Ways to Ease Ankylosing Spondylitis Pain Chapter 1

 

If you like me are living with ankylosing spondylitis, you know the back pain and fatigue that are hallmarks of the condition can be unpredictable. But fortunately, there are many approaches — besides simply relying on medications — that you can take to ease spondylitis pain and stiffness and move more freely. Most of these ideas are free or inexpensive, and even enjoyable to boot. You’ll find that the emotional boost you get from taking these steps can be as great as the physical improvement.

Make Mornings More Manageable

morning

If you’re like most people with ankylosing spondylitis, your lower back pain and stiffness is worse in the morning. “When joints are stationary for a time, the joint fluid actually thickens a bit, like ketchup,” says Sturdy McKee, MPT, physical therapist and CEO of San Francisco Sport and Spine Physical Therapy. “You can shake or stir your joints through repeated movements — any repeated movements.” Talk to your doctor or physical therapist to create a morning routine of gentle motions that can lessen spondylitis pain and get your joints moving.

Hit the Showers

Shower

When the fluids in your joints get thick and stiff, spondylitis pain gets worse. A great way to get those fluids moving is to warm them up with a warm bath or shower, which loosens up your muscles and makes it easier to exercise. In fact, you might find that doing some exercise in the shower can help get you going in the morning. You may also find that doing your posture training for ankylosing spondylitis after a warm bath or shower, when your body is warmed up, is easier for you.

Correct Poor Posture

posture

Poor posture ramps up spondylitis pain and stiffness. Minimize lower back pain with what medical experts call “posture training:” Think tall by keeping your head balanced and your back straight at all times, and practice standing with your back against a wall and prone lying, which is lying face down on a firm surface. A physical therapist can show you the ropes. “Posture training should be done for about 30 minutes every day, but you can break this time up into 10- or 15-minute sessions,” says Angelo Papachristos, a physiotherapist at St. Michael’s Hospital in Toronto, Ontario, Canada.

Special thanks  to : Chris Iliades, MD

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Food/ Diet & Ankylosing spondylitis

index

 

Whether a person is affected by a chronic illness or not, there are some straightforward guidelines that if followed, would lead to improved health and well-being for almost everyone. Both calcium and alcohol affect the strength of the bones, and it is a well known fact that people with spondylitis are already at higher risk for osteoporosis, a dangerous thinning of the bones that can lead to fractures. Following a diet with adequate amounts of calcium and vitamin D will help reduce the risk of osteoporosis. Alcoholic beverages can also weaken bones. Consuming more than two alcoholic drinks per day increases a person’s chances of developing weakened bones. In addition, alcohol mixed with certain medications can cause serious side-effects to the gastrointestinal tract and to major organs such as the liver and the kidneys. It is important to find out from your doctor whether any of the medications that you take affect how your body uses what you eat. For instance, some medications cause a person to retain sodium, while others cause potassium loss. Methotrexate can lower folic acid levels causing a variety of adverse symptoms which can be offset by taking additional supplements. Whatever you decide, expert agree that there are basic guidelines to good nutrition, which are: Eat a variety of foods that make you feel good – avoid those that do not. Eat plenty of vegetables, fruits, and whole-grain products. Use fat (especially saturated fat found in animal products), cholesterol, sugar, and salt in moderation. Drink 8-10 glasses of water a day. Most people receive daily requirements of vitamins and minerals by eating a well-balanced diet, but others need to take vitamin supplements. Avoid alcohol or foods that can interact with your medication. Talk with your doctor and/or pharmacist about potential interactions.

 

What Is Ankylosing Spondylitis?

Ankylosing spondylitis is a form of progressive arthritis due to chronic inflammation of the joints in the spine. Its name comes from the Greek words “ankylos,” meaning stiffening of a joint, and “spondylo,” meaning vertebra. Spondylitis refers to inflammation of the spine or one or more of the adjacent structures of the vertebrae.

