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Ankylosing spondylitis and impact on quality of life

A study released last month by researchers at the University of Aberdeen has drawn attention to a very debilitating condition: ankylosing spondylitis. Not only that, the research indicates that some of these factors – which include pain, fatigue and poor physical function – are currently better monitored than others, which suggests that new approaches to treating this painful condition may be needed.

The study, which analysed data from 959 patients involved in the Scotland Registry for Ankylosing Spondylitis, pinpointed a total of five factors which were identified as independent predictors of a poor quality of life among patients: moderate to severe fatigue, poor physical function, chronic widespread pain, high disease activity and poor spinal mobility.

The study concluded that physical function, disease activity, and spinal mobility are being tracked and monitored by the medical community to a high standard. However, two factors – chronic widespread pain and fatigue – aren’t receiving the same attention.

The painful truth of AS

Ankylosing spondylitis – otherwise known as AS – is an inflammatory condition that affects the joints in your spine. As part of the body's reaction to that inflammation, calcium builds up where the ligaments attach to the bones that make up the spine. This reduces the flexibility of your back, and causes new bone to grow at the sides of the vertebrae. This increases the risk of the individual bones of the spine fusing up, which is called ankylosis.

Ankylosing spondylitis typically starts in the joints between the spine and pelvis, but it may spread up the spine to the neck. It’s a condition which varies from person to person: people suffering from a mild case of AS can get on with life and almost forget they have the condition, but in more serious cases it could have a huge impact on a sufferer’s quality of life.

Ankylosing spondylitis can even have an effect on other parts of the body: symptoms can include tenderness of the heel, pain and swelling in fingers and toes, tenderness at the base of the pelvis which can make it difficult to sit, chest pains, inflammation of the eye, inflammation of the bowel, and fatigue.

Ankylosing spondylitis: it’s all in the genes

While AS can be contracted by anyone, it’s mainly a genetic condition that is most common in younger men, and is most likely to occur in the late teens and twenties. While your genetic inheritance is a factor as to whether you’ll contract AS or not, the condition isn’t passed on directly. Most people with the condition will have a gene known as HLA-B27, which will show up on a blood test, but having this gene doesn’t automatically mean you are at risk from AS.

As the report suggests, the non-specific nature of the symptoms of chronic pain and fatigue explain why they are not traditionally monitored in ankylosing spondylitis to the same degree as other factors. But as anyone suffering from the ailment is aware, they play a huge role in a patient’s quality of life, and it could be extremely helpful for these factors to be monitored more closely.

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