AS, for short, is an inflammatory condition primarily around the spine but can affect other joints. It’s a type of arthritis that over time can limit the range of movement in the spine from neck right down to coccyx. Unfortunately, I only have experience with two individuals suffering with such a condition and they are at either end of the spectrum. My knowledge of the condition and the effects of therapeutic intervention will be based on my last year treating said individuals, and current research to back up my choice of intervention.
AS in Europe affects around 0.8% of the population, two thirds of those being male on average. It’s a long term condition with no known cure, but there are methods to treat and manage the symptoms. When AS kicks in, it starts very slowly without a major recognition of its development. You may feel the occasional back stiffness as the majority of the public would and just shrug it off. Over time, especially if you are an inactive individual, the symptoms will worsen until you begin to notice a more severe stiffness and pain. In children it can sometimes start at the hip or knee. The end result if gone untreated or undiagnosed can lead to an almost fusion-like state in the spine, where most movements become a struggle. If caught early, intervention can begin from the start and the symptoms can be managed, though it may be a long-term management programme due to the condition having no cure.
From what I’m aware, when seeking medical help it tends to involve non-steroidal anti-inflammatory drugs alongside physical therapy. Some more recent medications have been prescribed but that is solely based on what my patient has been receiving, so I’ll not go into too much detail. If you suffer with AS and would like more information on the medication options please speak to a consultant to find out your options.
My less suffering patient, Mr. A, is in his early 40s and since being diagnosed has always maintained an exercise based lifestyle. On a daily basis he is involved in some form of training or movement and on presentation in the clinic, I’d not even realise he had the diagnosis without him informing me.
My more unfortunate patient, Mr. B, has had the condition for a number of years, maybe even decades, but has only in recent years been officially diagnosed with AS. Up until then, it was put down to a “bad experience in other treatments” and “excessive rowing” in his youth causing long term back pain. He is in his early 50s and since our very first session 3 years ago has been almost completely immobile from head to tail. In the last 6 months however, we developed a routine of rehabilitation for the AS, where previously it would be about other injuries such as a knee pain, or a shoulder strain. Since starting our exercise and movement routine both myself and Mr. B have seen a difference, more so in the lumbar spine than anywhere else. The intervention starts with massage, found to be beneficial in a study based around spa-type treatment, and passive range of movement once muscles have been loosened off with the occasional mobilisation. Due to previous fragility in the thoracic spine we tend to avoid that area, but the neck and lumbar take all the brunt! Every now and then I like to throw in some dry needles around the shoulders too, just to help out with the tension originating possibly from desk based work, or the AS itself.
At this stage, 6 months on, it’s safe to say that with therapeutic intervention AS can be managed effectively. In early stages it may be easier to self-manage, but if the symptoms start to show in daily life seek professional guidance as soon as you can. The research behind AS and physical therapy is quite absolute in the sense that you will always benefit, whatever severity of the condition you may be suffering with.