The bones and joints orchestrate very well with each other for smooth movements of various joints and the spine. However, due to various reasons, some identified and others unknown, there could be inflammation of the areas where the bones join the muscles leading to impaired movement. The range of motion could be reduced or it could be painful, thereby, limiting movement. Spondyloarthritis includes a group of inflammatory diseases that involves the bones and joints and enthuses which are areas where the ligaments and tendons attach to the bones. This causes conditions like plantar fasciitis, ankylosing spondylitis, psoriatic arthritis and reactive arthritis. The term spondyloarthritis is a blanket term to describe any of the above-mentioned conditions.

Read on to know a little more in detail about it:

Causes: While the exact etiology is not identified for sure, most patients with spondyloarthritis have an autosomal dominant gene (HLA-B27). Chronic infections could trigger the onset of the disease too.

Symptoms:

1. In all forms of spondyloarthritis, there is always inflammation of the spine, joints and entheses. If the fingers or toes are involved, there could be swelling leading to what are typically known as 'sausage digits'.

2. There is sacroiliitis which is inflammation of the joint between the pelvis and the spine, and spondylitis which is inflammation of the joints between the spines. 3. Family history and autosomal dominant gene.

Diagnosis:

A detailed medical history and physical examination form the cornerstone of a confirmed diagnosis. In addition, radiographic examination and diagnostic blood tests also could be done to confirm the diagnosis. Radiographs, especially, of the spine and the low back show typical changes including sacroilitis in suspected cases of spondyloarthritis. If the spine does not show these changes, but there is a high likelihood of spondyloarthritis, then MRI (magnetic resonance imaging) can be used to confirm the diagnosis.

As a final step, a blood test for the HLA-B27 gene can also be confirmatory. However, it is not true that a person with the gene will definitely develop the disease.

Treatment:

The most important aspect of treatment is the use of pain medications and anti-inflammatory drugs (NSAIDs) which help manage pain and inflammation.
Corticosteroid injections may sometimes be given directly into the joint spaces or the membranes to provide quick relief of these symptoms.
ESWT / RSWT has a definite role to cure enthesopathy. Plantar fasciitis, and achillodynia can be cured with ESWT. Even small joints of hand and feet are amenable to treatment with RSWT. It is nonoperative and noninvasive treatment and has no side effects.
Very rarely, stronger drugs such as methotrexate or sulfasalazine may be used.
Another set of drugs known as TNF-blockers (tumor necrotizing factor blockers) are also shown to be highly effective in controlling the pain of the spine and joints.
In very severe cases, surgery may be required to correct joint damages or correct severe degenerative changes.
Exercise plays a very vital role in controlling the issue and improving range of motion.

What You Should Know About Spondyloarthritis?

The human spine has 33 vertebrae. However, some conditions can fuse these vertebrae. Ankylosing Spondylitis is one such condition. This disease may also be known as AS or Bechterew's disease. It is an inflammatory disease that can make the spine less flexible by fusing the vertebrae of the lower back together. In some cases, it can also affect the rib cage and make it difficult to breathe. This disease typically affects more men as compared to women. Most patients begin showing symptoms in early adulthood.

Ankylosing Spondylitis affects the sacroiliac joints. These joints are located just above the tailbone. It causes inflammation of the spinal bones that in turn cause pain and stiffness. With time, this inflammation spreads to the entire spine and the vertebrae begin fusing together. This can make movement difficult and painful. In severe cases, it can also lead to the development of a hunchback. This disease also affects the other tissues of the body. For example, it can affect other joints and aggravate arthritis or affect organs such as the kidney, heart, lungs, and eyes.

A specific cause has not yet been identified for Ankylosing Spondylitis. However, studies show that genetic factors can be a trigger. In particular, the presence of the HLA-B27 gene increases a person s risk of developing symptoms pertaining to this condition. However, it is important to note that merely the presence of this gene does not make Ankylosing Spondylitis inevitable. Other genes that are associated with this disease are ARTS1 and IL23R. These genes influence the functioning of the immune system. While it can affect people of all ages, adults are at a higher risk of suffering from this condition.

In many cases, the initial inflammation of the spine is due to a bacterial infection of microbial infection. Though the infection itself may be treated and cured, it may cause the immune system to react and trigger inflammation. Once activated, if the immune system cannot be turned off, this inflammation will continue and can trigger Ankylosing Spondylitis. In each case, the disease presents a unique pattern of progression.

There is presently no cure for this condition, but with an early diagnosis and treatment, the symptoms can be managed and progression can be slowed. This treatment usually takes the form of medication to relieve pain, inflammation and discomfort and physical therapy. Surgery cannot be used to treat Ankylosing Spondylitis but in cases where it has caused severe joint damage, surgery may be advised to replace the damaged joint.

