Ankylosing spondylitis


How is ankylosing spondylitis treated?
The treatment of ankylosing spondylitis mainly consists of three types: The first is anti-inflammatory pain relief, primarily using non-steroidal pain relief medications, such as sustained-release diclofenac sodium tablets. The second is the selection of disease control medications, mainly involving drugs like sulfasalazine tablets. For ankylosing spondylitis, the most effective and economically expensive treatment is biological agents therapy. We commonly use drugs such as tumor necrosis factor antagonists. Patients with ankylosing spondylitis during acute pain periods are advised not to engage in intense exercise. However, during remission periods, appropriate functional exercises are recommended to prevent the adhesion and stiffness of spinal joints.


How to control ankylosing spondylitis
The treatment of ankylosing spondylitis mainly consists of three parts: The first part is the use of non-steroidal anti-inflammatory drugs, such as sustained-release diclofenac sodium tablets; the second is the choice of disease control medications, which may include sulfasalazine or methotrexate tablets, especially for patients with peripheral joint pain, immunosuppressive drugs can be chosen. The most effective for ankylosing spondylitis are biologics, but before using biologics, it is necessary to exclude hepatitis, tuberculosis, and cancerous diseases, and the cost of biologics is relatively high. (Please use medications under the guidance of a professional physician and do not self-medicate.)


What is the ESR level in ankylosing spondylitis?
Patients with ankylosing spondylitis, if not well controlled, can exhibit elevated erythrocyte sedimentation rates (ESR). An ESR higher than 20 mm per hour indicates elevation, suggesting poor disease control. At such times, it is necessary to utilize non-steroidal anti-inflammatory drugs (NSAIDs) such as sustained-release diclofenac sodium tablets. Additionally, medications that control the condition should also be used, like sulfasalazine tablets and thalidomide, among others. While biological agents, commonly tumor necrosis factor (TNF) antagonists, offer the best treatment effectiveness, they are also the most expensive. (The use of medications should be conducted under the guidance of a physician.)


Early symptoms of ankylosing spondylitis
The early symptoms of ankylosing spondylitis mainly include insidious onset of pain and discomfort in the back and hip joints. The pain is often intermittent and worse at night. Patients frequently wake up at night due to back pain, which can be alleviated by slight movement. Therefore, when patients experience unexplained back and hip joint pain, it is necessary to determine whether ankylosing spondylitis could be a possibility. In the early stages, a sacroiliac joint CT scan and hematological examination can be performed to confirm the diagnosis. Once diagnosed, prompt standardized treatment is necessary. Generally, this can control synovial inflammation and pain, prevent deformities of the spine and joints, and help patients return to normal life and work.


What tests are done for ankylosing spondylitis?
The main laboratory indicators for ankylosing spondylitis include the following: Testing for the B27 gene, formally known as HLA-B27 gene, which is hereditary and commonly found in male patients. Second, to determine if ankylosing spondylitis is in an active phase, inflammatory markers such as erythrocyte sedimentation rate and C-reactive protein can be checked. Moreover, the diagnosis of ankylosing spondylitis must involve the sacroiliac joints being affected. Therefore, a CT scan and MRI of the sacroiliac joints can be conducted to determine if there are issues with the sacroiliac joints. If the patient shows symptoms of inflammatory lower back pain, has affected sacroiliac joints, tests positive for the B27 gene, and shows elevated inflammatory markers, then a diagnosis of ankylosing spondylitis can generally be confirmed.


What to do about ankylosing spondylitis pain?
The methods for treating pain in ankylosing spondylitis primarily include non-steroidal anti-inflammatory drugs, such as sustained-release diclofenac sodium tablets; secondly, biologics can be considered for pain relief, but before using biologics, it is necessary to rigorously rule out diseases such as hepatitis, tuberculosis, and tumors. During the painful periods of ankylosing spondylitis, patients are advised to rest appropriately to alleviate joint inflammation. However, after the pain subsides, it is recommended that patients engage in functional exercises to prevent complications such as further adhesion and stiffening of the spinal joints. (Specific medications should be taken under the guidance of a physician.)


What to do about ankylosing spondylitis pain?
The medications for treating pain in ankylosing spondylitis fall into three major categories: The first category includes non-steroidal anti-inflammatory drugs, such as sustained-release diclofenac sodium tablets. The second category consists of disease-controlling drugs, which are often immunosuppressants, such as methotrexate and sulfasalazine. Third, if patients still experience significant back pain despite using anti-inflammatory analgesics and disease-controlling drugs, biologic agents can be considered. The main biologics currently include tumor necrosis factor antagonists. (Note: The use of medications should be under the guidance of a doctor.)


How long does ankylosing spondylitis take to cause paralysis?
Ankylosing spondylitis is an autoimmune disease and a chronic condition. It primarily involves damage to the axial joints. Additionally, extrajoint manifestations can occur, such as iritis, keratitis, and corneal perforation. Currently, there is no effective cure for ankylosing spondylitis, meaning it cannot be completely cured. The treatment focuses on long-term medication management to control symptoms, delay complications, improve quality of life, and reduce disability rates. This is the main goal of treatment. Without proper treatment, deformities in the joints and spinal ankylosis can develop within a relatively short period, about seven to eight years, leading to a hunched back and significant restriction in joint mobility. Proper treatment can significantly delay joint damage. Regarding whether ankylosing spondylitis can lead to paralysis, it does not cause paralysis but does result in decreased energy and ability for activities such as turning, twisting the head, or bending, which are significantly restricted.


How to exercise with ankylosing spondylitis?
Once diagnosed with ankylosing spondylitis, after ruling out contraindications such as hepatitis B infection and tuberculosis, it is necessary to administer standard medications to improve rheumatic conditions. At the same time, it is necessary to develop good living habits, such as abstaining from alcohol, quitting smoking, and avoiding carbonated drinks and coffee, as these can exacerbate osteoporosis. Secondly, it is important to exercise regularly; one can walk slowly, run, or swim. Swimming is the best form of exercise for patients with ankylosing spondylitis as it can enhance the coordination of limb muscles while also delaying joint wear. Thirdly, it is important to maintain good posture and sleep on a hard bed.


How is ankylosing spondylitis treated?
The treatment of ankylosing spondylitis mainly consists of three parts: The first part is anti-inflammatory and pain relief. For anti-inflammatory pain relief, non-steroidal pain relief medications are commonly chosen, such as slow-release diclofenac sodium tablets and celecoxib capsules. The second part involves the selection of medications to control the disease. Common drugs used to control the condition include sulfasalazine, thalidomide, and methotrexate tablets. The third part includes the most effective, yet most expensive, treatment option: biological agents. Common biological agents used are tumor necrosis factor antagonists. However, before using biological agents, strict screening for diseases such as hepatitis, tuberculosis, and cancer is required. Only after excluding these conditions can the treatment with biological agents be considered.