Largely unknown, ankylosing spondylitis is an inflammatory disease that affects nearly 300,000 people in the United States. Far from the classic image of rheumatism, it strikes more generally between 20 and 30 years and even from childhood. Faced with this very disabling disease, the treatment is more precise.

Ankylosing spondylitis is manifested by virtually permanent inflammation of the vertebral column and pelvis. It causes a stiffness called ankylosis and joint deformities. If there is a genetic predisposition, it is also known that it is far from being the sole cause of the disease: emotional events, infectious agents or environmental factors can trigger it. While the treatments have multiplied, two learned societies, EULAR and ASAS * have drawn up recommendations with a group of 20 experts.

The signs that need to worry

Ankylosing spondylitis occurs first in nocturnal pain in the column, in the joints and in the rib cage, but also in the stiffness of the same areas in the morning when waking. Other frequent signs: pain from the buttocks to the tip, great fatigue, heel pain, joint swelling, fingers or toes in the form of sausage, red eye and painful or even intestinal inflammations or psoriasis. It is often said that pain moves because it can regularly change location. Be careful though, do not panic if you have any of these signs in isolation this is not necessarily spondylitis. The best attitude remains to consult a doctor or a rheumatologist.

A difficult handling

Many drugs are now available to reduce pain, preserve joint mobility and reduce destructive damage. For the experts, it is fundamental to adapt these treatments to the types of clinical manifestations of the disease, the intensity of the symptoms and the wishes of the patients. This support meets three key objectives

Once the treatment is chosen, regular monitoring should also be carried out by the rheumatologist. The optimal management should include medication and non-drug treatments.

Treatments that work

Non-steroidal anti-inflammatory drugs or NSAIDs are recommended as first-line therapy. They mainly help to reduce pain and stiffness, their main problem residing in their lack of digestive tolerance. More conventional analgesics may be added to anti-inflammatories when patients are not adequately relieved by NSAIDs. Corticosteroids can be used in local infiltrations.

But the real recent revolution in treatments is the new treatments: anti-TNF alpha. Reserved for cases where anti-inflammatories and analgesics are no longer enough, they slow down or even stop the disease. On the other hand, their effect ceases as soon as the drug is stopped. They are generally well tolerated but require genuine medical monitoring.

Some tips to manage your disease

One often feels isolated and misunderstood because the patient has no really apparent sign and yet its repercussions on the daily life are numerous. To better face this disease on a daily basis

If ankylosing spondylitis remains a disease that is not known to be cured, adequate and early management can greatly reduce symptoms and bone deformities, a major objective of this management which must, once again, Begin immediately. For a quality of life found.

* EULAR and ASAS are two learned societies bringing together international experts working with spondylarthritis.

ASL / EULAR guidelines for the management of ankylosing spondylitis
ASL / EULAR guidelines for the management of ankylosing spondylitis