Ankylosing Spondylitis - Symptom, Treatment And Causes

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. If you wish to discuss about any specific problem, you can consult a Rheumatologist.

Arthritis is a painful joint condition that leads to pain and stiffness as well as lack of proper mobility due to inflammation and swelling. Usually, an orthopaedic specialist will prescribe anti-inflammatory and pain relieving medication for this condition, but there are various things that you can do to ensure that this condition does not become a debilitating one in the long run. One of the best ways of doing this is by limiting your diet in certain ways when it comes to inflammation producing food.

Here are a few types of food to avoid if you are suffering from arthritis.

1. Fried food: Fried and processed food is packed with too much of salt in order to better preserve it so that it has longer shelf life. Also, the use of oil in order to deep fry can have a detrimental effect on the inflammation that is already causing problems for your joints. Therefore, it is best to avoid fried, fatty and processed or packaged food that has been frozen for too long.
2. AGEs: When we speak of AGEs, we are not talking about the number of birthdays that you have celebrated. AGEs are actually Advanced Glycation End products that are a toxin released by food when it is heated, grilled, fried or pasteurised. These toxins can render damage to the proteins in your body. Once this process starts, the body retaliates by sending forth cytokines which are basically inflammatory messengers. This can lead to inflammation and arthritis.
3. Sugar: Sugar and other refined carbs also have a large amount of AGEs as discussed above. These types of food should also be avoided by patients suffering from arthritis. Also, artificially sweetened drinks and too many baked goodies should be avoided by these patients.
4. Dairy products: Owing to a certain kind of protein that most dairy products contain, these kinds of food are considered harmful for patients of arthritis. These proteins can encourage inflammation and irritation of the tissue that surrounds your joints. Switching to a vegan diet is considered helpful for arthritis patients.
5. Alcohol: Excessive drinking is a major problem that can aggravate your arthritis situation. Smoking and drug abuse also leads to such problems. Drinking excessively can lead to the development of gout.
6. Corn oil: This kind of oil is a part of most packaged, processed and fried food. It also leads to inflammation. Arthritis patients should switch to omega fatty three oils which can be found in fish.

Taking care of your body is a matter of maintaining a good diet with lots of activity that will be congenial for your condition. This will also help in keeping the painful symptoms of arthritis away. If you wish to discuss about any specific problem, you can consult an Orthopedist.

Whether you are an athlete or a ballet dancer, you will appreciate the importance of having a stable kneecap. Medically known as the patella, the kneecap is a triangular bone that connects the upper thigh to the lower half of the leg. It sits in a groove in the bottom of the femur (thigh bone). When the leg is bent, it stays within the groove. When the leg is extended, it provides support to the quadriceps muscles.

That being the case, a dislocation of the kneecap is a very common injury. Subluxation is a state where there is partial movement of the kneecap out of its position, thereby making the patient’s kneecap unstable. When it completely moves out of its place, it is known as dislocation. Whether you fall on your knees during a sport or have a fall from a bike or get injured during dance or aerobics, it is common to have a dislocated kneecap. Some people are prone to repeated dislocations.

Symptoms:

The initial injury is very painful and there might also be damage to the surrounding structures. Other symptoms include:

1. Buckling of the knee, where your legs cannot support your body weight

2. Sliding of the kneecap to a side

3. Catching of the knee in the groove when trying to move it

4. Pain in the front of the kneecap with any activity

5. Painful while sitting

6. Swelling and/or stiffness of the knee joint

7. Crackling/creaking sound when trying to move the knee joint

8. Inability to straighten the leg

Treatment:

Though these sound scary, the good news is that in 90% of the cases, the knee returns to its position spontaneously. However, putting it back into its place is a simple and safe procedure and can be done by almost any seasoned medical practitioner. The first step is to confirm that the kneecap is indeed dislocated. This can be done by a combination of physical exercise and x-ray. If required, MRI can be used, but it is not required in most cases. Initial treatment would include the following steps in sequence:

1. Immobilizing the knee with splint by keeping the leg in a straightened position.

2. Calling for medical assistance immediately. They can replace the knee back in its position carefully (reduction). An injured kneecap can cause what is known as foot drop by putting pressure on the peroneal nerve. The toes drag on the ground, making it difficult for you to walk.

3. Use ice in the affected area for 15 to 20 minutes, and repeat after three to four hours throughout the day to reduce pain and swelling.

4. Surgical correction may not be required, if there is a damage to the ligament.

5. Flat femur and/or tissue laxity can cause repeated dislocations, where physiotherapy and strengthening exercises are useful. If you wish to discuss about any specific problem, you can consult a physiotherapist.

