How Is Ankylosing Spondylitis Managed Or Treated
Ankylosing spondylitis is a lifelong condition. While theres no cure, treatments can prevent long-term complications, reduce joint damage and ease pain. Treatments include:
- Exercise: Regular physical activity can slow or stop disease progression. Many people experience worse pain when theyre inactive. Movement seems to lessen pain. Your healthcare provider can recommend safe exercises.
- Nonsteroidal anti-inflammatory drugs :NSAIDs, including ibuprofen and naproxen , ease pain and inflammation.
- Disease-modifying anti-rheumatic drugs : Medications such as sulfasalazine reduce pain and joint swelling. The drugs also treat lesions caused by inflammatory bowel disease. Newer DMARDs called biologics help control inflammation by changing the immune system. Biologics include tumor necrosis factor and interleukin inhibitors .
- Corticosteroids: Injectable corticosteroids temporarily ease joint pain and inflammation.
- Surgery: A small number of people with ankylosing spondylitis may need surgery. Joint replacement surgery implants an artificial joint. Kyphoplasty corrects a curved spine.
Treatments For Back Pain
More than 85 percent of people with lower back pain improve with minimal treatment in a matter of days. However, if back problems persist, doctors generally prescribe one or more of the following treatments: proper exercise, rest, heat and cold, posture training, weight loss, stress management and relaxation exercises, medication, spinal manipulation and/or surgery. For some back conditions, the doctor may refer you to another specialist such as an orthopedist, rheumatologist, physiatrist, physical or occupational therapist, psychologist, psychiatrist or surgeon.
How Ra Affects The Neck
Chronic inflammation in the neck causes the destruction of the synovial joints, which are the joints that allow movement. When arthritis damages this joint in the neck, the cervical spine can become unstable.
Vertebrae are small bones that form the backbone. There are seven, and rheumatoid arthritis typically affects the first and second, called the atlas and axis, respectively.
The atlas supports the weight of your head and the axis helps your neck move in different directions.
An unstable vertebra can shift or dislocate over time and eventually press on the spinal cord and nerve roots. When this happens, you may have numbness and tingling around the neck that radiates up the back of the head. This is in addition to joint pain, stiffness, and swelling.
Risk Factors / Prevention
Unfortunately, there is no way to prevent the aging process. Therefore, arthritis will generally affect most people as they age. The aging process is accelerated by improper lifting, smoking, as well as excessive body weight.
There are ways to slow this process down. By staying in good shape, exercising, and keeping weight down, stress on the joints is reduced, causing less repetitive trauma to the joints, and decreasing the progression of arthritis.
Ra And Gastrointestinal Problems
Your medications, comorbid conditions or the disease itself might be causing your tummy troubles.
Studies show that people with RA are more likely to have stomach problems than the general population.
The gastrointestinal tract has an upper and lower section. And RA can affect either one. Research shows that people with RA are about 70% more likely to develop a gastrointestinal problem than people without RA.
There are several culprits. While medication side effects are the most likely offender, an increased risk of infection or unchecked inflammation can also be the cause. And sometimes, your troubles have nothing to do with RA at all.
GI symptoms are a common topic of conversation when my patients come in for their checkup. While there are several potential problems, the odds are the digestive issue is caused by either a medication side effect or it is related to something completely different than the patients RA, says Laura Cappelli, MD, Assistant Professor of Medicine in the Division of Rheumatology at Johns Hopkins University. Since RA can affect the entire body, it is important that patients talk about any medical issue they are experiencing with their rheumatologist.
Here are some of the reasons your belly might be bothersome:
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How To Prevent Rheumatoid Arthritis Headaches
There many steps you can take to manage RA headaches easier. These may ultimately lead to less pain.
It is possible the reason you get headaches because of stress. Stress management techniques, including meditation, yoga, deep breathing, and exercise can help reduce the number of headaches you have.
With or without RA, people who do not consume enough fluids can get headaches. Make sure you are drinking at least six glasses of water per day and limiting your caffeine and alcohol intake.
Get Enough Sleep
RA joint pain and stiffness can interrupt your sleep, and the lack of sleep increases your risk for headaches. Consider cutting back on caffeine, especially close to bedtime, and get regular exercise to relax your mind and body, and to help you to sleep better and wake up feeling refreshed.
Avoid Staring at Screens for Too Long
Spending too much time front of the computer can trigger headaches. If you work in front of a computer, take breaks every half hour to get away from the screen for at least a few minutes.
Avoid Cigarette Smoke
Cigarette smoke contributes to headaches because it constricts blood vessels in the brain. If you are a smoker, quitting can reduce and relieve headaches, and if you are not a smoker, avoid secondhand smoke as much as possible.
Check Your Medications
Fish oil has many health benefits, although the research shows any benefit is modest at best.
How Do You Know If Joint Problems Are Causing Your Low Back Pain
Only a doctor can diagnose you with a joint disorder like arthritis. If your doctor thinks you may have a joint disorder, theyâll take your health history and do a physical exam.
