As ankylosing spondylitis progresses, unchecked inflammation may occur in the eyes causing painful eyes that may be red or puffy.
Certain treatment methods can help reduce these complications as well as the progression of the disorder.
This article looks at some of these complications and discusses the treatment options available for them.
Complications of ankylosing spondylitis
Ankylosing spondylitis (AS) is a type of arthritis and triggers painful inflammation in the body, most commonly centered in the back and buttocks. Symptoms can spread as the disorder progresses, with pain and inflammation commonly felt in the pelvis, hips, heels, and other large joints.
As the condition progresses, unchecked inflammation can contribute to other complications that can affect a person's life. The effects of these complications can vary from mild to debilitating, and people should speak with a doctor to understand what their options are to help manage all of their symptoms.
1. Eye problems
The doctor or rheumatologist will often encourage a person to visit an ophthalmologist regularly to have their eyes checked.
If inflammation spreads to the eyes, it can cause symptoms, such as swollen, painful eyes that may be red or puffy. Some cases can also cause blurred and impaired vision, sensitivity to light, and severe pain.
There are prescription medications used to treat these symptoms. Wearing dark glasses also can help.
2. Reduced flexibility
Damage to the back and joints caused by inflammation can restrict the movement of the muscles and bones as it progresses. For some people, this can result in very limited movement in the spine.
This reduced flexibility happens when the bones of the lower back fuse together. The fusing of the bones makes it difficult for a person to move and can even cause the back to get stuck in one position. Rare cases may lead to severe disability.
In many cases, people who follow a regular treatment plan that includes stretching and exercise can help keep their bodies more flexible and remain mobile for longer.
Caused by inflammatory markers called cytokines that are circulating in the body, tiredness is one of the more common symptoms of AS. Tiredness may get worse because the body using a lot of its energy to keep this inflammation at bay. The effect can leave a person feeling drained of energy.
Drugs called TNF-a inhibitors that are often prescribed for AS treatment may help lighten the load of the immune system. Regular exercise, such as swimming, can also help relieve fatigue and improve a person's quality of life.
Osteoporosis is a bone disease that makes the bones less dense than normal. It occurs when the body loses too much bone or makes too little bone. The bones then become weak and are prone to breaks.
This disease can develop in the spines of people with AS, increasing their risk of spinal injury. Medications are often given to help treat those with both AS and osteoporosis symptoms.
According to a study in Current Rheumatology Reports, osteoporosis frequently occurs in people with AS, even in the early stages of the disorder. It is the severe inflammation caused by AS that is thought to contribute to osteoporosis.
Treating AS correctly also seems to help prevent bone loss.
5. Gastrointestinal disorders
Inflammation may spread to the intestinal tract causing stomach pain and digestive issues.
In some cases of AS, inflammation can spread from the spine and hips to the intestinal tract. According to research posted to Current Opinion in Rheumatology, up to 50 percent of AS patients have inflammation in their gut.
Inflammation in the intestinal tract and bowels can contribute to issues like stomach pain, stomach ulcers, diarrhea, and problems digesting. More severe cases may lead to conditions, such as Crohn's disease or ulcerative colitis.
Dietary limitations and regular exercise help to control inflammation, as do certain medications.
6. Increased risk of heart disease
People with AS may also be at an increased risk of developing some heart problems. Cardiovascular issues that AS contributes to include:
- aortic valve disease
- conduction problems
- ischemic heart disease
Taking preventive measures to reduce the risk of cardiovascular symptoms is important for people with AS.
Regular exercise and eating a healthful diet are part of a good AS treatment plan, and also help reduce the risk of heart diseases. It also helps people to avoid tobacco use and maintain a healthy weight.
7. Social and employment problems
While having AS does not have any direct impact on employment, the disorder can affect a person's social and public life as it progresses.
Over time, AS can affect the type of work a person can do, especially physical labor. Some may be unable to work for long period, while others may not be able to work at all.
It is important for people with AS to learn to sit correctly and keep good posture. As the symptoms often improve with movement, people should take regular stretch breaks.
A person's social life can also be affected by AS. People experiencing chronic pain may be less likely to visit friends, and may find that they are facing symptoms of isolation and depression.
It is important for people to stay active and keep up with a regular treatment plan to help reduce symptoms and promote feelings of well-being as much as possible.
Most of the common complications caused by AS are treatable. There are, however, some very rare complications of AS. These include:
8. Cauda equina syndrome
The inflammation that causes bony overgrowth in AS can lead to an extremely rare condition called cauda equina syndrome. The condition causes bone growth, which leads to pressure and swelling at the end of the spinal cord. This swelling can compact the nerves in the lower back and cause symptoms such as:
- pain and numbness
- stinging or tingling sensations in the legs
- inability to walk
If it is left untreated, cauda equine syndrome can lead to paralysis and other severe issues. The condition usually requires emergency surgery.
Caused by the buildup of a protein called amyloid in the organs, amyloidosis can cause symptoms such as weight loss, water retention, and tiredness.
Some people also experience symptoms that resemble nerve damage, such as tingling in the hands and feet. Chemical medications are used to treat the condition.
A healthcare professional may recommend some light stretching and gentle exercise to help reduce symptoms.
AS presents in a variety of ways and the condition requires different forms of treatment. Doctors often prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce the inflammation in the body.
Other medications can be used to help reduce particular symptoms. For example, doctors may also recommend medications called tumor necrosis factor inhibitors that target TNF-alpha, a protein that promotes inflammation and influences AS.
Alongside medical treatments, doctors may suggest that people with AS do some physical activity. Having a workout plan that includes physical therapy, light stretching, and exercises, such as swimming or bicycle riding, may help promote flexibility and reduce symptoms.
Using topical ice or heat packs may also bring relief from symptoms.
Ankylosing spondylitis is a complex disorder that can cause some serious complications when left unchecked. However, symptoms and complications for many people can be controlled or reduced by following a regular treatment plan.
People should work directly with their rheumatologists to find a treatment plan that works for them and helps them experience the best quality of life possible.