What to do about ankylosing spondylitis pain?

Written by Yang Ya Meng

Rheumatology

Updated on December 17, 2024

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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.)

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Written by Li Jing

Rheumatology

54sec

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Does ankylosing spondylitis have a genetic component?

Ankylosing spondylitis is an autoimmune disease primarily affecting the axial joints. The onset is determined by both genetic and environmental factors, leading to the disease. This means that the disease exhibits a significant familial aggregation and genetic predisposition. If the parents have it, the incidence in their children is much higher than in others. However, it is definitely not a genetic disease; it just has familial clustering and genetic tendencies. If symptoms like stiffness in the neck or pain in the lower back intensify when at rest and decrease after activity, it is essential to use CT or MRI scans and test for HLA-B27 to check for damage or narrowing in the sacroiliac joints. Early diagnosis and early treatment are crucial to improve the prognosis of the condition.

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Written by Na Hong Wei

Orthopedics

1min 34sec

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What is Ankylosing Spondylitis?

Ankylosing Spondylitis (AS), where "A" stands for fusion and "S" for spine, refers to the condition where the bones and joints of the spine are fused together. Ankylosing Spondylitis is defined as a chronic inflammatory disease primarily affecting the axial skeleton and major limb joints. It is characterized by fibrosis and ossification of the intervertebral discs’ annulus fibrosus and nearby connective tissues, as well as ankylosis (stiffening) of the joints. It presents as a sterile inflammation occurring in the spine. However, it is not solely limited to the spine as it also involves the axial bones and major limb joints. The pathological hallmark of the disease includes inflammation mainly at the sacroiliac joints and points of attachment to the spine, leading to joint stiffness and calcification of the spinal ligaments and joints. The disease progression begins at the sacroiliac joint, spreading upwards through the entirety of the spine, and eventually stops at the cervical vertebrae. Symptoms start with pain in the early stages, followed by restricted mobility in the intermediate phase, and ultimately leading to deformities of the abdomen and back, culminating in severe hunchback. The exact cause of Ankylosing Spondylitis remains unclear, with various theories proposed but none universally accepted. Additionally, it is categorized under rheumatologic and immunologic disorders.

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Written by Yang Ya Meng

Rheumatology

52sec

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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.)

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Written by Yang Ya Meng

Rheumatology

55sec

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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.)

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Written by Li Jing

Rheumatology

53sec

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Can people with ankylosing spondylitis have children?

Firstly, ankylosing spondylitis is an autoimmune disease and is chronic. This disease cannot be cured; rather, it is managed long-term through medications to alleviate symptoms, control the progression of the condition, and delay the onset of joint deformities, which is the main purpose of treatment. This disease is not hereditary, but there is a clear phenomenon of familial aggregation. For instance, if one or both parents have it, the incidence in their children is over 50%. Patients with ankylosing spondylitis can have children, but there is a very high probability that their children will also suffer from the disease. Additionally, it is advised not to conceive while on medication during the treatment period; one must stop taking the medication for more than three months before considering pregnancy.