Currently, there is no cure for AS, but it can be managed using medications, surgery, and physiotherapy.
Rheumatologists are the most specialized and experienced doctors in the diagnosis and management of AS and other spondylopathies.
Nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen*, naproxen) work by reducing inflammation, which helps relieve the pain, stiffness, and swelling of AS. They do not slow down the progression of the condition; in other words, they don't stop the disease from getting worse. Possible side effects of NSAIDs include nausea, abdominal pain, asthma, liver damage, heart problems, high blood pressure, stomach ulcers, and bleeding.
Corticosteroids (e.g., prednisone, triamcinolone, methylprednisolone) work by reducing inflammation. They are used to relieve symptoms but do not affect spinal changes. Corticosteroids do not slow down the progression of the condition. They may be injected into an affected joint or taken by mouth. Side effects of the injection include joint damage (if the injection is used too often) and infection. Short-term side effects of the pills include increased appetite, weight gain, menstrual changes, emotional changes, and stomach irritation. Long-term use of high doses can lead to diabetes, cataracts, glaucoma, increased risk of serious infection, high blood pressure, osteoporosis (bone thinning), moon face (rounding of the face), mood changes, acne, joint damage, reactivation of hidden infections, muscle weakness, or increased body hair.
Biologics, (e.g., adalimumab, etanercept, golimumab , infliximab) are used to relieve signs and symptoms of the condition, including symptoms in the spine. Some biologics can also help to improve physical function for people with AS. They can slow or stop the progression of the disease, but they may not work for everyone. They work by neutralizing a molecule called tumour necrosis factor alpha (TNF-α), which is involved in causing inflammation. Biologics are given as an injection under the skin (a subcutaneous injection) or as an injection into the vein over a period of time (an intravenous infusion). Possible side effects include infusion reactions (e.g., rash, flushing, headache, and difficulty breathing), irritation at the injection area, nausea, headache, vomiting, diarrhea, fatigue, joint pain, or an increased risk of serious infection (including brain infection). There have also been reports of multiple sclerosis and systemic lupus erythematosus.
Disease modifying antirheumatoid drugs (DMARDs; e.g., methotrexate) are used to relieve AS symptoms and slow down the progression of the condition. DMARDs may be beneficial to people with peripheral AS (AS that involves other joints). They do not relieve inflammation in the spine. Possible side effects include nausea, diarrhea, increased risk of infections, liver damage, lung damage, and bleeding.
Make sure you understand and discuss all the risks and benefits of taking any medications before you start them.
Surgery may be used to repair joint damage or replace damaged areas. For example, some people with AS may need a hip replacement.
A physiotherapist can show you special exercises to improve your flexibility, strength, and mobility. If the disease is not slowed or stopped, regular exercise and supervised physical therapy are essential to maintain a working posture once the spine becomes fused - it is far better to be stiff upright than bent over.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
All material copyright MediResource Inc. 1996 – 2017. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Ankylosing-Spondylitis