Ankylosing Spondylitis (AS) is an auto-immune disease. It refers to abnormal functioning of the bodys immune system, where the system starts mistakenly attacking the bodys own normal tissues causing inflammation (swelling) of the joints in the spine. If untreated the joints can get permanently damaged and can lead to irreversible bone fusion.

Reducing the disease progression with treatment

Early and correct diagnosis of disease can substantially reduce disease progression and severity. Regular exercise and maintaining healthy weight are essential to complement medical therapy. Modern treatment aims at stopping the disease progression, easing the pain and stiffness, keeping the spine mobile and thus helping the patient towards finding a balanced normal living situation. Ideally, the disease can be managed through a combination of pain relief exercises and disease modifying drugs.

A Rheumatologist is an expert in treating ankylosing spondylitis and must be consulted early in the course of illness. Advanced therapies like biologics used by Rheumatologists help slow down or stop the disease progression altogether. Biologics have been the most significant advancements towards managing the condition, especially for patients who do not respond well to the traditional disease modifying drugs.

Lifestyle changes to curb the pain of the disease

Patients with AS have found a significant amount of relief by adopting a regular routine of physical activities, sports, and stretching exercises. The disease demands movement because it reduces inflammation. Activities like swimming, yoga, light weightlifting etc. can significantly help in marinating mobility.

Taking a professional advice for types of excises is important. Physiotherapy is a very important part of the treatment for Ankylosing Spondylitis. A physiotherapist can put together a programme of exercises that increase your muscle strength and help you maintain mobility in your spine and other joints. Its especially important to exercise your back and neck to avoid them stiffening in a bent position.

Awareness about the disease, its signs and symptoms

Awareness about Ankylosing Spondylitis is relatively less among general population in India. Most people will commonly mistake AS as posture-related back pain. Its important to understand and be aware of the initial signs such as early-morning stiffness in the spine that finds comfort through activity, and excessive pain during the night. Such patients traditionally suffer from an exhilarating pain in their lower back and hip, which gradually leads to spine fusion. The disease manifests at the early ages of 15-35 years, and starts to show itself and grow significantly, if left untreated. The pain can impact patients everyday productivity.

Most, but not all, people with AS carry a gene called HLA-B27. Although people carrying this gene are more likely to develop the disease, it is also found in up to 8% of normal population who have no signs of the condition. Having this gene doesnt mean youll definitely get AS.

Delayed treatment of AS in India

Unfortunately, delayed diagnosis of AS is a globally recognized problem. On an average, Indian studies show a delay of 3-6 years in the diagnosis of AS. Delayed diagnosis and treatment can cause irreversible structural damage which, consequently, can affect patients mobility and quality of life.

Only a small number of patients (>25%) directly visit a rheumatologist for initial assessment of their symptoms of AS.Many patients only reach rheumatology clinics after seeing multiple specialists, which contributes to the long diagnostic delay. Along with the patients not knowing whom to reach out to, the insufficient number of rheumatologists in India, is simultaneously a key reason behind this delay.

Additionally, opting for unregulated alternative therapy also results in a longer delay in reaching to a rheumatologist. Fear of adverse effects of modern medicine is another barrier in the early treatment initiation. Its now become an urgent requirement to find methods of elucidating available information regarding modern medicine in order to address patients concerns and improve their health seeking behaviour.

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Views expressed above are the author's own.

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Delayed treatment of Ankylosing Spondylitis can lead to lifelong bone fusion - Times of India