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Dr. Santosh Yadav (M.D.)
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What is Ankylosing Spondylitis? 
If you regularly wake up feeling stiff with pain in your lower back which becomes better or reduces during the day with excercise or as you ease into your routine, and this has persisted for more than 3 months, there are chances that it
could be more than just simple bodily wear and tear. You could be suffering from ankylosing spondylitis. Ankylosing Spondylitis (AS) is a member of a group of rheumatic diseases that affect the spinal column known as 'spondyloarthropathies'.

Ankylosing spondylitis is a chronic, inflmammatory rheumatic disease that causes arthritis of the spine and sacroiliac joint (the joint at the base of the spine where the spinal column joins the pelvis). The chronic inflammation and irritation of the spinal joints (vertebrae) can eventually cause the vertebrae to fuse together, a condition known as 'ankylosis'.

Ankylosing spondylitis is a debilitating condition that eventually can cause loss of spinal mobility and function and, therefore, severely impact a person's quality of life. However, ankylosis may also cause inflammation and pain in other parts of the body :

where your tendons and ligaments attach to bones.
joints between your ribs and spine.
joints in your hips, shoulders, knees and feet.
your eyes, heart, lungs and kidneys.
Approximately 350,000 Americans suffer from ankylosis spondylitis. The sex ration is 3:1 for Men : Women. Symptoms of ankylosis spondylitis usually begins between ages of 20 to 30 although the disease can also affect children, adolescents or adults over 40 years of age. The number of women with ankylosis spondylitis is underdiagnosed, as women tend to manifest symptoms in their neck / shoulders / upper chest and peripheral joints instead of their lower spinal area (lumbar, sacrum, hips, pelvis), where the first symptoms appear in male patients.
Symptoms of Ankylosis Spondylitis
Your symptoms may change over time (symptoms may be intermittent), with symptoms getting worse, improving or completely stopping at any point. Early signs and symptoms may include pain and stiffness in your lower back and hips which is often worse in the morning, at night and after periods of inactivity. Over time, the pain and stiffness may progress up your spine and to other joints, such as those in your hips, shoulders, knees and feet.

Hence your symptoms may be summarized as :

Lower back pain.
Stiffness in the back.
Loss of flexibility of the affected part of the spine.
Pain radiating from lower back upwards.
Diffuse radiating pain down one or both the legs.
Chest expansion reduced in thoracic involvement.
Pain and limitation of movement of shoulders and hip joints.
Joint deformities.
Fever.
Fatigue.
Weight loss.
Anemia.
Eye inflammation (iritis).
Complications of Ankylosing Spondylitis
Ankylosing spondylitis (AS) does not follow a set course. The severity of symptoms and development of complications vary widely among individuals :

Difficulty walking or standing : Typically, ankylosing spondylitis (AS) begins with soreness in your lower back. As the disease progresses, the affected bones may fuse together, rendering your joints immobile and causing a stiff, inflexible spine (Bamboo spine). This can make walking or standing difficult. Your joints may fuse even if you undergo proper treatment - and once joints fuse, additional treatments would not help restore mobility. However, if fusion occurs with your spine in an upright position, you can remain more able to perform activities of daily living.
Difficulty breathing : Inflammation can also spread up your spine and cause the bones in your rib cage to fuse. This results in breathing problems. When your ribs can not move when you breathe, it is difficult to fully inflate your lungs.
Heart problems : If the inflammation reaches your heart, you can develop valve problems, such as inflammation of the body's largest artery (aorta), also known as aortitis.
Lung infections : In some people with ankylosing spondylitis (AS), cavitary lesions develop in the upper portion of the lungs.
Inflammatory bowel disease.
How is Ankylosing Spondylitis Diagnosed?
Early diagnosis of ankylosing spondylitis (AS) is important if fusion of the joints and permanent stiffening of the spine are to be avoided. It can be difficult to diagnose in the early stages as symptoms may be attributed to more common causes of back pain.

A doctor will evaluate the following :

A detailed medical history, including any family history of ankylosing spondylitits (AS).
Detailed current symptoms including a history of back pain.
The age of the patient when the pain started.
Physical assessment.
X-rays - which may show signs of inflammation of the joints in the spine.
Blood tests - which may show the presense of the HLA-B27 and a raised ESR and C-reactive protein which indicates inflammation.

Life Style Management Tips in Ankylosing Spondylitis
There is no known way to prevent ankylosing spondylitis (AS). It can only be managed with medications and some do's and dont's.

