This type of arthritis is often confused with spondylitis or slip disc and affects 15-30 year olds

The month of May every year is considered to be World Arthritis Month. General perception is that arthritis affects old people.

However, contrary to that belief, arthritis affects a number of young people, particularly from a consition called Ankylosing Spondylitis which is a type of Arthritis. The disease is more common in younger age groups between 15-30 years of age and especially more common in males.  The disease adversely impacts the level of efficiency in the most productive years of life. The signs may include chronic back pain and stiffness from the neck down to the lower back which are common symptoms brushed away untreated.

The ankylosing spondylitis treatment market is growing at a significant rate due to the increasing prevalence of ankylosing spondylitis and rising awareness about diagnostics and treatments for the disease. In addition, government initiatives and improving healthcare infrastructure are driving the market for ankylosing spondylitis treatment. However, factors such as the high cost of treatment and lack of skilled surgeons and physiotherapists restrain the market from growing.

Speaking to DNA, Dr Shashank Akerkar Rheumatologist and member of the Indian Rheumatology Association, addressed the issue and answered a few questions.Excerpts

What is Ankylosing Spondylitis. How is it caused?

Ankylosing spondylitis is a type of arthritis that affects the joints of the spine (in the back). It is an autoimmune disease in which a person’s own immune system begins to think that the joints in the body are ‘foreign bodies’ or ‘intruders’ and starts attacking them. This attack causes swelling in the joints, accompanied by pain. If the joint swelling goes on unabated for years, it leads to thickening of the ligaments of the vertebrae. This causes a stooped posture and puts a restriction on spinal movements.

What are early symptoms? Like regular spondylitis or slipped discs, is there radiating pain?

AS starts with pain in the back and the buttocks. Unlike regular spondylitis, the pain is maximum at night and can be so severe that it may awaken a patient from sleep. Mornings are also horrible with a lot of stiffness in the back.

AS may also cause pain and swelling in the knees, ankles or feet. Generally, the back pain does not radiate to the thighs or legs.

At times, AS may also affect the eyes causing redness and pain.

Can people confuse this or mix it with some other condition?

Yes; because backache is a common symptom, it is often overlooked as a muscle sprain or a slipped disc. Even today, the average delay in reaching a diagnosis is almost 5 to 6 years.

Given the increase in urban workforce, who mostly lead a sedentary life, what are the necessary precautions needed?

Ankylosing spondylitis is not a lifestyle disease nor is it caused by a sedentary life. However, for patients with AS, regular exercise and physical activity are a must to manage the pain and keep the joints flexible. They should talk to their rheumatologist about the kind of exercise most suited to them.

Is there a way to cure it? If not, what is the physiotherapy recommended? How different is it from regular spondylitis?

There is specific treatment available. The earlier the diagnosis, the better is the outcome of the treatment. Medicines called DMARDs and biologics have changed the lives of many!

Physiotherapy has a very important role in maintaining flexibility of the spine and preventing deformities

Could you share some success stories as well as struggles?

It is painful to see what delay in diagnosis can do to many with this ailment. A bodybuilder who was a state champion 10 years ago is today confined to bed, purely because of a delay in diagnosis and lack of proper treatment. It shows that a simple backache that may sound trivial today, can lead to devastating consequences if not attended to.

At the same time, life can be completely different with proper diagnosis and treatment. I have many patients who, with the help of the treatment and regular exercises, have run shoulder to shoulder with me in marathons.

At the end of the day, do not take a backache lightly, particularly if is accompanied by pain in the buttocks, gets worse at night or early morning and is associated with pain in any joint. Taking pain killers without a definite diagnosis can be hazardous. Instead, timely action can be highly rewarding.dnaindia