DEAR DOCTOR K: I have ankylosing spondylitis. Can you discuss this condition and the best way to treat it?
DEAR READER: Ankylosing spondylitis is a form of arthritis in which the spine and other joints become inflamed and stiff.
A person with this condition usually feels pain or stiffness in the lower back, especially in the morning or after inactivity. Pain tends to begin in the two joints between the spine and the pelvis (the sacroiliac joints) and be felt in the buttocks. It then works its way up the lower spine. Eventually, the disorder can affect the entire spine and can cause discomfort in the torso and legs. Symptoms may alternately improve and worsen.
As the spine and its supporting structures stiffen, a person may begin to stoop over.
The stoop can become very severe. With time, the bones of the spine can fuse or grow together. This causes an extremely stiff, rigid backbone.
In addition to the spine and joints of the chest, ankylosing spondylitis can inflame the hip joints and fingers and toes. People with the disease also appear to be at greater risk for developing inflammation elsewhere in the body: the eyes (a condition called uveitis), the intestines (inflammatory bowel disease) and the inflammatory skin disease called psoriasis.
Pain and rigidity in the lower back can cause extreme pain and problems walking. At some point, a back brace or other devices, such a corset, cane or joint splints, may help. A rigid spine and stiff joints between the ribs and breastbone may make it harder for the chest to expand. As a result, it may be difficult to take a deep breath. Breathing exercises can help maintain your lung capacity.
Stiffness often improves with activity. Regular exercise can help prevent the disorder from getting worse. A physical therapist can develop an exercise routine to help the spine remain flexible. The routine probably will include range-of-motion and stretching exercises. Abdominal and back exercises can help maintain good posture. Swimming is a good exercise because it may be easier to move stiff, painful areas in the water. Biking is another good option.
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