Ankylosing Spondylitis

Ankylosing spondylitis (AS) is a progressive, chronic, seronegative inflammatory disease involving the spine and the sacroiliac and peripheral joints. It is commonly seen in the age group 15-40 years and develops in approximately 0.5-1 percent of the general population. Classical AS is two to three times more common in men than in women. The onset is usually gradual and delay in its diagnosis is rather common, especially in women.

Genetics:

About 90% of patients with definite AS are HLA B27 positive; the risk of development of AS in HLA B27-positive individuals is probably less than 2%. First-degree relatives of HLA B27-positive AS patients have a risk of near 20%.

Clinical Features::

In the early stage fluctuating aches or sharp pains in the heels, pelvis, buttocks, hips and shoulders may be prominent. The pain of sacroiliitis is characteristically associated with morning stiffness and is improved by exercise.

Chest pain is due to enthesitis of the costovertebral, sternocostal, costochondral and sternal joints. Such enthesites leads to diminished respiratory excursions. There is flattening of lumbar lordosis and later development of smooth dorsal kyphosis in some patients. Hip involvement is more common in early-onset AS.

Patients with AS are vulnerable to injury from even trivial trauma, leading to spinal fractures which may not be detected on ordinary radiography. There is an association of AS with cauda equina syndrome and vertebrobasilar insufficiency.

Extra-particular features in AS:

Organ Main features
Lung Apical fibrosis, cavitation and restrictive lung disease (can be mistaken for pulmonary tuberculosis)
CVS Aortic regurgitation, heart block
Eye Acute anterior uveitis, conjunctivitis
Kidney Amyloid nephropathy, IgA nephropathy
CNS Cervical myelopathy (secondary to AAD), cauda equina syndrome

Diagnosis:

The diagnosis of AS is essentially clinico-radiological and may be defined by the criteria as follows

Criteria for diagnosis of ankylosing spondylitis:

1. Limitation of motion of lumbar spine in forward and lateral flexion and extension
2. Pain in low back and dorsolumbar region
3. Limitation of chest expansion to one inch or less at the level of fourth intercostal space and
Radiological bilateral sacroiliitis or unilateral sacroiliitis if associated with criteria 1 or 2 and 3

Treatment in Allopathy:

There is no cure but the disease can be controlled. The therapy is directed towards pain relief and exercises with the aim to maintain mobility and to prevent deformities due to excessive pull of flexor muscles.

Treatment @ Homeocare International (HCI):

We at Homeocare International study each Ankylosing spondylitis (AS) patient in detail clinically and homeopathically and prescribe advanced constitutional medicines according to their individual genetic constitution.

Constitutional approach, an excellent method of selecting proper homoeopathic medication for a variety of health issues ranging from common cold to a large variety of incurable cases, especially all chronic diseases, in brief-“Homoeopathic approach is holistic as well as individualistic; holistic in the sense that the medicine is selected for the patients as a whole, but not for individual diseased organs/parts; individualistic from the view point that each individual patient is considered different from others, although all are suffering from the same disease.