Morning Stiffness in Ankylosing Spondylitis: A Parent-Child Perspective - Internal Medicine

More Info

---

Morning stiffness is a common symptom experienced by individuals with ankylosing spondylitis (AS), a type of inflammatory arthritis that primarily affects the spine and can lead to severe, chronic pain and discomfort. The variability in symptoms between individuals, even within the same family, can be quite striking, as you've observed between yourself and your son.
In ankylosing spondylitis, morning stiffness typically occurs after prolonged periods of inactivity, such as sleeping. This stiffness is often most pronounced in the morning and can improve with movement throughout the day. The stiffness is usually associated with inflammation of the joints and surrounding tissues, which can lead to pain and reduced mobility.
Your experience of stiffness when bending forward but not when arching backward, contrasted with your son's experience of the opposite, highlights the individual nature of AS symptoms. The differences in how morning stiffness manifests can be attributed to several factors, including the severity of inflammation, the specific joints affected, and individual variations in anatomy and physiology.

In your case, the stiffness when bending forward may suggest that the forward flexion of the spine is more affected by inflammation or structural changes due to AS. This could be related to the degree of spinal fusion or the presence of enthesitis (inflammation at the sites where tendons and ligaments attach to bone), which can vary significantly from person to person. On the other hand, your son's ability to bend forward without stiffness might indicate that his spinal mobility in that direction is less affected, or that he has a different pattern of inflammation affecting his spine.

The fact that your son experiences stiffness and mild pain when arching backward but not when bending forward could also be indicative of how the disease is progressing in him. In AS, the inflammation can lead to changes in the vertebrae and the sacroiliac joints, which may affect the range of motion differently for each individual. The stiffness and pain he feels when extending backward could be due to inflammation in the joints or soft tissues that are more engaged during that movement.

It's also important to note that AS can present differently in children compared to adults. Pediatric cases may have distinct patterns of symptoms, and the disease can sometimes progress more rapidly in younger patients. The absence of stiffness and pain during forward bending in your son could suggest that his condition is currently less aggressive in that range of motion, or it may reflect a different inflammatory response.

In managing ankylosing spondylitis, it's crucial to maintain an active lifestyle, engage in regular physical therapy, and follow a treatment plan that may include anti-inflammatory medications or biologics. These approaches can help reduce inflammation, improve mobility, and alleviate pain.
If you have concerns about your son's symptoms or how they differ from yours, it would be beneficial to discuss these observations with your rheumatologist. They can provide insights into the implications of these differences and adjust treatment plans as necessary to ensure both you and your son are managing your conditions effectively.
In summary, the variability in morning stiffness and pain between you and your son is not unusual in ankylosing spondylitis. Each individual's experience with the disease can differ significantly, and understanding these differences can help in tailoring effective management strategies. Regular follow-ups with your healthcare provider are essential to monitor the progression of the disease and adjust treatment as needed.