Not just back pain!

An inflammation that affects the joints of the spine, reduces its flexibility, damages the posture and poses risk of mobility is often misunderstood as back pain. However, there is more to the condition than meets the eye. Known as ankylosing spondylitis (AS), it is a type of arthritis which is not age related and affects one in 100 of the adult population. The condition is accompanied by constant pain which impacts efficiency and also leads to psychological problems, affecting the quality of life of a person.

The disease is largely prevalent in men (as high as 90 per cent). It has also been found that 90 per cent of patients suffering from the condition are HLA-B27 positive. Youngsters are more prone to AS due to sedentary lifestyles, poor sitting postures, stress and also highly-demanding professional lives. These habits further aggravate the pain and make the condition worse with time. Dr V. Sarath Chandra Mouli, Clinical Director, Department of Rheumatologist Clinical Immunology, KIMS Hospital explains how long-term AS increases the risk of osteoporosis and spinal fractures.

Why is ankylosing spondylitis under-diagnosed?
It is under-diagnosed due to the lack of awareness both in the medical fraternity and public. Even after the diagnosis of the condition, general physicians, orthopedicians and physicians do not refer the AS patient to a rheumatologist soon enough as they are not aware of the latest developments on the therapeutic front.

What are the psychological issues that are faced by AS patients?
With time, patients get depressed owing to their condition. Some patients stop working or take a break from work and sit at home thinking that rest will help them. However, resting makes the disease worse in that the joints become very stiff.

Are biological medicines cheap or affordable? Which category of patients require it?
A decade ago biological drugs used to be expensive. Now the cost of these medicines has become relatively cheaper. Biological drugs are used when oral disease modifying drugs (like Sulfasalazine, Methotrexate) are not working and when the disease is confined only to the spine. Pain killers, anti-inflammatory drugs and disease modifying anti-rheumatic drugs (DMARDS) are usually the first choice of treatment to ease the inflammation and accompanying pain. But in case the disease is severe in nature, biological drugs have displayed significant improvement in curbing disease progression and improving quality of life.

What are the major lifestyle changes that the individual must make once diagnosed with the disease?
Leading an active lifestyle is very important. Physiotherapy and regular exercise is important. Exercises like yoga, swimming will help them a lot. They can opt for gymming and aerobics too.

What are the preventive measures that patients must undertake to prevent the progression of the disease?
Regular physical exercise will help to keep the joints healthy and prevent deformities. Regular medication and monitoring by the rheumatologist are essential to halt the disease progression.

What are the food choices one must make? Are there any nutrient deficiencies that escalate the condition?
There are no dietary restrictions. Foods rich in calcium and vitamin D are very important however.