Ankylosing spondylitis (AS) is a chronic inflammatory condition primarily affecting the spine. While serious and impacting quality of life, AS is rarely a direct cause of death. Health risks typically stem from associated complications that can arise over time.
Understanding Ankylosing Spondylitis
Ankylosing spondylitis is a long-term inflammatory disease primarily targeting the joints within the spine and the sacroiliac joints, where the spine connects to the pelvis. This inflammation causes persistent pain and stiffness, especially in the lower back and hips. Over time, chronic inflammation can lead to new bone formation, potentially fusing spinal segments. While mainly affecting the spine, AS can also inflame other joints like the hips and shoulders, and occasionally impact other organs.
Ankylosing Spondylitis and Mortality Risk
Ankylosing spondylitis itself is not typically considered a fatal condition, and many individuals with AS experience a normal life expectancy. However, people with AS may have a slightly increased mortality risk compared to the general population due to complications. These concerns relate to the systemic nature of inflammation and its effects on various body systems.
Cardiovascular health is a significant concern, as individuals with AS face an increased risk of heart disease, including heart attack and stroke. Inflammation can contribute to issues such as aortitis or irregular heart rhythms. Pulmonary complications can also arise, including restrictive lung disease from chest wall stiffness, which can limit lung capacity. Some individuals may develop lung fibrosis, increasing susceptibility to lung infections.
Chronic inflammation and potential treatments can influence the risk of infections. Another serious complication involves spinal fractures, as the fused or stiffened spine becomes more brittle and prone to injury even from minor trauma. These fractures can lead to neurological damage, including paralysis. Prolonged inflammation can lead to amyloidosis, a protein buildup that can impair kidney function.
Managing Ankylosing Spondylitis for Better Outcomes
Effective management of ankylosing spondylitis is important for mitigating risks and improving long-term health outcomes. Early diagnosis and consistent medical care are integral to controlling disease progression and preventing severe complications.
Treatment often begins with nonsteroidal anti-inflammatory drugs (NSAIDs) to alleviate pain and reduce inflammation. For more pronounced inflammation or when NSAIDs are insufficient, healthcare providers may prescribe disease-modifying antirheumatic drugs (DMARDs) or biologic medications like TNF inhibitors, IL-17 inhibitors, and JAK inhibitors.
Physical therapy and regular exercise are fundamental components of AS management. These activities help maintain spinal flexibility, improve posture, and strengthen core muscles, which can reduce pain and prevent further stiffness or fusion.
Lifestyle adjustments also play a significant role in managing AS and improving overall well-being. Avoiding smoking is particularly important, as it can worsen symptoms, increase lung problems, and elevate cardiovascular risks. Maintaining a healthy weight through a balanced diet supports joint health and reduces stress on the body. Practicing good posture and managing stress can further contribute to improved comfort and disease control. Regular medical check-ups are also crucial to monitor disease activity and screen for any potential complications.
Recognizing Signs of Serious Complications
It is important to know when to seek immediate medical attention for ankylosing spondylitis. Sudden, severe chest pain or significant shortness of breath could signal a serious cardiovascular or pulmonary complication.
Any new or worsening neurological symptoms, such as numbness, weakness, or loss of bladder or bowel control, especially following a fall or injury, warrant urgent evaluation for potential spinal fractures or nerve damage. A high fever accompanied by chills or other signs of a severe infection requires prompt medical consultation.
Persistent, severe pain that does not respond to usual medications should also be reported to a healthcare provider. Eye inflammation, known as uveitis, which can manifest as a painful red eye, severe light sensitivity, or blurred vision, needs immediate assessment by an eye specialist. Unexplained weight loss or profound, persistent fatigue are also symptoms that should prompt a discussion with a doctor.