How is ankylosing spondylitis treated?

Written by Yang Ya Meng
Rheumatology
Updated on December 01, 2024
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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.

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Written by Yang Ya Meng
Rheumatology
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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
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Does ankylosing spondylitis have a genetic component?

Firstly, ankylosing spondylitis is a chronic disease that primarily affects the axial joints, and this disease is incurable. It can only be managed with medications to control the progression of the disease, delay the appearance of joint deformities, and reduce disability. This is the main purpose of its treatment. The cause of the disease is also unclear, and it is somewhat related to genetics. If parents have it, the incidence in their children is significantly increased, and there is a phenomenon of familial aggregation. It cannot be considered a hereditary disease, but there is indeed a phenomenon of familial aggregation. Moreover, the incidence of the disease in children is much higher than in families without a history of the disease.

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Written by Li Jing
Rheumatology
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What should I do in the late stage of ankylosing spondylitis?

Firstly, ankylosing spondylitis is an autoimmune disease primarily affecting the axial joints, but it can also present with extra-articular manifestations. Severe cases can lead to ankylosis and deformities of the spine, which are complications of late-stage ankylosing spondylitis. At this stage, surgery is needed to manage the activity of the disease. If the activity of the disease is not controlled, even joint replacement can still lead to the progression of the disease and further damage to the joint structures. For severe disabling deformities, spinal orthopedic surgery can be considered, and spinal surgery is required when an acute fracture occurs.

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Written by Li Jing
Rheumatology
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How is ankylosing spondylitis diagnosed?

Ankylosing spondylitis is an autoimmune disease that cannot be cured but can be managed primarily through medication. Its main typical symptoms include stiffness in the neck or pain in the lower back, with the pain becoming more apparent when at rest or after sitting for a long time. Symptoms tend to improve with movement. A typical occurrence is pain that awakens the patient at night. Peripheral joints like the knee joint and heel can also be affected. However, the main symptoms are stiffness in the neck and pain in the lower back. Diagnosing ankylosing spondylitis requires combining symptoms with a positive B27 blood test result, and imaging tests such as CT or MRI of the sacroiliac joints, showing signs of sacroiliitis, narrowing or damage in the sacroiliac joint space, to confirm the diagnosis.

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Written by Yang Ya Meng
Rheumatology
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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.