Understanding Ankylosing Spondylitis: Symptoms, Diagnosis, and Physiotherapy

Ankylosing spondylitis is a condition characterized by stiffness and inflammation of the spine, leading to painful discomfort and reduced mobility. The inflammation primarily affects the sacroiliac joint, where the spine connects to the pelvis. Typically emerging between the ages of 20 and 40, this autoimmune disease is more prevalent in men than women. While the exact cause remains unknown, genetic factors, particularly the HLA-B27 gene, and environmental influences are believed to play a role.

Key symptoms include widespread spinal pain, a feeling of spinal stiffness and inability to bend (sometimes referred to as bamboo spine), hip pain that worsens in the morning, persistent fatigue, and pain in other joints like the knees, shoulders, and ankles. Enthesitis, pain at the sites where tendons and ligaments attach to bone, and inflammation of the joints between the ribs and sternum can also occur, alongside eye inflammation.

Diagnosis involves a physical examination followed by X-rays of the sacroiliac joints and sometimes the entire spine to identify bamboo spine. Blood tests may reveal a positive HLA-B27 marker. Management focuses on maintaining spinal and joint flexibility through range-of-motion and stretching exercises, alongside aerobic activities like walking, swimming, and cycling. Physiotherapy interventions include spine mobility exercises, cat camel, pelvic tilts, posture correction, and chin tucks. Hydrotherapy can relax muscles, while heat and cold therapy help reduce inflammation and pain. Breathing exercises, such as nasal inhalation and mouth exhalation, are recommended to prevent chest muscle stiffness. A comprehensive physical assessment at a physiotherapy center guides personalized management plans, evaluating joint mobility, strength, pain levels, and daily function. Lifestyle advice includes quitting smoking, regular swimming, using a soft mattress, consistent exercise, a vitamin-rich diet, and adequate water intake. This information is provided by Dr. Md. Saidur Rahman, Assistant Professor, Chairman, and Chief Consultant at Reactive Physiotherapy Center, Tejgaon, Dhaka.