Ankylosing spondylitis belongs to a group of disorders called seronegative spondyloarthropathies. Seronegative means an individual has tested negative for an autoantibody called rheumatoid factor. The spondyloarthropathies are a family of similar diseases that usually cause joint and spine inflammation. Other well-established syndromes in this group include psoriatic arthritis, the arthritis of inflammatory bowel disease, chronic reactive arthritis, and enthesitis-related idiopathic juvenile arthritis.

Although these disorders have similarities, they also have features that distinguish them from one another. The hallmark of ankylosing spondylitis is “sacroiliitis,” or inflammation of the sacroiliac (SI) joints, where the spine joins the pelvis.

In some people, ankylosing spondylitis can affect joints outside of the spine, like the shoulders, ribs, hips, knees, and feet. It can also affect entheses, which are sites where the tendons and ligaments attach to the bones. It is possible that it can affect other organs, such as the eyes, bowel, and—more rarely—the heart and lungs.

Although many people with ankylosing spondylitis have mild episodes of back pain that come and go, others have severe, ongoing pain accompanied by loss of flexibility of the spine. In the most severe cases, long-term inflammation leads to calcification that causes two or more bones of the spine to fuse. Fusion can also stiffen the rib cage, resulting in restricted lung capacity and function.

The cause of ankylosing spondylitis is unknown, but it is likely that both genes and factors in the environment play a role. The main gene associated with susceptibility to ankylosing spondylitis is called HLA-B27. But while most people with ankylosing spondylitis have this genetic marker, only a small percentage of people with the gene develop the disease.

 

 

Thanks to : N I H

I’m Back

Dear Friends,

has been hard be far away from all of you, but It was  and still it is hard for me, but I’m a warrior and I have to fight to be well in my body and in my mind.

I will do my best to search and share with you any tips can be helpful.

I wish you a wonderful night and I hope i can blog soon .

A virtual hug to all you

Adriana

 

Pregnancy with Ankylosing Spondylitis

 

Does ankylosing spondylitis (AS) worsen with pregnancy?

Pregnancy tends to improve AS in 20-30%, worsen AS in 20-30% while it remains unchanged in 50-60%. In general, spinal disease remains unchanged during pregnancy while peripheral arthritis and uveitis are suppressed during gestation and tend to exacerbate after delivery. Women carrying a female foetus fare better than those carrying a male foetus. Those with active spinal disease are advised not to plan pregnancy unless the disease is controlled.

When can one plan pregnancy with ankylosing spondylitis?

Your arthritis must be reasonably controlled for a period of at least 3-4 months before planning pregnancy. You should not have had any flare during these months.
Always speak to your Rheumatologist before planning pregnancy as he may have to make changes in your medicines. He would be the best person to guide you regarding the timing of your decision. Please speak to him well in advance as Methotrexate has to be stopped at least 3 months prior to planning to conceive.Those with active spinal disease are advised not to plan pregnancy unless the disease is controlled.

Is the pregnancy outcome different in patients with ankylosing spondylitis?

No. Ankylosing spondylitis doe not affect the course of pregnancy or the fetal well-being. The risk of fetal loss, prematurity or low birth weight does not increase with AS. Women with Ankylosing spondylitis are more likely to require a cesarean section as inflammed/ ankylosed sacroiliac joint is a mechanical hindrance to childbirth.

What to expect after delivery?

50-80% of the AS patients experience aggravation of symptoms 4 to 12 weeks after delivery. Episodes of uveitis & peripheral arthritis are more common after delivery.

Does Ankylosing spondylitis impair fertility?

No. Ankylosing spondylitis does not impair fertility. Sulfasalazine can impair the maturation of sperm cells and thereby impair the fertility of men. However, this generally settles after stopping the medicine (after an average of 2 ½ months). Sulphasalazine does not affect fertility in women.

Does Ankylosing Spondylitis start during pregnancy?

Ostenson & colleagues studied 939 patients & found that AS starts during pregnancy in about 21% patients.

What is the risk of your child inheriting AS?

The risk of your child inheriting AS is higher if you are HLA-B27 positive. If you are HLA-B27 positive & your partner negative; the chance of your child being positive is 50%. However that does not mean that he/ she has to develop AS. The chances of developing AS are even lower; probably 5- 20%. The chances are higher If you have any other family members affected by AS.

