyx), the first in a new class of medicines called interleukin-17A (IL-17A) inhibitors was FDA approved to treat AS. Consentyx significantly reduces signs and symptoms of AS and increases overall mobility.
4. Myth or Fact? Diagnosis of Ankylosing Spondylitis Requires Many Tests
Not really, this is a myth. Usually the diagnosis is fairly straightforward. A rheumatologist, a specialized arthritis doctor, will usually make the initial diagnosis.
An X-ray or MRI can show if there is inflammation of the sacroiliac joint. The doctor may also run a blood test for the presence of genetic markers, and symptoms and history help to make the diagnosis.
Evidence of low back pain and stiffness for a period of 3 months, which improves with exercise, but is not relieved by rest.
Limits of lumbar spine motion while bending
Limits of chest expansion when breathing.