Other symptoms, like swollen joints or morning stiffness, can be a sign that your back pain is from a condition that affects your joints rather than muscle strain. Your doctor may also recommend tests like X-rays and blood tests to see whatâs going on.
It can be helpful to keep a journal about your pain. Jot down when it hit and what you were doing before and when it came. Youâll also want to write down whether you had any other symptoms that day. This can help your doctor figure out the cause of your pain and come up with a treatment plan.
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What It Feels Like
Neck pain is a primary symptom of RA in the neck. The severity of neck pain varies from person-to-person. You may feel a dull or throbbing ache in the back of your neck around the base of the skull. Joint swelling and stiffness can also make it difficult to move your head from side to side.
The difference between RA neck pain and a neck injury is that stiffness and pain from an injury may gradually improve over days or weeks. If left untreated, RA in the neck may not get better it can actually worsen. Even if symptoms do improve, inflammation, swelling, and stiffness can return.
RA in the neck also differs from osteoarthritis. RA pain is due to inflammation in the joints, whereas osteoarthritis involves the natural wear and tear of joints.
Osteoarthritis can also affect the neck. However, pain and stiffness with RA can be worse in the mornings or after periods of inactivity. Osteoarthritis neck pain tends to worsen with activity.
How Is Spinal Arthritis Treated
The treatment for spinal arthritis depends on many factors. They may include your age, level of pain, type and severity of arthritis and personal health goals. Because the joint damage caused by arthritis is irreversible, the treatment usually focuses on managing pain and preventing further damage.
Nonsurgical treatments for spinal arthritis may include:
Nonsteroidal anti-inflammatory drugs and corticosteroids to reduce pain and swelling
Other medications targeting specific symptoms or triggers of inflammatory arthritis
Physical therapy to improve back muscle strength and range of motion in the spine
Lifestyle changes to reduce inflammation or stress on your spine: losing weight, quitting smoking, changing your posture, etc.
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Small Blood Vessel Nerve Symptoms
RA may damage the small vessels that feed the nerves. This damage is known as rheumatoid vasculitis . RV impacts only about 1 percent of those with RA, but the condition may be severe. RV can cause damage to the nerves of the hands and feet, which can disable the person impacted. RV may lead to damage to multiple nerves in the body. Signs of RV may include:2
- Numbness, tingling, burning, or pain in the hands or feet
- Muscle weakness or paralysis
- Muscle wasting, or loss of muscle
Although rare, RV may affect the small vessels in the brain. This may increase the risk of conditions such as stroke.2
Costochondritis Is Not The Same As Tietze Syndrome
Costochondritis is often confused with Tietze syndrome, a similar but less common disorder that typically involves swelling of the second or third rib that can last for months. According to the American Family Physican review, Tietze syndrome typically affects people who are younger than 40 and is considered rare, while costochondritis is more common and can affect children, teens, and adults, says Gewanter. In fact, he says, the rib cages of kids are extra flexible, so that increases the opportunity to irritate the costochondral junctions. Local swelling is typically present with Tietze’s, while it is not with costochondritis, though the RA advocate ONeill notes inconspicuous swelling with her costochondritis. In reality, whatever you want to call it, both conditions are treated in essentially the same way, says Gewanter. Tietze syndrome can subside without treatment, but over-the-counter pain medication may be used.
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Rheumatoid Arthritis And Low Back Pain
This article describes the connection between rheumatoid arthritis and low back pain, including sciatica. Also discussed are ways to safely relieve low back pain at home when RA is present.
Rheumatoid arthritis is an autoimmune disease that causes painful swelling, stiffness, and deformities of the joints. Watch:Rheumatoid Arthritis Overview Video
Questions To Ask The Doctor About Medications:
- What will the medication do?
- How long will it take before I notice results?
- What is the name of the medication? Is there a generic brand?
- Are there side effects I should know about?
- How should I take the medication ?
- How often should I take the medication?
- What should I do if I forget to take a dose at the specified time?
- Let your doctor know if you are taking other medications. Sometimes certain medications cannot be taken together.
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Back Pain: Acute Vs Chronic
Before looking at treatments for your back pain, youll need to know if you have acute or chronic back pain.
Acute back pain is usually a result of straining your back. It can be treated with medication and usually will get better over time. Exercise isnt recommended.
Chronic back pain is different. Its a long-term problem caused by conditions like RA. It can be treated in a number of ways, and exercise can be beneficial.
Ra Rarely Attacks The Joints Of The Lower Spine
Rheumatoid arthritis causes the bodys immune system to attack the lining of synovial joints. However, it is rare for RA to attack the synovial joints of the lower spine,4 which connect vertebrae to each other and to the pelvis .
Rheumatoid arthritis is more likely to affect the lower spine in other ways.
