Introduction to Integrative Rheumatology



8 Things Rheumatologists Want You to Know About Ankylosing Spondylitis

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    What Ankylosing Spondylitis Experts Wish You Knew

    When it comes to managing ankylosing spondylitis (AS), knowledge is power. This type of arthritis affects the spine, but the complications and symptoms can also affect your joints, heart, and eyes. Whether you're newly diagnosed or have lived with ankylosing AS for years, there's always more to learn. Here, ankylosing spondylitis experts explain what you need to know about managing the condition.

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    Your Prognosis Is Better Than You Think

    Ankylosing spondylitis is a challenging disease, but thanks to advancements in treatment options, the prognosis is much brighter than it once was, says John S. Sergent, MD, a rheumatologist at Vanderbilt University Medical Center in Nashville, Tennessee. Working with your ankylosing spondylitis care team to find a treatment plan that works for you can help improve symptoms and slow progression of the condition.

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    Exercise Is Good for You

    You might think that rest is better than movement when it comes to easing an aching body, but physical activity can actually help manage ankylosing spondylitis symptoms. "Exercise is a critical part of maintaining healthy joints and a healthy body," says Anca Askanase, MD, MPH, a rheumatologist and director of rheumatology clinical trials at Columbia University Medical Center in New York City. When combined with biologics known as TNF inhibitors, exercise can even lower ankylosing spondylitis activity, according to research published in the December 2015 issue of the journalMedicine. Dr. Sergent recommends people do exercises that don't involve twisting the neck or back. Consider working with a physical therapist to learn the best exercises for you. 

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    AS Needs a Lot of Attention

    Treatments can allow a fully functional life, but you have to work at ankylosing spondylitis management because the condition never goes away. "It can be hard for people with ankylosing spondylitis to understand that arthritis is, in the absence of a cure, a chronic condition that needs to be managed all the time," Dr. Askanase says. "The medications are chronic medications, [and] the condition is likely to recur if meds are stopped." In addition to taking AS medications as prescribed and anti-inflammatory drugs as needed, be sure to monitor your weight, diet, and alcohol consumption, and follow healthy lifestyle habits that can help you better manage the condition. 

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    Protect Your Heart

    "People with ankylosing spondylitis need to maintain good health because of the increased risk of cardiovascular and cerebrovascular disease," Askanase says. These complications include arrhythmias, valve diseases, cardiomyopathy (weakened heart muscle), and atherosclerosis, according to the Spondylitis Association of America. Think about protecting your whole body, inside and out. It's especially important to work closely with your doctor to manage risk factors such as high cholesterol and high blood pressure levels. 

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    Be Extra Careful Not to Get Injured

    Ankylosing spondylitis causes inflammation that leads to the breakdown of bone, followed by new bone growth on the spine. In very severe cases, it can cause the spine to fuse. Yet despite this type of growth, osteoporosis is a common complication, according to the Spondylitis Association of America, and your spine can actually be quite brittle. "Just a little bump could cause a fracture that could be catastrophic," Sergent explains. Part of ankylosing spondylitis management is taking steps to protect yourself from injury. Always make sure you fasten your seatbelt in the car and don't climb up on ladders or put yourself in any situation where you could easily fall. 

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    If You Smoke, Quit

    A person’s rib cage grows more rigid as ankylosing spondylitis progresses, Sergent says. "When you breathe, you have the normal up-and-down motion of the rib cage," he says. "If you add the complication of lung disease, especially the obstructive lung disease that occurs in smokers, you have a really severe problem on your hands." Though the exact association isn't clear, smoking has been linked to both osteoporosis and AS. Sergent says he discusses the importance of quitting smoking with all of his patients.

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    Don't Delay Treatment

    Early treatment can stave off some of the most severe symptoms of ankylosing spondylitis, Sergent says. While nonsteroidal anti-inflammatory drugs (NSAIDs) might be the first type of medication your doctor suggests, some people are candidates for disease-modifying anti-rheumatic drugs (DMARDs) and biologic drugs that block inflammation-causing proteins called tumor-necrosis-factor alpha (TNF-a). Work with your doctor to develop a treatment plan that’s right for you and be sure to take all medication as prescribed.

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    Make Friends With Your Rheumatologist

    To keep your ankylosing spondylitis in check, you need to have a good relationship with your rheumatologist. "Your rheumatologist should be someone that, if he or she were not your doctor, could be your friend," Askanase says.






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Date: 12.12.2018, 18:57 / Views: 62142