Ankylosing spondylitis is a progressive disease of joints that primarily affects sacroiliac joints and spine. It may cause stiffness and pain in different body parts such as neck, back, jaw and hips. It may also involve some other organs such as heart, eyes, kidneys and lungs. Although exact causes of ankylosing spondylitis are not clear, some genetic factors, immune response and inflammatory bowel disease are supposed to be responsible for the development of this disease. This disease is more common in men than in women. Onset of this disease is more frequent in younger people between the age group of 17-35. However, it may affect older people as well as children.
Positive HLA-B27 maker, family history of ankylosing spondylitis and frequent gastrointestinal infections are the main possible causes of ankylosing spondylitis. The genetic marker, HLA-B27 is the most significant gene that contributes a lot in the development of this disorder. Recently identified two more genes such as IL23R and ARTS1 are found to be associated with ankylosing spondylitis. A person with the age less than 40 and positive for HLA-B27 gene and having the family history of ankylosing spondylitis is at the higher risk of developing this disease.
A person with immune response mediators, genetic predisposition and inflammatory bowel disease is at greater risk of developing this disease. Genetic predisposition is one of the significant causes of ankylosing arthritis. About 90% of patients with this disorder may give positive results for HLA-B27 gene. If either parent has HLA-B27 gene, the chances of passing-on this gene to their child are about 50%. However, there are less than10% chances of developing ankylosing spondylitis in their child.
The excessive immune response to the gastrointestinal bacterial infections such as ulcerative colitis and Crohn’s disease may give rise to underlying pathogenesis of ankylosing spondylitis. Other possible causes of ankylosing spondylitis are trauma such as cervical spine fracture, epidural hematoma, infections like meningitis, cervical lymphadentitis, epiglottitis, epidural abscess and discitis, dystonic reaction and tumors.
As ankylosing spondylitis is related to genetic factors, its prevention is not possible. However, some alternative measures such as exercise, physiotherapy, acupuncture, therapeutic massage and yoga can help to manage the symptoms. Conditioning and strengthening exercises can help to maintain flexibility and mobility of joints and reduce pain.
Besides this, physiotherapy can be advantageous to maintain proper posture and deep breathing exercises may help to improve lung capacity. Physiotherapy involves application of heat and cold which is helpful to reduce pain and stiffness in the joints. Alternative therapies like acupuncture and yoga can relive pain, manage the symptoms and improve quality of life. In addition to these therapies, some assistive devices such as walkers or canes reduce the stress on joints and help to maintain physical activities.
