Ankylosing Spondylitis, Research Paper Example

Introduction

Ankylosing spondylitis (AS) is a disease that attacks the spine and the sacroiliac joints in the pelvic area. In addition, the vertebrae becomes inflamed which is called spondylitis.  This is a very debilitating rheumatic disease that is very painful while rending the patient almost motionless because of the severe amount of pain. Ankylosing spondylitis (AS) is a rheumatic disease that is in the same class as Inflammatory arthritis (IA) I and rheumatoid arthritis. The characteristics of this auto-immune diseases is severe swelling, inflammation and pain of the joints, bone and cartilage (Ursum et.al 1). One of the most often diagnosis of ankylosing spondylitis is peripheral arthritis which has been documented in a study by Schafer et al.(2014) that 46% of patients is diagnosed with peripheral arthritis which fuses the spine(Schafer et al. 1).

This can lead to inevitable fusion of the vertebrae which means they are bond together which is called ankylosis. These disease damages the ligaments, muscles and bones while inflaming the spin and sacroiliac joints causing severe stiffness and pain.  The ankylosing spondylitis is one of the most unforgiving disease that causes a person to lose massive amounts of weight, inability to eat, severe weight loss, joint pain and unbearable swelling of the knees, shoulders and ankles. The pain becomes worse when the person is not that active because they lose control of the motion of the spine.

Causes

The medical community has lead the challenge in finding a testing that can detect the damaged gene marker that causes ankylosing spondylitis. The scientist has successfully developed a blood tests that has the capability to detect the HLA-B27 gene marker. This is a breakthrough for this disease because more studies can be completed to better understand the connection between HLA-B27 and ankylosing spondylitis. The HLA-B27 has been the driving factor in patients developing the ankylosing spondylitis disease.  There are characteristics that can identify patients with ankylosing spondylitis who have the genetic markers that have been inherited from a family member. Furthermore, it has been found that over 90% of population was born with the HLA-B27 gene that signifies the patient has ankylosing spondylitis (MedicineNet.com 1).

Effects

The primary effects of anklylosing spondylitis is the pain and damage of the spine. In addition, the patient will have signs and symptoms of severe red hot pain in the neck and back area. This includes very limited range of motion of the neck which does not allow the patient that peripheral vision required to drive. In addition, to the effects of the prescribed medication impacts the patient’s ability to function. The disease is so deadly it can impact some many different organs that leaves the patient helpful to fight at the different effects of anklylosing spondylitis. The effects of severe arthritis and pain the spine develops into sacroiliac joints damage. This disease can effect organs such as eyes, lungs and kidneys (University of Maryland Medical Center 1). They also indicated AS that the disease affects joints, organs and the axial skeleton such as joints and ligaments. One of the major effects of anklylosing spondylitis is the patient’s limited range of motion of the neck or any strenuous activities.

The effects of ankylosing spondylitis (AS) go way beyond the physical pain and discomfort for a patient. The AS can impact the patient’s mental state because they spend most of their time isolated because of the spine pain. Each day patients indicated the pain is different each day because it can impact joints, bones and organs at a moment’s notice. There are rare neurological instances of ankylosing spondylitis which is inflammation of the eye. Overall, each person has their own set of characteristics that can include all of the above qualities or just a few. Regardless, the disease is cruel and unforgiving.

Types of Treatments

The best treatment for ankylosing spondylitis patients can do at home is exercise. This exercise regiments keeps the joints moving and spine from becoming rigid and stiff. The patients that are not able to move around or be more active tend to be come introverts because the pain is too unbearable to be in public or take long trips in a vehicle. The literature concerning anklosing spondylitis has documented that this disease can affect organs. The patients that have ankylosing spondylitis may have some form of joint and spine pain however, this disease can impact other parts of the body such as ligaments, tendons, eyes, bowel and organs.

It is an effect treatment that will help every patient which is exercise. It should be a daily practice to exercise to increase heart rate increases that will circulate oxygen through the blood stream. The more the patient can exercise, the more they fight off damage to the heart and other major organs such as the kidneys. The commitment to working out with generous amounts of exercise will help the patient boost brain cell functions that can help ward off some of the painful anklosing spondylitis affects. In addition, exercise triggers the chemicals in the brain called neurotransmitter that create endorphins. Regardless, of the other advance treatments, physician exercise is one the best ones for patients (National Institute of Arthritis and Musculoskeletal and Skin Disease 3). The most comment treatment are nonsteriodal drugs to treat inflammatory conditions, however some drugs often have side effects that damage the gastrointestinal tract. The group of medicine that is take by patients with anklosing spondylitis is sulfasalazine, methotrexate and corticosteroids anti-rheumatic drugs.

Physical Therapy

The patient with ankylosing spondylitis can use exercise combined with physician therapy. A clinically trained physical therapist can be invaluable in providing relief with the daily pains of ankylosing spondylitis. The patient can help themselves with practicing good posture elimination old habits of slouching which puts pressure on the spine into a downward curve. The physical therapy can help relieve the pain of spine while ensuring the patient is more flexible.

