1. What is it?
Ankylosing spondylitis is a common cause of chronic low back pain in young men. It usually occurs between the ages of 15 to 35, with an average age of 26-27 years old.
The disease involves a process of joint inflammation followed by joint erosion and then finally joint fusion. This series of events can occur over a period of 10 years but only a minority of patients end up with the most severe joint problems.
Approximately 1/3 of patients with this disease also have other systemic changes such as iritis (inflammation of the eye) and, heart, blood vessel, gastrointestinal and genitourinary problems.
2. What are the causes/predisposing factors of injury?
This inflammatory condition appears to be an autoimmune disorder.
3. What are the symptoms?
General symptoms include aching and stiffness felt in the lower back, buttocks and thighs that can change from side to side or be on both. Most of the symptoms are felt predominantly in the morning and evening hours. There may also be periods of complete remission of symptoms. Other locations where stiffness and aching may be found are in the hips, mid-back and shoulders. Chest expansion may be diminished in some instances where fusion of the mid-back joints has occurred. Sciatica may also occur, but does not go below the knee.
What can be done to prevent or treat this injury?
Diagnosis is the key. This condition must be differentiated from other causes of chronic low back pain, so that appropriate management can occur. To achieve this, x-rays and specific blood work (erythrocyte sedimentation rate and HLA-B27) should be performed.
Treatment consists of antiinflammatories, postural training, and therapeutic exercise to maintain joint mobility and proper posture.