Ankylosing Spondylitis - What Are The Causes?

Cervical spondylosis is an age related disorder affecting the discs and joints in your neck. The overuse of the bone and cartilage in the cervical spine of your neck leads to cervical spondylosis. While it is mostly caused by age, it can also be caused by other factors. Stiffness and severe, chronic pain are the most common problems with patients afflicted with cervical spondylosis. While in others, it might not cause problems and they can go about their daily activities.

Physiotherapy for Cervical Spondylosis
There is no cure for cervical spondylosis, but its symptoms can be treated with physiotherapy. If you have chronic pain in your neck, shoulder blades or arms, a physiotherapist can provide effective pain relief by strengthening your vertebrae and neck. This will improve your posture and prevent any relapse of the pain.

Firstly, the physiotherapist will evaluate your condition; check your reflexes and strength. Then, the physiotherapist will move on to the following treatments:

Stretching, strengthening and straightening exercises: Before beginning these exercises, your physiotherapist will first apply cold or heat to the affected area and then proceed with a deep tissue massage or electric stimulation. When your muscles are relaxed, the exercises will begin only then. These exercises are performed to strengthen the muscles in your neck. Through these, you will learn how to improve your range of movement and posture.
Neck traction: Pulling your head to stretch out your spine is called neck traction. This technique is used to improve movement and ease the pain. Traction is used to open the spaces between the vertebras gently in order to ease pressure on the distressed discs. Traction is done continuously or sporadically, with short periods of rest in between. If you cannot find the right physiotherapist to do this for you, there are devices to help you stretch your spine.
Cervical collars and pillows: Neck pillows or cervical pillows, are made to keep your neck steady while you sleep. Cervical collars are also called neck braces which are used to support the neck. While cervical collars have been proven to be quite beneficial, there isn t much evidence to support cervical pillows in treating cervical spondylosis. You can always consult your physiotherapist before purchasing a cervical pillow.

Cervical Spondylosis - How Physiotherapy Can Help Treat it?

Most of the arthritic conditions don t have any cures. Ankylosing Spondylitis is also a type of arthritis that does not have a cure. It is a kind of arthritis of the spine; it affects the vertebrae. It primarily affects the spine, but it may also affect other areas such as shoulders, hills, hips, ribs, small joints of the feet and hands etc. In very advanced stages, it may also affect eyes, lungs and heart. 

However, what really makes it scary is Ankylosis. When Ankylosis takes place, there is formation of new bony structures in the spine. These structures cause some sections of the spine to fuse and make the spine immobile. 

Symptoms of Ankylosing Spondylitis 

  Pain and Stiffness 

One may feel a constant pain coupled with stiffness in areas like buttocks, lower back, hips etc. These symptoms may go on for months. It often starts at the sacroiliac joint. 

  Bony Fusion 

The formation of bony structures in the spine in advanced stages may affect movement of the back, neck, hips etc., and may also impair the ability to perform daily activities. The formation of bony structures may go to the extent of fusing the ribs in the rib cage to the breastbone or spine. This may limit the ability to expand the chest while taking deep breaths. 

  Pain in Ligaments and Tendons 

Ankylosing Spondylitis may also affect the tendons and ligaments that attach the muscles to the bones. This may precipitate pain and stiffness beneath or behind the heels. 

Cause of Ankylosing Spondylitis 

The cause of this disorder is not yet known, yet a genetic link cannot be ruled out. It has been observed that most of the people affected with Ankylosing Spondylitis carry a specific gene in them. People carrying this gene are susceptible to spondylitis. However, there are about 10% people who carry this gene, but don t have any sign of Ankylosing Spondylitis. So, a sure determinant of cause of this disease is not completely known. 

Diagnosis of Ankylosing Spondylitis 

To diagnosis Ankylosing Spondylitis, the physician has to look at several factors. 

These include: 

  Symptoms exhibited by the patient 

  Physical Findings 

  X-Rays of pelvis and back regions 

  Taking chest measurements while taking deep breaths 

  Laboratory tests Based upon the complete diagnosis, physician can positively determine if the condition is indeed Ankylosing Spondylitis. 

Treatment 

While a cure for Ankylosing Spondylitis is still not on the horizon, there are some treatments which can reduce pain and discomfort and thereby improve daily activities. Goals of treatment Since the disease can t be cured, the goal is to reduce pain and stiffness, prevent deformity, maintain a good posture, and help perform daily activities. In fact, if treatment is proper, the patient may lead to a semblance of a normal life. However, it calls for a team approach. The team must include a physical therapist and an occupational therapist, apart from a rheumatologist. If the patient is suffering from bony growth, the doctor may go for an osteotomy.

Ankylosing Spondylitis - How To Handle It?

