Ankylosing Spondylitis

Response to a recent email:

Hi Allan,

Thank you for email requesting advice about your Son aged 35 yrs diagnosed as suffering from Ankylosing Spondylitis.

Latest research has shown that 96 percent of people who have the condition carry a genetic marker called HLA-B27. It's thought that this marker is involved in the process of developing ankylosing spondylitis.

Not everyone who has the HLA-B27 marker will develop the condition. If someone with the marker has children, there is a 50 percent chance that they will pass it on to them, but there is still only a small chance that the child will go on to develop ankylosing spondylitis.

From what you have said all of the diagnostic tests that your Son is getting are appropriate.

Self-help

It's important that he stays fit, do plenty of exercise and keep a good posture. Exercising may provide relief from the pain and it may also control how bent his spine becomes. Swimming is an ideal activity as it strengthens your muscles without putting weight on your joints. His GP or physiotherapist may also recommend:

Making sure that he keeps his back as straight as possible when he is sitting

lying face down (prone) for 20 minutes a day to prevent your spine from becoming set in a bent position sleeping on a firm bed to stop his back from curving

A physiotherapist will also be able to give him more advice about exercises to help him keep as much movement as possible. These might involve breathing exercises to keep his ribs and chest flexible, and others that target his back, arms and legs.

He may find that heat treatment helps with ankylosing spondylitis. Having hot showers or baths, and using hot water bottles or electric blankets can also ease the pain. He may find an ice pack helps relieve a particularly painful area.

Anti-inflammatory medicines

Painkillers that you would normally take for a headache may give him enough relief. However, if they don't help, his GP may prescribe anti-inflammatory medicines. These are known as non-steroidal anti-inflammatory drugs (NSAIDs). He can buy some NSAIDs, such as ibuprofen (eg Nurofen), from your pharmacist - it's best for him to speak to his GP or pharmacist before taking these. Other NSAIDs, such as diclofenac (eg Voltarol), have to be prescribed by your GP. NSAIDs will reduce inflammation and pain so that he can continue to exercise.

However, these medicines can have serious side-effects such as stomach pain or bleeding from the stomach. He should see his GP immediately if he experiences any pain that feels like indigestion while taking NSAIDs.

He may also be prescribed steroid injections that his GP will inject directly into joints that are very painful.

Disease-modifying medicines

These affect the actual disease process of ankylosing spondylitis. They are used to treat rheumatoid arthritis and don't work as well in the treatment of ankylosing spondylitis. It may take some time before he notices any effect. They can also have serious side-effects so he will need to see his GP regularly for check-ups. Examples of these medicines include methotrexate (eg Maxtrex) and sulfasalazine (eg Salazopyrin).

Biological therapies

Three new medicines called infliximab (Remicade), etanercept (Enbrel) and adalimumab (Humira) have been shown to be successful in treating some forms of arthritis. These are given by injection. They can also have serious side-effects - His GP will explain these to him. These may be suitable if other medication has not helped.

Surgery

It's unlikely that he will need surgery, but if his hip or knee becomes severely affected his doctor may recommend replacing the damaged joint. He may need to have surgery on his spine or neck to correct a very bent back. However, this is very rare and is usually only done if his stoop is so severe that it prevents him from looking forward.

You can only do what you are both doing now!

Thats being very supportive parents !

For further detailed information please visit: http://www.nass.co.uk/

Best Wishes,