The wayankylosing spondylitis(AS) progresses varies person to person.
Some people never experience anything more than back pain and stiffness that comes and goes.
Treatment is important regardless of the severity of AS.
Yuttana Jaowattana / EyeEm / Getty Images
Fortunately, there are many different medication classes available to slow down the disease and its effects.
AS treatment might also include surgery and treatment of disease complications.
Keep reading to learn about the effects of advanced AS and your treatment options.
Early on, changes to the spine might be harder to spot but they will become visible with time.
If AS gets worse, it will affect other body parts.
This includes theentheses, the areas where tendons and ligaments attach to bone.
Treatment for early, mild AS starts withnonsteroidal anti-inflammatory drugs(NSAIDs) to reduce pain andinflammation.
But if NSAIDs dont provide relief, your healthcare provider may suggest stronger treatments.
The more fusion there is in the spine, the less movement a person will experience in the spine.
Severe AS can also lead topulmonary fibrosis(lung scarring), which increases the risk for lung infections.
Advanced AS might also causeeye inflammationthat needs to be addressed to prevent vision loss.
AS can also cause inflammation of the digestive tract.
Up to 10% of people with advanced disease will developinflammatory bowel disease(IBD).
This might include corticosteroids, DMARDs, biologics, JAK inhibitors, or surgery.
Corticosteroid drugs lower inflammation in the body.They can also reduce the effects of an overactive immune system.
Your healthcare provider might prescribe a corticosteroid drug to relieve swelling and pain associated with AS.
These injections can give you short-term relief from pain and swelling.
Corticosteroids can help manage flares, but they are not considered the main treatment for AS.
Corticosteroids are available as oral medicines.
The primary endpoint was a 50% improvement at week two.
The biggest improvements in disease activity were found using 50 mg prednisolone.
Conventional DMARDs
DMARDscan protect joints by blocking inflammation.
There are two types of DMARDsconventional (or nonbiological DMARDs) and biologic drug therapies.
Conventional DMARDs are considered second-line treatments for ankylosing spondylitis.They work by interfering with inflammation-producing processes.
By blocking inflammation, they can prevent joint damage.
DMARDs like methotrexate andsulfasalazineare useful for treating different types ofinflammatory arthritis.
Biologics might be given in combination with methotrexate or other conventional DMARD.
These drugs are genetically engineered medicines that target specific proteins in the body.
Biologics can relieve pain and stiffness and might prevent disease and disability associated with AS.
While these medications pose an increased risk for infection, they are highly effective in improving AS symptoms.
The FDA has approved all of them for treating another key in of inflammatory arthritis,rheumatoid arthritis.
A study reported in 2019 randomly assigned 187 patients with AS to one of two groups.
Surgery
Most people with AS wont need surgery.
A laminectomy is a minimally invasive procedure that can be done in less than two hours.
Treatment of Disease Complications
Treating AS also involves treating complications as they occur.
Symptoms include eye pain, blurred vision, and eye redness.
Uveitis is treated with medications that reduce inflammation, including corticosteroid eye drops.
CES is a medical and surgical emergency.
Amyloidosis
Amyloidosis(AA) can affect people with AS.
It is a condition where the protein amyloid builds up in the organs.
Secondary AA is treated by managing the underlying cause and with corticosteroids.
A Word From Verywell
Ankylosing spondylitis is a progressive disease with no cure.
This means it will get worse with time.
Treatment is key to slowing down the disease and keeping you active.
Even long-standing and advanced ankylosing spondylitis is treatable and manageable.
Treatment is also vital for preventing complications and easing the effects of the disease.
Your treatment plan is central to your living a normal and productive life with and despite AS.
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