Your spine can fuse solid.

“My spine fused itself, before they figured out why.” The pain and stiffness from ankylosing spondylitis is treatable, so your symptoms of severe back stiffness should not be ignored as ‘just routine back pain’. It could be due to severe inflammation in the connective tissues of the spine.

The symptoms of low back pain due to inflammation are different in several important ways from more common lower back pain, but especially in how long the stiffness lasts, several hours to all day. Also, the stiffness tends to worsen after a period of rest or sleep. The worst stiffness is usually in the morning, and also may be in the middle back and neck. This is different than other more common causes of back pain where the extra morning stiffness is usually no more than thirty to sixty minutes. It may be difficult to expand your chest when taking a deep breath, as your rib joints to the spine may be involved. In advanced cases, X-rays of the spine have a bamboo appearance, as the vertebrae are fused together.

In order to see if you are at high risk for having this disease based on your symptoms, go to http://www.painspot.com/ , choose your painspot and take the quiz. If you are found to be at high risk, print out your results and take them or email them to your doctor. (Photo credit of bamboo forest – commons wikimedia.org)

Your lower backbone is called the lumbar spine is made of a stack of 5 block-like bones called vertebrae with a triangular bone attached underneath. These bones are separated by oval cushions called discs. The tip of the triangular bone is your tailbone, or coccyx. The large hip bones on each side under the buttocks attach to the sides of the lowest triangular bone and are called the sacroiliac joints, near the ‘dimples’ in your low back area.

If ankylosing spondylitis is present there may be damage to your sacroiliac joints or your spine. This leads to stiffness and in severe cases the spinal bones fuse together. The entire spine and sometimes other joints in the arms and legs are involved. There may be inflammation in your eyes, called iritis. Inflammation in your sacroiliac joints is called sacroiliitis.

In many cases a blood test for a gene named HLA-B27 is positive, especially in ankylosing spondylitis.

A physical examination and x-rays by an arthritis specialist called a rheumatologist may confirm ankylosing spondylitis is present.

Very successful treatment now is available for patients with ankylosing spondylitis. Newer medications reduce inflammation and improve pain, stiffness, function, and quality of life when the disease is treated.

The FDA has approved several medications called “TNF inhibitors” for the treatment of ankylosing spondylitis (Enbrel, Humira, Remicade, Simponi, Simponi Aria). Usually rheumatologists are asked to help provide care for this form of arthritis.

About Doug Roberts MD

Board certified practicing rheumatologist and founder of PainSpot.com
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