Family Planning and Rheumatoid Arthritis

Although anyone can get rheumatoid arthritis, women with RA outnumber men by about three to one. Many women with rheumatoid arthritis are diagnosed in their 20s and 30s, just when marriage and family start to take life’s center stage.

With pain, fatigue, and medication side effects to consider, there’s no question rheumatoid arthritis makes family planning more complicated. But RA doesn’t have to put your dreams of having a family out of reach. If you’re thinking about starting a family while living with rheumatoid arthritis, consider these tips.

1. Don’t Worry That Rheumatoid Arthritis Could Hurt Your Baby

Rheumatoid arthritis itself doesn’t seem to harm the developing baby, even if RA is active during pregnancy. In fact, 70% to 80% of women with RA have improvement of their symptoms during pregnancy. Although some women with RA may have a slight risk of miscarriage or low-birth-weight babies, the vast majority of women have normal pregnancies without complications.

However, many drugs for rheumatoid arthritis — including methotrexate and leflunomide — can cause birth defects. These same medications may also cause birth defects if they are taken by men who father children. Therefore, it’s important to talk to your doctor about altering treatment several months before you or your spouse try to get pregnant.

With the right treatment and prenatal care, babies born to moms with rheumatoid arthritis are as healthy and happy as any.

2. Have Patience As You Try to Get Pregnant

Experts disagree whether rheumatoid arthritis reduces fertility in women or men. It’s true that many women with RA take longer to conceive than women without rheumatoid arthritis. Inconsistent ovulation, decreased sex drive, or having sex less often due to pain and fatigue are possible explanations.

For men, acute flares of rheumatoid arthritis temporarily reduce sperm count and function, and can cause erection problems and decreased libido. For both men and women, effective treatment for RA improves sexual symptoms and function. In well-treated rheumatoid arthritis, fertility in most men and women is probably normal.

3. Know That the Future Looks Bright for Rheumatoid Arthritis Treatment

New biologic drugs for RA have created a new era of treatment for rheumatoid arthritis, according to rheumatologists. With early and aggressive treatment, most people with RA can avoid joint deformities and major disability.

For most women, that means being present and active throughout your children’s years at home. While bad days from RA symptoms may be unavoidable, doctors believe most women will keep their independence for decades, and possibly their lifetimes.

4. Alter Rheumatoid Arthritis Treatment Well Ahead of Your Pregnancy

As soon as you’re considering starting a family, see your rheumatologist. Some drugs need a months-long “washout” period before trying to conceive. And that goes for men as well as women; although unproven, methotrexate might result in sperm problems that could cause birth defects.

If you’re taking leflunomide for RA, even more advance planning is necessary. Due to its long half-life, leflunomide needs to be stopped two years before trying to conceive a baby, although there are ways to “wash” it out of your system quicker.

5. Work With Your Doctor on Rheumatoid Arthritis Treatment During Pregnancy

Your rheumatologist will help you decide on a treatment plan that includes both control of your RA symptoms and safety for your baby.

Low-dose prednisone, for example, is generally considered safe during pregnancy. Hydroxychloroquine (Plaquenil) and sulfasalazine are also considered safe. While evidence is limited for biologic medicines like Enbrel and Remicade, many rheumatologists are confident in their relative safety during pregnancy.

One way to avoid the risk of pregnancy problems from RA medications is to simply not take any. Under a doctor’s supervision, some women quit RA drugs “cold turkey” when they begin trying to conceive, through delivery and breastfeeding.

This method has its own risk, of course: possible progression of joint damage from flares during the time when you are off treatment. In certain women, though, some rheumatologists endorse the approach, with close monitoring for disease activity.

6. Expect Improvement in Rheumatoid Arthritis Symptoms During Pregnancy

Interestingly, pregnancy usually has a positive effect on rheumatoid arthritis symptoms, albeit temporary. About 70% to 80% of women experience improvement in their RA symptoms during pregnancy.

