One of the many causes of low back pain is ankylosing spondylitis. Ankylosing spondylitis is a chronic form of arthritis that is present in the spine. It can appear at any level of the spine as well as the chest wall, hips, knees, wrists, hands, feet and heels. There is no known cause for this disease and it is generally a hereditary condition that affects men more often than women. It typically appears in young people under the age of 35. The disease can vary in severity from moderately mild to quite severe. In cases of severe ankylosing spondylitis, the vertebrae in the spine can actually fuse together, causing marked stiffness at that location of the spine. This spinal fusion can be seen with diagnostic imaging. Unfortunately, this fusion appears in later stages of the disease, after many years of pain felt by the patient. Also present in severe cases of ankylosing spondylitis is inflammation of the iris of the eyes (iritis) and difficulty in breathing if the walls of the chest become stiff. In very severe cases, this inflammation can also affect the valves of the heart as well as the aortic artery, the lungs, kidneys and the intestinal tract. There is no cure for this disease but treatment options are available to help control the symptoms and to possibly prevent the arthritis from worsening, allowing the patient to continue with their daily activities.
It is not quite clear as to how much benefit a patient who presents with ankylosing spondylitis will receive from chiropractic care. Some patients experience incredible pain relief and increased motion in joints affected by the disease while others find no improvement following a program of chiropractic care. It is important that the chiropractic physician be informed that the patient is presenting with low back pain caused by ankylosing spondylitis if previously examined by another physician. If the patient has not been to any other doctor for their low back pain, a complete health history and physical, as well as imaging, will be done to assess the condition of the spine for a proper diagnosis. Based on the specificity of the disease, a treatment plan can be made to address the common symptoms of ankylosing spondylitis. Gentle chiropractic manipulations as well as gentle massage therapy and modalities such as heat and ice, ultrasound and electrical stimulation may be used to keep the symptoms of the arthritis under control. The progression of the disease cannot be reverse but it may be slowed and under brought under control with the use of chiropractic care.
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