Neck Pain, Back Pain and Sciatica – Understanding and Treating Ankylosing Spondylitis

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Ankylosing spondylitis is an arthritic condition that affects the spine and is also characterized by sacroiliac joint involvement, peripheral inflammatory arthropathy, and an absence of the rheumatoid factor. Symptoms of ankylosing spondylitis include neck pain, back pain, and sciatic nerve pain. Individuals with this condition experience the destruction of the cartilage and bone resulting in fibrous and bony ankylosing or fusing of the spine, pelvis, ribs, and other joints of the body. Patients with ankylosing spondylitis typically exhibit what is referred to as a stiff or "poker spine." Mobility of the spine usually is decreed symmetrically, meaning on both sides, but does seem to improve with exercise. The pain associated with this condition may range from mild to chronic and acute and has often been referred to as insidious. The pain associated with ankylosing spondylitis is often described as morning stiffness. Ankylosing spondylitis is slightly more prevalent in men and symptoms in men are generally more severe. Native American populations are most affected, although the reasons are unclear. Depending on the severity of the disease, posture may become affected. Ultimately, the condition may result in total disability.

Ankylosing spondylitis is often responsible for significant changes in the spinal and the pelvis, particularly the sacroiliac joint, that joint between the pelvis (hips) and the sacrum (tailbone), as mentioned above. In skeletal samples, the vertebrae are often visibly fused over significant portions of the spine from the cervical (neck) to the base of the lumbar region or curvature (low back). The fusions in this condition are often bony with several vertebrae locked into place, thus the name ankylosing spondylitis. Because the spine, and often the sacroiliac joint becomes fused, mobility is restricted, bending becomes a problem if not impossible, and side to side motion is restricted. It was once believed that an individual diagnosed with ankylosing spondylitis was faced with a life without prospects, this no longer needs to be the case. Given the proper treatment strategy individuals may lead a long and productive life.

In addition to ankylosing of the spinal, ankylosing spondylitis may cause significant changes, and varying degrees of pain, at other areas of the body, as well. While bony fusions of the vertebrae and sacroiliac joint are the most common, fusions of the ribs to vertebrae and the sternum (breastbone) are not uncommon and may cause difficulties expanding the chest and breathing. Additionally, tendons and ligaments that attach themselves to or come into contact with bone may also become inflamed and painful. Tendonitis may be expressed at any point in the body and is often evidenced in the Achilles tendon, causing a significant amount of heel pain.

Because ankylosing spondylitis is a systemic disease, symptoms may present themselves anywhere in the body. It is not uncommon for people suffering from ankylosing spondylitis to have elevated sedimentation rates, fevers, fatigue, loss of appetite, eye irritation, and even heart and lung disease. The condition itself may be difficult to diagnose, as the cause is yet unknown and no cure is available. An individual suffering from ankylosing spondylitis, in its worst expression, may end debilitating neck pain, back pain, and sciatic nerve pain along with stiffness and / or immobility over vast areas of the spinal, hips, and even the peripheral joints.

While there is no known cure for ankylosing spondylitis, there are treatments available to alleviate, and in some cases eliminate, the pain and discomfort. Programs have been developed to improve flexibility and function. Ankylosing spondylitis is progressive but it is possible, through exercise and stretching, to improve and even maintain good posture, preventing the stoped-over appearance and deformity, allowing individuals to conduct a reliably normal amount of daily activity and / or activities. And, a daily exercise program, one that includes stretching, deep breathing exercises, and even swimming will help individuals minimize many of the most debilitating consequences of the disease, long term. Inactivity should never be advised or prescribed, as it will only hasten the worst possible consequences of the condition and exacerbate the immobility, neck pain, back pain and sciatica often associated with the condition.

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