Heat/Cold Treatments

The patient condition with anklosing spondylitis can resort to treatments that many of the athletes use to treat stiff joints. The heat and cold method can help along with physical therapy, good posture and consistent regiment of medication. The therapy can use heat to assist in relaxing the joint muscles. The application of heat to the tight muscles in the back can help the patient with mobility and range of motion. The cold treatment for the inflamed areas have been known to help with reducing the amount of swelling. The hot baths can provide relief to the parts of the body that ache while exercise can help with lubricating the joints for better movement. The anklosing spondylitis patient must keep the exercise routine as an essential part of AS daily management.

Laboratory Test

At this time, there is not a blood test that can diagnosis the AS disease, however the presence of HLA-B28 gene allows the physician to detect the disease in earlier stages of the patients life. It has been proven that over 95% of patients with the ankylosing spondylitis have the AS gene. Most individuals who have AS also have a gene that produces a “genetic marker” – in this case, a protein – called HLA-B27. This marker is found in over 95% of people in the Caucasian population with AS (Spondylitis Association of America 1). The physician can test seeking any clinical evidence of inflammation anywhere in the body. This is a standard test that can gauge the amount of inflammation in the patients’ blood. It must be noted it’s difficult because other illnesses such as pneumonia can skew the test rendering it ineffective. There is another laboratory test that is used to determine the amount of inflammation which would indicate the presence of AS is the Erythrocyte Sedimentation Rate (ESR). This test can measures how quickly red blood cells sink in a laboratory tube.  The more the red cells fall to the bottom, the higher indication of ankylosing spondylitis.

Symptoms

The main symptoms of ankylosing spondylitis is spine pain, inflammation of joints, stiffness of the back and problems with range of motion. There are other characteristics such as inflammation of the eye, gastrointestinal problems and severe lumbar pain. The patient normally has problems laying down because when the lumbar spine becomes flatten or curved. The curvature is called kyphosis.  The severe pain can move to the shoulders and hips while the vertebras is fused together. The symptoms can be present over a number of years with the physician misdiagnosing as basic arthritis, however, if detected too late the bony part of the spine ligaments have already fused together. There is an increased risk of a spinal fracture however, not every patient moves on to the states of spondylitis.

Testing

The traditional testing begins with the physician seeking the causes of the inflammation.  The examinations looks for tenderness in the areas of the chest, heels, sacroiliac, pelvic bones and the back area. Another test performed by the physician is determining whether the patient has limited spinal mobility in any direction including expanding the chest. A rheumatologist will test for ankylosing spondylitis searching for disorders of the bones, connective tissue, ligaments, muscles and joints. The secondary phase would be performing radiological tests which include a make-up of family medical history, family history of AS, as well as testing for the presences of the HLA-B27 gene.

 Medical Advances

There are several pharmaceuticals company, which have been approved for the treatment ankylosing spondylitis. Alvogen a pharmaceuticals leader in the industry has a new bio similar medicine that is the first monoclonal antibody to be approved through the European Medicines Agency (Alvogen to Launch Inflectra in Europe 1). The pharmaceutical treatments has some serious set-backs such as it lowers the person’s immune system. The immune system cannot fight the inflammation and the continue weight gain.

Supports

The Spondylitis Association of America (SAA) is an organization that supports people with Ankylosing Spondylitis while providing information about the diseases and promotes education to the community. The SAA has quarterly newsletter called Spondylitis Plus. In addition, the SAA works with other organization to find the cure for AS. The SAA works in conjunction with the University of Texas-Houston to find the cures for AS. They have combined to create the North American Spondylitis Consortium (NASC). This consortium is made up of nine well-known medical establishments in different parts of the country that is diligently seeking a cure for AS (Spondylitis Association of America 1).The NASC advises that patients should maintain a simple and normal life that is active and with a positive attitude. The primary goal is not to let AS dominate your life, talk control and exercise.

References

Alvogen to Launch Inflectra in Europe.” Health & Beauty Close-Up 18 Feb. 2014. Gale Power Search. Web. 27 Feb. 2014.

National Institute of Arthritis and Musculoskeletal and Skin Disease (2014). Questions and answers about Ankylosing Spondylitis. Retrieved from http://www.niams.nih.gov/health_info/Ankylosing_Spondylitis/

Schafer, Valentin S., et al. “Evaluation of the novel ultrasound score for large joints in psoriatic arthritis and ankylosing spondylitis: six month experience in daily clinical practice.” BMC Musculoskeletal Disorders 14 (2013): 358. Gale Power Search. Web. 28 Feb. 2014.

Spondylitis Association of America (2014). Ankylosing Spondylitis. Retrieved from http://www.spondylitis.org/about/as.aspx

Spondylitis Association of America. (2013). Learn about ankylosing spondylitis. Retrieved from http://www.spondylitis.org/

University of Maryland Medical Center (2014). Ankylosing Spondylitis: A patient’s guide to Ankylosing Spondylitis. Retrieved from  http://umm.edu/programs/spine/health/guides/ankylosing-spondylitis#ixzz2udJEZTYe