Ankylosing Spondylitis: Symptoms, Treatment, and Concerns

Ankylosing spondylitis is a type of inflammatory arthritis that primarily affects the spine, leading to severe, chronic pain and discomfort. It can also affect other joints and areas of the body, including

Hello LYC, this is Joann.
You might remember me a little.
I apologize for losing your email address and hope to connect with you through the internet! A week ago, I went to the Tri-Service General Hospital for a diagnosis, and the doctor prescribed me medication to take for a week: 1.
DICLOFENAC SODIUM, 2.
ORPHENADRINE CITRATE, ACETAMINOPHEN, 3.
ALUMINUM HYDROXIDE, MAGNESIUM CARBONATE CO-DR, 4.
SULFASALAZINE.
The fourth item is an immunomodulator.
At first, I felt okay, but for the past two days, I've been experiencing some headaches.
Could this be a side effect of the medication? Additionally, I would like to ask if flat back syndrome can be caused by ankylosing spondylitis, or if there is no connection.
Thank you for your answers!

Irene, 20~29 year old female. Ask Date: 2005/04/13

Dr. Lin Yijun reply Orthopedics

Remember that your HLA-B27 test at National Taiwan University was negative, and your inflammatory markers were normal.
Clinically, diagnosing ankylosing spondylitis in HLA-B27 negative patients requires caution.
Due to anatomical factors, early sacroiliitis is often difficult to assess on X-rays, and inflammatory markers must be considered.
If necessary, a nuclear medicine bone scan or CT scan may be required for diagnosis.
I suggest you copy all the reports for me to review.
When starting sulfasalazine, many people experience dizziness or gastrointestinal discomfort; usually, starting with a low dose can help avoid these issues.
A straighter lumbar spine can be a manifestation of ankylosing spondylitis, but any discomfort in the lower back can also lead to a straightening of the lumbar spine, making it insufficient for diagnosing ankylosing spondylitis.
Lin Yi-Chun, Department of Rehabilitation Medicine, Taipei Medical University Hospital, [email protected].

Reply Date: 2005/04/13

More Info

Ankylosing Spondylitis (AS) is a chronic inflammatory disease primarily affecting the spine and the sacroiliac joints, which connect the spine to the pelvis. It is characterized by pain and stiffness in the back and hips, particularly in the morning or after periods of inactivity. Over time, AS can lead to the fusion of the vertebrae, resulting in a rigid spine. The symptoms can vary significantly among individuals, and some may experience additional complications such as eye inflammation (iritis or uveitis), which can lead to vision problems if not treated promptly.

Your current medication regimen includes several drugs aimed at managing pain and inflammation associated with AS. Diclofenac sodium is a nonsteroidal anti-inflammatory drug (NSAID) that helps reduce pain and inflammation. Orphenadrine citrate is a muscle relaxant that can help alleviate muscle spasms, while acetaminophen is a common pain reliever. Aluminum hydroxide and magnesium carbonate are typically used to manage stomach acidity, which can be beneficial if NSAIDs cause gastrointestinal discomfort. Sulfasalazine is an immunomodulatory medication often used in inflammatory conditions, including AS, to help control inflammation.

Headaches can indeed be a side effect of some medications, including NSAIDs and muscle relaxants. If you have recently started these medications and are experiencing headaches, it is advisable to discuss this with your healthcare provider. They may adjust your dosage or suggest alternative treatments to mitigate these side effects.

Regarding your question about "平板腰" (flat back), it is essential to clarify that AS can lead to postural changes over time, including a flattening of the lumbar spine. This condition can result from the fusion of the vertebrae and the loss of the normal curvature of the spine. However, flat back syndrome can also occur due to other factors unrelated to AS, such as degenerative disc disease or muscle imbalances. If you are experiencing symptoms related to a flat back, such as pain or discomfort, it would be beneficial to consult with a physical therapist or a specialist in spinal disorders. They can assess your posture and provide exercises or interventions to improve your spinal alignment and alleviate discomfort.

In managing AS, it is crucial to maintain an active lifestyle, including regular physical therapy and exercises tailored to your condition. Stretching and strengthening exercises can help maintain flexibility and reduce stiffness. Additionally, practicing good posture and ergonomics in daily activities can help minimize discomfort.

If you have concerns about your treatment plan or the progression of your symptoms, it is essential to maintain open communication with your healthcare provider. Regular follow-ups can help monitor your condition and adjust your treatment as necessary. Remember, managing AS is a long-term commitment, and addressing any new symptoms or side effects promptly can lead to better outcomes and improved quality of life.

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