The backbone is made up of multiple small bones which are connected together by a softer bone. The spine is what allows important body movements including bending and walking. The issue is, with age, the backbone also loses its elasticity and becomes rigid. Though this is a natural process with ageing, lack of exercise and sedentary lifestyle makes it worse.

Lumbar spondylosis is the medical term for this chronic, degenerative condition of the lumbar and the sacral spines (the lower portion of the backbone). This leads to chronic stiffening of the spine, affecting movement. This joint is very crucial in all bending movements and spinal movements.

Causes of Lumbar Spondylosis:

Ageing: As the condition progresses, the nerves that run through the spines can get exposed and there could be pain and irritation
Genetic abnormalities that produce a weak bone
Spinal trauma like accident or falls
Sedentary lifestyle: Sitting in front of the computer for prolonged hours also causes lumbar spondylosis
Overuse: People who are weightlifters tend to put excessive pressure on the spine, causing lumbar spondylosis
Symptoms:

Stiffness and pain in the low back
Pain with continued sitting
Numbness and tingling if nerves are getting affected
Loss of balance, leading to frequent falls
Losing control over bowel and bladder movement
Pain radiating to the lower legs
Ayurvedic remedies: This includes a combination of external applications, yoga, and food preparations including kashayas and tailas.

This condition is caused by increased Vata and Kapha. Maharasnadi kashayam, Astavarga kashayam, and Dashamoola kashayam reduce these elements.
Pain and inflammation is relieved by the use of various Guggulu including Mahayogaraja Guggulu, Simhanada Guggulu, Trayodashang Guggulu, and Dhanvantara Vati  
The affected joints can be hydrated with the use of gandha taila and dhanwantharam.
Kukkutandatvak bhasma is known to strengthen the bone.
Ashwagandha is known to lubricate the vertebral disks and joints
External treatments like Abhyanga are useful in improving joint movement. They improve circulation and help in removal of toxins so that pure blood can flow and reduce inflammation.
Vasti: This helps in improving nutrition to the joints and bones, thereby helping them repair themselves and heal.
Yogas for lumbar spondylosis: The five most effective asanas are:

Ardhakati chakrasana
Pada hastasana
Matsyasana
Ardha chakrasana
Vakrasana (sitting in a chair)
Additional measures:

Sit in a comfortable position with adequate back support
Take short breaks to avoid continued sitting
Sleep comfortably, by resting the back adequately
Strengthen the back muscles by regular exercises.
Eat healthy, avoid junk, and drink plenty of water.

Lumbar Spondylosis & Ayurveda - What To Expect

It is important for you to know about degenerative disc disease (DDD) and spondylosis. Spondylosis is an umbrella term for spine pain, which occurs because of degenerative conditions. Spondylosis refers to several conditions. They include spinal stenosis, which is the abnormal narrowing of the spinal canal, leading to leg pain, degeneration due to DDD and degenerative arthritis or osteoarthritis involving the spine. It may also include cervical osteoarthritis or neck arthritis.


About spondylosis
Spondylosis is a common condition, which is age related. The joints and discs present in the neck are specifically affected as a result of this condition. It commonly develops on account of the wear and tear of the cartilage and bones present in the neck. This condition, in spite of being common, worsens with age. In many patients, symptoms are not observed externally, but pain and muscle spasms are experienced. 


Many people with spondylosis do not undertake treatment in spite of suffering from the symptoms and pain. In case the symptoms are prevalent over a long time and tend to worsen, you have several modes of treatment to choose from. They may include medicines, corticosteroid injections, physical therapy and even surgery in some extreme cases. 


How does DDD or spondylosis occur? 
DDD is a spinal condition. It is caused due to the breakdown of the intervertebral discs. With ageing, the spine starts to show signs of wearing and tearing. This happens on account of the discs drying out and shrinking. All these age-related changes are responsible for arthritis, spinal stenosis and disc herniation. Because of these factors, pressure is likely to fall on your nerves and spinal cords, which may further cause back pain. DDD or spondylosis also develops on account of these factors.


Treatment for DDD and spondylosis
There are various modes of treatment, which are available for you to choose from in order to get relief from the symptoms and pain associated with DDD or spondylosis. You may be prescribed typical painkiller medications, such as non- steroidal anti-inflammatory drugs or NSAIDS, muscle relaxants, epidural injections, ultrasound and massage, oral steroids, transcutaneous electrical nerve stimulation (TENS) and many more. Every mode of treatment has got its own benefits, but has its limitations as well.


If you experience any symptoms of DDD or spondylosis, you must consult a doctor immediately. Your pain management physician or doctor will be able to diagnose your condition properly and will determine the mode of treatment which will suit you best.

Degenerative Disc Disease (DDD) and Spondylosis - How You Can Get it Treated?

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