In many of these women, drugs for RA may be safely reduced or even eliminated during pregnancy. For about one-quarter of women, though, rheumatoid arthritis activity continues during pregnancy, or gets worse.

Unfortunately, the respite from RA symptoms during pregnancy is short-lived. Most women relapse after delivering their babies.

7. Until You’re Ready to Get Pregnant, Use Contraception

Again, remembering the potentially harmful effects of some rheumatoid arthritis drugs on the fetus, it’s essential to avoid pregnancy until you’re ready. Experts say that used properly, a variety of methods are appropriate and effective, such as:

  • Condoms
  • Oral contraceptives
  • Vaginal ring
  • Intrauterine device (IUD)

Although controversial studies have suggested oral contraceptives might prevent rheumatoid arthritis in some women, there is no evidence that they help control RA symptoms.

Thanks to webmed

Diagnosing Ankylosing Spondylitis in Women

Ankylosing spondylitis has often been considered more of a man’s disease, yet the reality is that it affects some women, too.

The genetic marker for ankylosing spondylitis, HLA-B27, is found equally in men and women. However, ankylosing spondylitis is two or three times more common in men than women, said Rodney Tehrani, MD, a rheumatologist at Loyola University Medical Center in Maywood, Ill.

Ankylosing Spondylitis Diagnosis in Women: Why the Difference?

Many experts believe several factors may explain why it’s harder to reach an ankylosing spondylitis diagnosis in women. Some women may have milder symptoms, so ankylosing spondylitis symptoms may not be as obvious. Progression also may be slower, and symptoms can seem like other ailments, such as rheumatoid arthritis or fibromyalgia. The area of discomfort also can interfere with making the correct diagnosis. Along with back pain, women also might experience soreness in the neck and peripheral joints, in contrast to men who mainly tend to note back pain.

When to Suspect Ankylosing Spondylitis in Women

Getting the correct diagnosis is critical to getting started on the right treatment. “Clinicians should suspect the disease in women who complain of back pain, particularly when associated with any or all of the following: morning stiffness or stiff back after resting, psoriasis, inflammation of the eyes, frequent canker sores, irregular nails, swelling of the joints, painful joints, particularly shoulders and hips, and frequent abdominal pain and diarrhea,” said Ali D. Askari, MD, chief of the rheumatology division at University Hospitals Case Medical Center and a professor at the Case Western Reserve University School of Medicine in Cleveland.

Symptoms also should be carefully studied. For example, back pain from ankylosing spondylitis typically lessens with movement and exercise and gets worse with rest — a feature that sets it apart from some other ailments, like degenerative arthritis.

The Progression of Ankylosing Spondylitis in Women

Anyone with an ankylosing spondylitis diagnosis is naturally concerned about what comes next, but “there is no set course for this disease,” Dr. Tehrani explained. “It is variable in every individual, whether male or female.”

Most often, people with ankylosing spondylitis experience flares — painful episodes — mixed with times of remission when symptoms lessen. As the disease progresses, some of the vertebrae in the spine may fuse together, which makes the back more rigid and at greater risk for fracture.

How Ankylosing Spondylitis in Women Is Treated

Treatment options are similar for women and men. Medications for ankylosing spondylitis symptoms include non-steroidal anti-inflammatory drugs (NSAIDs) as the first line of attack to help address stiffness, neck pain, and back pain in women. When something stronger becomes necessary, most doctors turn to disease modifying anti-rheumatic drugs like corticosteroids and sulfasalazine. Biologics or TNF blockers are the latest additions to the treatment option arsenal.

Exercise also is important to retaining flexibility and keeping pain at bay. For example, Pilates has been shown to improve physical capacity and endurance in ankylosing spondylitis. A physical therapist can offer other suggestions.

Maintaining good posture, using heat to reduce soreness and using cold to lessen swelling also can help. Those with very serious cases might need to consider surgery.

Regardless of your symptom level, it’s important for women — and for men, too — to see a rheumatologist at least once a year to make sure you aren’t developing any other issues

Source Everyday Health