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Ankylosis Spondylitis

A chronic and generally progressive inflammatory arthritic disease affecting the spinal joints and adjacent connective tissues. Also called �Marie Strumpell Disease.� This appears to be a disease mainly of young men aged 10-30 years old. It seems to have a genetic component, as it is seen in male relatives and especially in patients with histocompatibility complex HLA-B27 (who have a 300 times greater risk of developing AS, particularly in white men). The etiology is unknown. It is seen throughout the world.

Conventional treatment does not stop the progression of the disease. Stretching exercises and careful adherence to correct posturing are absolutely required to maintain as much mobility as possible over time. Occasionally surgery is used to replace a badly affected joint or to straighten the spine.

Symptoms

Initial Symptoms: Low back pain especially in sacroiliac and lumbar areas (may appear to be sciatic pain); stiffness on awakening; nocturnal pain; and stiffness causing insomnia.

Advanced Disease: Pain spreads up spine often into the mid-back and neck; hips and shoulders may also be involved (1/3 of patients); fatigue; weight loss and anorexia; slight anemia; muscle stiffness or cramping; pain breathing or decreased ability to draw in deep breath; limited mobility of spine, bent-over stance, increased dorsal kyphosis, waddling gait; normal neurologic examination; chronic iritis.

Joints Affected: Sacroiliac (nearly always); general spinal from neck to lumbar (always, eventually); hips (often); shoulders (often); peripheral joints (rarely).


Dietary Suggestions

Anti-Inflammatory Diet

Exercise Considerations

The object of exercise is to build up muscle groups that oppose the direction of potential deformities (i.e. to strengthen extensor rather than flexor muscle groups).

Spondylitis Exercise

Lie on back with hands behind head; bend at knees and draw them up to abdomen; then raise feet with some force; relax and lower them

Lying on back, stretch out with arms over head; use momentum of arms to raise to a sitting position

Lying face down, extend arms to sides then lift them over back as though flying

Standing, do neck range of motion exercises slowly

Standing, lean to right then left, bending slowly at trunk

Repeat each of the above exercise 10 times, once or twice a day