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Follow on Google News | Dr Les Bailey looks at ankylosing spondylitis . By Dr Les Bailey phd,DO,acopm,apta(int part)Dr Les Bailey looks at ankylosing spondylitis and treatment regimes.
By: Dr Les Bailey 
P1000869smalll Les Bailey phd DO,acopm,apta( an article inspired by the work of Les Bailey Ankylosing spondylitis is a form of chronic inflammation of the spine and the sacroiliac joints. The sacroiliac joints are located in the low back where the sacrum (the bone directly above the tailbone) meets the iliac bones (bones on either side of the upper buttocks). Chronic inflammation in these areas causes pain and stiffness in and around the spine. Over time, chronic inflammation of the spine (spondylitis) From a diagnostic point of view it can be first visible in far flung places as the sternum or the eyes,so it is prudent that the physical therapist has a good working knowledge of early onset and differential diagnosis. Another interesting fact about anky spon is its tendency to hit males of gaunt appearance in their late 20,s,a fact I soon came to realise was true when I began treating casae of ank spon.HOWEVER, there are cases in females and other body types. Les Bailey Ankylosing spondylitis is also a systemic disease, meaning it can affect other tissues throughout the body. Accordingly, it can cause inflammation in or injury to other joints away from the spine, as well as to other organs, such as the eyes,(the pupils tend to remain open even in light conditions) heart, lungs, and kidneys. Ankylosing spondylitis shares many features with several other arthritis conditions, such as psoriatic arthritis, reactive arthritis (formerly called Reiter's disease), and arthritis associated with Crohn's disease and ulcerative colitis. Each of these arthritic conditions can cause disease and inflammation in the spine, other joints, eyes, skin, mouth, and various organs. In view of their similarities and tendency to cause inflammation of the spine, these conditions are collectively referred to as "spondyloarthropathies." Les Bailey Ankylosing spondylitis is two to three times more common in men than in women. In women, joints away from the spine are more frequently affected than in men. Ankylosing spondylitis affects all age groups, including children. When it affects children, it is referred to as juvenile ankylosing spondylitis. The most common age of onset of symptoms is in the second and third decades of life. Ankylosing spondylitis is often abbreviated AS and has been referred to as Bechterew's disease Les Bailey The tendency to develop ankylosing spondylitis is believed to be genetically inherited, and a majority (nearly 90%) of people with ankylosing spondylitis are born with a gene known as the HLA-B27 gene. Blood tests have been developed to detect the HLA-B27 gene marker and have furthered our understanding of the relationship between HLA-B27 and ankylosing spondylitis. The HLA-B27 gene appears only to increase the tendency of developing ankylosing spondylitis, while some additional factor(s), perhaps environmental, are necessary for the disease to appear or become expressed. For example, while 7% of the United States population has the HLA-B27 gene, only 1% of the population actually has the disease ankylosing spondylitis. In northern Scandinavia (Lapland), 1.8% of the population has ankylosing spondylitis while 24% of the general population has the HLA-B27 gene. Even among HLA-B27-positive individuals, the risk of developing ankylosing spondylitis appears to be further related to heredity. In HLA-B27-positive individuals who have relatives with the disease, the risk of developing ankylosing spondylitis is 12% (six times greater than for those whose relatives do not have ankylosing spondylitis) Les Bailey Recently, two more genes have been identified that are associated with ankylosing spondylitis. These genes are called ARTS1 and IL23R. These genes seem to play a role in influencing immune function. It is anticipated that by understanding the effects of each of these known genes researchers will make significant progress in discovering a cure for ankylosing spondylitis My own treatment regime for this disease from a physical therapy perspective is to keep my patient mobile and as pain free as my remit allows by mobilising the spine and joints and using deep tissue massage to keep the musculature moving well. I have enjoyed very good results in the past with regular treatment and the relevant drugs from the patients specialist. Regular stretching and strengthening exercises help spondylitis patients maintain good posture, flexibility and eventually help to lessen pain. In many cases, good posture and mobility can even be regained with proper doses of medicine and exercise. Most people with spondylitis feel much better with exercise, although the inflammatory nature of the disease makes it difficult for some people to feel physically able to exercise,and during attacks of inflammation,exercise is best avoided. certain exercises are potentially dangerous for the person with spondylitis. physical therapists /osteopaths play a crucial role in the lives of people with spondylitis, regardless of the person's level of physical impairment. Some people have the notion that physical therapies are used only for injuries or after surgery. While spondylitis patients may need physical therapies for such occasions, they can benefit from using a therapist knowledgeable with the disease to create an appropriate exercise and manual treatment/massage/ physical therapists/osteopaths evaluate each person based on their physical and functional status (posture, body mechanics, movement ability), joints and musculoskeletal system, the neuromuscular and cardiopulmonary systems, special equipment or devices (modified footwear, splints, wheelchair), and the need for therapeutic exercise/massage/ Therapeutic exercises are prescribed and used to improve muscle strength, joint mobility, and cardiovascular function. The PT teaches self-management skills enabling patients to modify their individual exercise programs according to disease activity level. In preparing a person with spondylitis for exercise and activity, PTs may recommend the application of heat, cold, electrical therapy, or hydrotherapy to temporarily relieve pain and reduce muscle spasms. PTs also may offer suggestions on how to best perform functional activities safely and efficiently, like movement from a bed, chair, toilet, and bathtub. I also find a good hands on regime of gentle manipulation,deep massage and mobilisation is particularly useful. Dr Les Bailey phd,DO,acopm,apta( Les Bailey,Les Bailey, banstead,surrey author of "the laymans guide to foot and heel pain drlesbailey@ Les Bailey. http://www.drlesbailey.com End
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