Ankylosing spondylitis is a chronic autoimmune disease that currently has no cure. People with the condition should be aware of the potential health complications.
Certain treatment methods can help reduce these complications, as well as slow the condition’s progression.
This article looks at some of the complications associated with ankylosing spondylitis (AS) and discusses the treatment options available for them.
AS is a type of arthritis. It triggers painful inflammation in the body, most commonly in the back and buttocks. Symptoms can spread as the condition progresses, with pain and inflammation commonly in the pelvis, hips, heels, and other large joints.
As AS progresses, unchecked inflammation can contribute to other complications affecting a person’s life. The effects of these complications can vary from mild to debilitating, and people should speak with a doctor to understand their treatment options.
1. Eye problems
Up to 50% of people with AS will develop uveitis or iritis — or eye inflammation — at least once.
If inflammation spreads to the eyes, it can cause symptoms such as:
- eye pain
- eye redness
- eye puffiness
- blurred or impaired vision
- sensitivity to light
- floating spots in vision
There are prescription medications available to treat these symptoms. Wearing dark glasses also can help.
A person’s doctor or rheumatologist will often encourage them to visit an ophthalmologist regularly to check their eyes.
2. Reduced flexibility
Damage to the back and joints caused by inflammation can restrict movement of the muscles and bones as AS 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. In rare cases, it 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.
Fatigue is one of the more common symptoms of AS. It results from the circulation of inflammatory markers in the body called cytokines. Fatigue may worsen because the body uses much of its energy to keep this inflammation at bay. The effect can leave a person feeling drained of energy.
Osteoporosis 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. The inflammation involved in AS may contribute to osteoporosis.
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5. Gastrointestinal disorders
In some people with AS, inflammation can also involve the intestinal tract.
Inflammation in the intestinal tract and bowels can contribute to issues such as stomach pain, stomach ulcers, diarrhea, and digestion problems.
A person’s doctor may recommend they see a gastroenterologist to help manage IBD or other gastrointestinal issues.
6. Increased risk of heart disease
People with AS may also have an increased risk of developing heart problems, such as:
- aortic valve disease
- conduction problems
- ischemic heart disease
Taking preventive measures to reduce the risk of cardiovascular symptoms is important for people with AS. These include:
- regular exercise
- eating a well-balanced diet
- avoiding tobacco use
- maintaining a moderate weight
7. Social and employment problems
While having AS should not have any direct impact on employment, being unable to work for long periods may make getting or keeping a job difficult. As it progresses, the condition can also affect a person’s social and public life.
People experiencing chronic pain may be less likely to visit friends and may find that they are facing symptoms of isolation and depression.
Staying active and sticking to a treatment plan can help reduce symptoms and promote feelings of well-being.
Most of the common complications caused by AS are treatable. However, there are some less common complications of AS, including:
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
- pain that improves when bending forward
Without treatment, cauda equina 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 produce 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. Doctors use medications to treat the condition.
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 inflammation.
If NSAIDs alone are not enough, other medications may help reduce particular symptoms and slow disease progression. They include:
- Biologics: These injectable medications target specific parts of the immune system. Types of biologics include TNF inhibitors, IL-17 inhibitors, and IL-12/23 inhibitors.
- JAK inhibitors: JAK inhibitors are a newer type of AS treatment. They target the JAK family of enzymes, which signal cells to make inflammatory proteins called cytokines. People take JAK inhibitors orally.
- Corticosteroids: Doctors inject corticosteroids directly into a joint to help reduce inflammation and ease pain. Due to the potential side effects, doctors do not recommended them for long-term use.
Alongside medical treatments, doctors may suggest 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 help relieve symptoms.
People living with an autoimmune disease, such as AS, can connect with others who understand the challenges they face. To find a support group, people can contact:
- online groups and forums
- their local hospital, which may offer support groups for people with chronic conditions
- social workers or social services
- health or religious organizations
Places to find support online include:
Ankylosing spondylitis is a complex condition that can cause complications, such as fatigue, reduced mobility, and eye problems.
However, many people can manage these complications by following a regular treatment plan and staying active. It is also vital to have regular check ins with a rheumatologist.