Hip replacement surgery is a method wherein a defective hip joint is removed and replaced with an artificial hip joint. This procedure is only opted for after all the other treatments have failed to yield the desired effects. Hip replacement surgery removes damaged or diseased parts of a hip joint and replaces them with new, man-made parts. The goals of this surgery are to:

• Relieve pain

• Help the hip joint work better

• Improve walking and other movements.

Who Should Have Hip Replacement Surgery?

The most common reason for hip replacement is osteoarthritis in the hip joint. Your doctor might also suggest this surgery if you have:

1. Rheumatoid arthritis (a disease that causes joint pain, stiffness, and swelling)

2. Osteonecrosis (a disease that causes the bone in joints to die)

3. Injury of the hip joint

4. Bone tumors that break down the hip joint.

Your doctor will likely suggest other treatments first, including:

1. Walking aids, such as a cane

2. An exercise program

3. Physical therapy

4. Medications.

These treatments may decrease hip pain and improve function. Sometimes the pain remains and makes daily activities hard to do. In this case, your doctor may order an x-ray to look at the damage to the joint. If the x ray shows damage and your hip joint hurts, you may need a hip replacement.

The Procedure-

Hip replacement surgery is a procedure that can either be performed by traditional means or a minimally invasive procedure. The primary difference between the two procedures is the size of the incision. The procedure begins with the doctor administering local anesthesia, though in certain cases, general anesthesia is also administered.

1. An incision is then made along the hip and the muscles that are connected to the thigh bone are shifted, so that the hip joint is exposed.

2. An equipment is then used to remove the ball socket of the joint by cutting the thighbone.

3. The artificial joint is then fixed to the thighbone and it is allowed to adhere properly.

4. Once the joint is fixed, the ball of the thighbone is then put in the hip socket.

5. The fluids from the incision area are then allowed to drain.

6. The hip muscles are then put in place and the incision is closed.

Post -surgery-

After the surgery, the recovery stage begins. The period of hospital stay post-surgery usually lasts for 4-6 days. A drainage tube is attached to the bladder to get rid of waste products from the body. Physical therapy begins immediately after the surgery and you will be able to walk after a few days with walking aids. The physical therapy continues for a few months after the surgery.

After care-

It is advised to avoid activities that involve twisting your leg for at least half a year. You should also avoid crossing the leg along the mid portion of your body. Your physiotherapist will provide you with exercises that aid to help you recover. Avoid climbing stairs and sit on chairs that have strong back support. If you wish to discuss about any specific problem, you can consult a orthopedist.

The problem of morning back and neck pain may be due to the position of sleeping or it may be related to inflammatory arthritis which can be familial. Morning back pain is largely related to wrong sleeping posture and less commonly due to arthritic conditions like Ankylosing Spondylitis or Rheumatoid Arthritis. Whatever be the cause- this condition requires attention by an Orthopedic doctor as it may worsen in due course of time and should not be taken lightly. 

Some common factors causing this are: 

1. Mattress: Too soft or too hard a mattress might induce back ache after sleep. For people with waist and hips of equal proportion, a firmer mattress would do well. For those with narrower waist than their hips, a flexible and softer mattress that can move with the pelvic weight would be a perfect choice. Refrain from using old hardened mattresses. 
2. Pillow: The pillow you use must be able to render support to your neck naturally. Instead of using excessively firm or soft pillow, try substituting it with memory foam pillows, refillable water pillows or cervical support pillows. 
3. Posture: Not changing your position while sleeping or sleeping on the belly exerts strain on the back muscles, causing pain. On the other hand, sleeping on the back or on the sides causes comparatively less strain on the spine. 
4. Other causes such as strenuous workouts or physical activities or sitting at a stretch during the day might cause pain while sleeping or after getting up from bed. 

Remedies for Morning Back Pain: 

Fortunately, there are some home remedies to cure the morning back pain. 

1. Switching your mattress is a more expensive remedy for back pain, but may often be the ultimate cure. Most people sleep the best on medium-firm mattresses. Be sure to try out the mattress before you buy it. 
2. For occasional back pain after sleeping, apply heat to your back to relax your muscles before you go to bed and when you get up in the morning. 
3. Massage your back with pain relieving creams and apply heat on it with a heating pad for quick relief. 
4. Specific spinal stretching exercises and Planks (a type of exercise) can greatly help in easing back pain, if done on a regular basis. 
5. It is always recommended to CONSULT an Orthopaedic doctor if you suffer from morning back pain.