Posture : Maintaining correct posture is vital for people with ankylosing spondylitis. Keeping the spine straight plays an important role in preventing complications.
Get a suitable chair : The ideal chair at home or at work has a firm seat and an upright, firm back, preferably extending to the head. The chair should be of a height which will allow you to keep a right angle with the knee and hip joints. Whatever you do, avoid low, soft chairs and sofas as they will encourage bad posture and increase pain.
Lie flat on your back or your front for 20 minutes a day. Try to use as few pillows as possible, preferable only one. A feather pillow can be moulded to suit any position and still give your neck good support.
Watch how you sit : Try to move your spine regularly, straighten it out and stretch it by sitting tall and putting your shoulders back. Try not to sit for too long. Stand up, walk about and limber up.
Take care with your bed, mattress and pillow : The ideal bed should be firm, without sag, but not too hard. Try to use as few pillows as possible, preferably only one. A feather pilow can be moulded to suit any position and still give your neck good support.
Do some form of daily exercise. Swimming is especially good.
Deep breathing for several minutes each day will help to keep the joints between your spine and ribs mobile.
Try heat or cold : Various forms of heat will help to relieve pain and stiffness. Hot bath / or shower first thing in the morning and / or before bed reduces pain and stiffness, especially if some stretching exercises are done at the same time. Hot weater bottles or electric blanckets are quite useful in bed. For a particularly inflammed area, an ice-pack or bag of frozen peas wrapped in a damp tea towel may help.
Do not wear a corset or a brace : These often make matters worse, as they hold the spine rigid. And with ankylosing spondylitis (AS), not moving leads to not being able to move.
Eat well : Eat a good nourishing diet with plenty of proteins. Eat fruit and veggies and also drink milk. However, avoid becoming overweight.
Quit smoking.
Physiotherapy : This greatly influences the outcome of ankylosing spondylitis (AS). Learn an exercise routine for daily use from a physiotherapist. You will also learn how to increase the range of movement of certain joints, especially shoulders and hips.
Homeopathic Treatment of Ankylosing Spondylitis (AS)
Treatment of anlylosing spondylitis in allopathy

No cure is known for ankylosing spondylitis (AS), although treatments and medications are available to reduce symptoms and pain.

There are three types of medications used in the management of ankylosing spondylitis which includes :

Non Steroidal Anti Inflammatory Drugs (NSAIDs) such as aspirin, ibuprofen, indometacin and so on which work by reducing pain and inflammation. These are vital in the management of ankylosing spondylitis and are usually very effective. Larger doses than normal are often required along with their side effects on body as damage or irritation of the stomach lining (peptic ulcers).

Corticosteroids such as prenisone may suppress inflammation and slow joint damage in severe cases of ankylosing spondylitis.
TNF alpha blockers.
Severe disability and deformity are unusual in ankylosing spondylitis (AS) but in cases where pain is extreme and deformaties are disabling, surgery is the last option left and may be appropriate.

Homeopathy for ankylosing spondylitis (AS)

Ankylosing spondylitis (AS) is a lifelong problem, and people who fail to continue treatment risk permanent loss of posture and mobility. Homeopathic treatment can be a great boon to the patient especially if intervention is well in time. If treatment is started in the initial stages when not too much of the elastic tissue is lost, the prognosis is good and in most cases, the condition can be reversed. At a later stage where extensive bone formation has replaced elastic tissue, homeopathic medicines may not be able to reverse the situation but can still help in easing many symptoms.
Homeopathic treatment works in 2 ways :
Control underlying disease process.
Significant relief in pain and stiffness.
Ankylosing spondylitis being a constitutional disorder calls for a constitutional approach to its treatment. Homeopathic approach incorporates detailed study of the cases of ankylosing spondilitis inclusive of the genetic trend of the patients. The remedy prescribed after such detailed evaluation offers effective pain control as well as helps in controlling the progress of this condition.

Success with homeopathy, being ankylosing spondylitis an autoimmune entity

Success with patients with autoimmune disease is 100 percent if we have favorable therapeutic conditions, meaning that the homeopathic doctor finds the right remedy and the patient is compliant and has a lifestyle favorable to recovery.

Recovery means that the inflammatory process stops and there is certain amount of tissue regeneration, but within the limits of the organism's capacity to heal.

Certain tissues may be permanently destroyed and will not return even under the best homeopathic care. What is observed that what is within the capacity of the body to heal will be restored under good homeopathic treatment. So, this means that in the best of circumstances, the disease process of all patients with autoimmune disease should stop under homeopathy.

Success will be reduced when the skills of the practitioner are not adequate, when the patient's lifestyle is not conducive to good health, when the stressors in the patient's life keep overwhelming the capacity of the organism to recover health. For example, someone with an inconsolable grief, or when the patient is not compliant or cannot readily describe his or her symptoms, which may be due to allopathic medications masking or altering the symptoms.

Homeopathic remedies are considered safe and unlikely to cause side effects. Also, homeopathic medicines are not known to interfere with conventional drugs.

However, conventional anti-inflammatory drugs are notorious for side effects such as ulcers and low immune function - problems that can be avoided using homeopathy. It reduces inflammation and facilitate healing quickly and gently according to the age-old principle : Like Remedies Cure Like Diseases.

There are many homoeopathy medicines which give great relief in ankylosing spondylitis. However, the correct choice and the resulting relief is a matter of experience and right judgment on the part of the homeopathic doctor. The treatment is decided after thorough case taking of the patient. Thus homeopathic remedies of ankylosing spondylitis are tailor made unlike allopathy in which all patients receive the same drugs although trade name may be different.
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