Ankylosing spondylitis refers to a form of arthritis that affects the spinal column. This condition causes the bone vertebrae to fuse together leading to a rigid spine. Depending on the extent of the damage, this could result in mild changes or in a stooped posture. Although the cause of this disease is not known, it is said to be passed down from one generation to another through a gene called the HLA-B27. This gene is also linked to spondylitis.

Ankylosing spondylitis cannot be cured, but with treatment, the pain and stiffness associated with it can be managed. Along with medication, physical and occupational therapy is a must when treating this disease. In some cases where the disease has caused severe deformities, surgery may also be recommended. However, an early diagnosis can also help prevent significant deformity.

A physical exam and an X-ray are the key factors used to confirm a diagnosis of Ankylosing spondylitis. Some of the symptoms associated with this disorder are:

Pain and stiffness: Everyone complains of a backache at some point or the other but a persistent lower back ache could be a sign of something serious. Spondylitis often starts in the sacroiliac joints and hence the lower back, buttocks and hips are the first to be affected. Pain that lasts for more than three months should not be ignored as it could be a sign of Ankylosing spondylitis.
Bony fusion: This condition causes an abnormal growth of bones in the spinal column. This can lead to the fusing of bones in the spine. The bones of the neck, back and hips are most affected by this bone fusion. While this can affect a person s mobility it can also cause complications. For example, the fusing of the ribs to the spinal column or the breastbone can restrict the expansion of the chest while breathing.
Pain in ligaments and tendons: Apart from the bones, this condition also affects a person s tendons and ligaments attached to the bones. For example, pain in and around the heel may be caused by tendonitis.
Other symptoms: The symptoms of ankylosing spondylitis are not restricted only to the joints. Hence, it is also known as a systemic disease. Some of the other symptoms exhibited by people suffering from this condition are fever, fatigue, inflammation of the eyes and a loss of appetite. Some people may also complain of lung and heart problems. 

Ankylosing Spondylitis - How To Know You Are Suffering?

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

Spondylitis, or cervical spondylitis, is a common condition that affects a large section of the adult population. This most common disorder of the cervical spine is a degenerative condition. There are soft disks between the vertebral bones which shrink with age and gets stiff. This leads to formation of small bone spurs. This reduces the space available for the disk to move, causing nerve pinching.

Causes:

Ageing is the most common cause for spondylitis. Injury, incorrect sleeping posture, and heavy weight-lifting can also cause spondylitis. While earlier it was common in people who were 60-plus, with more people spending more time at their computers and workstations, the onset happens much earlier in 30s and sometimes even in 20s.

Symptoms:

Most symptoms related to spondylitis are centered on the neck and shoulder regions. There is pain and stiffness in the neck that can extend to the shoulders, nape of the neck, arms, and sometimes even the fingers. In rare cases, the pain can extend into the forehead and back of the head too. Associated symptoms include numbness, weakness, and a pricking sensation in the hands, arms, and sometimes fingers.

Homeopathy in cervical spondylitis:

Homeopathy treats the root of the issue after taking into account all symptoms. Listed below are some common homeopathic remedies for spondylitis.

Conium: there is neck pain along with vertigo when lying down or turning in bed. There is constant mild pain in the back of the head and a tight sensation in the forehead region.
Rhus tox: when the neck pain is worse in the morning and with rest, rhus is a good option. Moving the neck helps relieve this pain, which is often as a result of some injury.
Kalmia latifolia: when there is pain extending from the neck to the arm and hand and fingers, kalmia works wonders. There may also be pain from the nape of the neck to the shoulder blades. The pain is increased with leaning forwards or looking down. The patient may also have nausea with the pain.
Gelsemium: when there is pain extending from the neck to the back of the head, centering in the occipital region. The patient also feels weak, dull, and dizzy. The pain is triggered by emotional excitement.
Silicea: when there is pain extending from the neck to the eyes and forehead, silicea provides good relief. The patient will have intolerance to cold and feels chilly. The pain is improved by heat pads and lying down.
Calcarea phos: if the radiographs show bony changes in the cervical spine with the spondylitis, this is very useful. The bony spurs that form can be painful and cause nerve pinching leading to vertigo.

Spondylitis - Causes and Symptoms

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?

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?

Spondylitis includes swelling of the vertebra. It happens because of wear and tear of the ligament and bones found in your cervical spine, which is in your neck. While it is to a great extent because of age, it can be brought on by other reasons too. Side effects incorporate pain and stiffness starting from the neck to the lower back. The spine's bones (vertebrae) get fused, bringing about an unbending spine. These changes might be mellow or extreme, and may prompt a stooped-over posture. Some of the non-surgical methods to treat spondylitis are as follows-

Exercise based recovery/physiotherapy: Your specialist may send you to a physiotherapist for treatment. Non-intrusive treatment helps you extend your neck and shoulder muscles. This makes them more grounded and at last, relieves pain. You may neck traction, which includes using weights to build the space between the cervical joints and decreasing pressure on the cervical disc and nerve roots.
Medications: Your specialist may prescribe you certain medicines if over-the-counter medications do not work. These include:
Muscle relaxants, for example, cyclobenzaprine, to treat muscle fits
Opiates, for example, hydrocodone, for pain relief
Epileptic medications, for example, gabapentin, to ease pain created by nerve damage
Steroid infusions, for example, prednisone, to decrease tissue irritation and diminish pain
Home treatment: In case your condition is less severe, you can attempt a couple of things at home to treat it:
Take an over-the-counter pain reliever, for example, acetaminophen or a calming medication, for example, Advil or Aleve.
Use a warming cushion or an ice pack on your neck to give pain alleviation to sore muscles.
Exercise routinely to help you recover quickly.
Wear a delicate neck prop or neckline to get transitory help. In any case, you shouldn't wear a neck brace for temporary pain relief.
Acupuncture: Acupuncture is a highly effective treatment used to mitigate back and neck pain. Little needles, about the extent of a human hair, are embedded into particular points on the back. Every needle might be whirled electrically or warmed to improve the impact of the treatment. Acupuncture works by prompting the body to deliver chemicals that decrease pain.
Bed Rest: Severe instances of spondylitis may require bed rest for close to 1-3 days. Long-term bed rest is avoided as it puts the patient at danger for profound vein thrombosis (DVT, blood clots in the legs).
Support/brace use: Temporary bracing (1 week) may help get rid of the symptoms, however, long-term use is not encouraged. Supports worn for a long time weaken the spinal muscles and can increase pain if not continually worn. Exercise based recovery is more beneficial as it reinforces the muscles.
Lifestyle: Losing weight and eating nutritious food with consistent workouts can help. Quitting smoking is essential healthy habits to help the spine function properly at any age.

Spondylitis - Can Non Surgical Methods Help You?

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