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Friday, 20 October 2017

There are over 200 types of rheumatic disease and over nine million people in the UK have some form of arthritis. Arthritis means inflammation of the joints. Most people with arthritis will experience pain and some difficulty in moving around.

Arthritis affects people of all ages, including children. It is not clear what causes it and there is no cure at present. However, treatment can largely alleviate the symptoms and enable people to continue to live an active life, although some modifications may be necessary.

Rheumatic Conditions FAQs

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Ankylosing spondylitis

Ankylosing spondylitis (AS) is a form of inflammatory arthritis that affects the joints of the lower back. Ankylosing means stiffening and spondylitis means inflammation of the spine. There is no cure for AS, but, like most forms of inflammatory arthritis, it can go into remission – often when people reach their fifties.

The disease is more common in people with the HLA-B27 tissue type, one of the HLA genes from the HLA-B family. HLA-B27, while not being the only determining factor in ankylosing spondylitis, is present in 95% of people with this condition. It is, however, present in 8% of the general population. Other diseases such as reactive arthritis and psoriatic arthritis can also be associated with HLA-B27.

The cause is not clear, but it is more common in men than women, and is more frequently seen in younger people. In AS, the sacroiliac joints (which join the base of the spine to the pelvis) become inflamed. This is why your lower back may feel sore first thing in the morning. Longstanding or repeated bouts of inflammation cause scar tissue to form in the spaces between vertebrae (the chain of bones that make up the spine). In time, this scar tissue may turn into bone and fill the space between the vertebrae. This effectively fuses the joint, which limits movement of the spine.

The initial symptoms of AS are pain, aching and stiffness in the lower back. You may also feel pain further up the back and restricted movement of the chest. Some people experience pain and discomfort on and off for a number of years until the inflammation ceases, but most are able to lead a full and active life. In others movement of the spine may be severely limited. You may feel overwhelmingly tired at times. Another symptom is inflammation of the eyes (iritis) which needs immediate treatment to prevent further damage. The hip joints are also sometimes affected.

Early diagnosis and treatment is important to minimise damage to your joints. Exercise is vital to maintain mobility, prevent the joints from being fused into a bad position and to help relieve pain. You will be referred to physiotherapy for a specific exercise programme. Anti-inflammatory drugs can be prescribed to reduce pain and stiffness.

Information about the Inflammatory Spinal Group which meets at Ipswich Hospital.

More information from the National Ankylosing Spondylitis Society.