ANKYLOSING SPONDYLITIS(Marie-Strrumpell Disease) |
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ANKYLOSING SPONDYLITIS (Marie-Strrumpell Disease)
DESCRIPTIONAnkylosing spondylitis is a chronic, progressive disease of the joints, accom panied by inflammation and stiffening. It is characterized by a "bent forward" posture caused by stiffening of the spine and support structures. Body parts involved include the sacroiliac region, the hip joints, and the lumbar, thoracic and cervical spines. Ninety percent of all cases of ankylosing spondylitis begin in males after age 10.
Appropriate health care includes:
Self-care after diagnosis.
Physician's monitoring of general condition and medications.
Surgery to replace a damaged hip or to insert bone grafts in the spine (advanced stages only).
SIGNS & SYMPTOMS
Early stages: recurrent episodes of low backache; pain can also occur along the sciatic nerve; stiffness that is worse in the morning.
Later stages: progressive worsening of symptoms; pain spreading from the low back to the middle back or higher in the neck; joint pain in the arms, legs, feet, and hands (sometimes).
Anemia; muscle stiffness; fatigue; weight loss.
CAUSES
Unknown, but it may be caused by genetic changes or an autoimmune disorder.
RISK FACTORS
Family history of ankylosing spondylitis.
PREVENTING COMPLICATIONS OR RECURRENCENo specific preventive measures.
BASIC INFORMATION
MEDICAL TESTSYour own observation of symptoms; medical history and physical exam by a doctor; laboratory blood studies; X-rays of the spine.
POSSIBLE COMPLICATIONSCongestive heart failure; loss of vision; amyloidosis (See Glossary); heart-valve disease; gastrointestinal disease; lung disease; permanent disability and immobilization.
PROBABLE OUTCOME
This disease is currently considered incurable. Symptoms progress slowly and unpredictably for 10 to 20 years, but they can be relieved or controlled.
Life expectancy is reduced by the complications--not from the disease.
Medical literature cites instances of unexplained recovery. Scientific research continues, so there is hope for increasingly effective treatment and cure.
TREATMENT
HOME CAREInstructions for the patient:
Sleep on your back on a firm mattress. Use a small pillow or none at all.
Take hot baths or use heat compresses before exercising or to relieve pain.
Avoid excessive rest or exhaustion.
Have regular massages, if possible.
Exercise to help maintain muscle strength and prevent deformity. (See Appendix 10 for instructions).
MEDICATION
Your doctor may prescribe non-steroidal anti-inflammatory drugs. Don't give your child narcotics for pain; they are addictive.
ACTIVITY
The child should stay as active as strength allows. Instructions for the patient: Exercise to maintain good posture and retain as much upright carriage as possible--back braces don't help. Swim regularly, if possible -- your buoyancy in water will allow you to move stiff, painful areas more easily. Avoid activity that puts stress on the back.
DIET & FLUIDS
No special diet.
OK TO GO TO SCHOOL?When alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of ankylosing spondylitis.
The following occurs during treatment:
--Temperature of 101F (38.3C) or higher. This may indicate the recurrence of an acute phase.
--Increasing pain and disability, despite measures outlined above.
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