Read more about Lumbar Spine Anatomy and Pain on Spine-health.com
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What Is Ankylosing Spondylitis
Ankylosing spondylitis is a type of arthritis that mainly affects the back, by causing inflammation in the spine. This can make your back, rib cage and neck stiff and painful.
It often starts in people who are in their late teens or 20s.
In response to the inflammation, the body produces extra calcium around the bones of the spine. This can make extra bits of bone grow and cause your back and neck to be more stiff.
In rare cases some of the bones of the spine may link up, or fuse together because of the extra calcium. In serious cases this can make the spine curve forward more. You can reduce the risk of this happening, if you:
- keep active
Other Potential Causes Of Si Joint Pain
In addition to arthritis, SI joint pain may be caused by
- Heavy lifting, prolonged physical activity, and manual labor
- Prolonged sitting or standing
- Traumatic injuries such as falls
- Lumbar spinal fusion surgery
It is essential to have a complete assessment of your condition by a qualified medical professional if you have lower back pain. Due to the many possible causes of sacroiliac joint pain contact your primary care provider for more information and diagnostic evaluation.
For persistent joint pain that is interfering with your daily activities, see a Tristate rheumatologist to make the correct diagnosis and begin the proper treatment.
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How Rheumatoid Arthritis Affects The Back
Rheumatoid arthritis can affect any of the moveable joints within the human body, including joints directly responsible for movements of the spine. When RA affects the back, symptoms can range from mild to severe enough to require spine surgeryto relieve pressure caused by the swelling and inflammation of joints thats characteristic of this type of arthritis.
Additional Symptoms And Complications
- Compression of either the vertebral arteries or spinal cord can reduce blood flow in the neck. The decreased oxygen to your brain that results could mean dizziness and blackouts.
- Compression of the spinal cord also affects balance and your ability to walk and may even cause bowel and bladder control problems.
Unstable vertebrae can press on the nerve roots and spinal cord, which can cause numbness and tingling that goes up into the back of your head. It can also lead to pain, stiffness, and swelling.
In a small percentage of people, extreme cervical instability can cause quadriplegia or even sudden death.
A serious condition called myelopathy can result from compression that causes injury to the spinal cord. Myelopathy is associated with increased disability with symptoms that include:
- Muscle atrophy
- Loss of awareness of the body’s position or movements
However, most people with cervical spine problems from RA don’t have any symptoms. In fact, research from a 2018 Mexican study finds that asymptomatic cervical instability is quite common in people with RA. The majority of the patients in this study were asymptomatic for neck pain and other cervical spine symptoms despite advanced RA and severe disease activity.
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What Are The Different Types Of Arthritis That Affect The Back
There are several types of arthritis. The different types of arthritis that may affect the back or neck include
- Osteoarthritis of the spine: This is noninflammatory, degenerative arthritis. It is the most common form of arthritis that affects the back. Wear and tear seem to be the reason that osteoarthritis develops.
- Rheumatoid arthritis of the spine: This is an autoimmune disorder where the lining of the joints is affected. Its a type of inflammatory arthritis because wear and tear on the joints is not involved.
- Fibromyalgia: This causes chronic, widespread muscle pain and fatigue.
- Spondyloarthritis: This is a group of inflammatory diseases that affects both the joints and the areas where the ligaments and tendons are attached to the bones. There are several forms of spondyloarthritis, including
- Ankylosing spondylitis: This is a type of spinal arthritis that causes inflammation of the vertebrae and the joints at the base of the spine.
- Psoriatic arthritis: This is an autoimmune disorder triggered by psoriasis and it is characterized by an itchy, scaly rash.
- Reactive arthritis: In this type of arthritis, a gastrointestinal or genital infection probably triggers joint inflammation. It usually affects the lower back.
- Enteropathic arthritis: This is a type of arthritis linked to inflammatory bowel disease.
- Undifferentiated spondyloarthritis
Rheumatoid Arthritis Of The Cervical Spine
When you wake up to stiff joints compliments of rheumatoid arthritis , one becomes gallingly aware of each place the body bendsknuckle, knee, wrist and anklebut when the stiffness affects the atlantoaxial and atlanto-occipital joints in your upper neck, the cervical spine, the disease can turn dangerous. These joints, which pivot your head to look up, down, right and left, share neck space with the spinal cord and lie just below the brain stem. It is important to seek quick treatment to prevent swelling in this area and damage to these joints.
Rheumatoid arthritis can affect the neck joints causing stiffness and pain when moving your head up, down and/or side to side. Photo Source: 123RF.com. Understanding your rheumatoid arthritis diagnosis and treatment options can help you comprehend your doctors game plans. Gaining knowledge about what can be done to manage the disease can also dissolve feelings of depression or isolation.
Patients who fare best make peace with the fact that RA is a lifelong condition that will alternately flare up and go into remission, says Wendy Chi, MD, Assistant Professor of Medicine in the Division of Rheumatology at Mount Sinai in New York City.
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