Ankylosing Spondylitis in Men

Ankylosing Spondylitis in Men
by

Dr. Saziya Salmani

It is one of the most common rheumatic diseases found in both men and women but what lies underneath this is the difference in its prevalence and clinical presentation with relation to gender.

What is Ankylosing Spondylitis?

Ankylosing Spondylitis (AS) comes from Greek word origin ankylos meaning stiffening, spondylos meaning vertebra, and -itis meaning inflammation, which together means stiffening of the spine. It primarily affects the spine, although other joints can also get affected. It is a chronic, progressive and painful inflammation of the spinal joints (vertebrae). In advanced cases this inflammation can lead to ankylosis i.e. formation of new bones in the spine which can cause sections of the spine to fuse in a fixed and immobile position. The hallmark feature of AS is the involvement of the sacroiliac (SI) joints i.e. the joint between the sacrum and ilium bones of the pelvis, during the progression of the disease.

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This condition has been included in the issue due to its high prevalence seen in males over the years. More than 1 million cases per year in India have been registered and its prevalence is 3 times more common in men as compared to women, usually affecting young adults between the age group of 20-30 years.

Diagnostic differences-

The major difference in how ankylosing spondylitis affects men and women appears to be the rate at which they progress. The progression of symptoms in women is comparatively slower than that in males. The pain intensity is found to be more severe in males than females but this does not exclude pain to be exclusive only in males. Also men are more prone to experience in their spine and lower back region and women usually experience pain in other joints like the hips or knees prior to the back affection. These are subtle but important differences. Diagnosis of AS is easier in men than women.

Common symptoms include-

  • Initially one may experience long term backache with stiffness, gradually progressing to reduced flexibility and mobility of the spine.
  • The posture can get affected due to the affection of the spine bones
  • Extreme fatigue in both men and women
  • Pain in major joints of the body like the shoulder, hips and knees.
  • Inflammation in other parts of the body like the eyes

Genetic predisposition-

Many people with AS have been tested positive for HLA-B27 (this test is performed to identify a specific protein on the white blood cells (WBCs) which is a sign of autoimmune disease.). HLA-B27 causes immune system dysfunction, which means, its presence can cause the immune system to attack the otherwise healthy cells, which can give rise to an auto-immune disease or immune- mediated disease. Hence AS is to a great extent an autoimmune disease.

Apart from a detailed patient history and physical examination by a well-trained doctor or health care practitioner, which is the first step, medical imaging and blood tests investigations can help confirm the diagnosis of this condition.

Treatment-

Conventional treatment- there is no cure for Ankylosing spondylitis in the modern system of medicine hence the mainstay treatment includes controlling the disease symptoms and pain intensity by means of medications like NSAIDs (non-steroidal anti-inflammatory drugs), steroids, DMARDs (disease modifying anti rheumatic drugs along with physiotherapy and surgery in some advanced cases.

Homeopathic treatment- Homeopathic remedies act on the immune system and are proven to be very effective in halting the progression of the disease and alleviating the symptoms.

Cases of Ankylosing sonondylitis

 A 40-year male, who was a grocery store owner by profession, was diagnosed with Ankylosing spondylitis with HLA-B27 positive since 20 years. He consulted us at the other song for treatment. He was seen at the clinic by our consultant Dr. Gajanan Dhanipkar and me.

He complained of severe pain in the back and cervical spine since more than 10 years. The pain in the lower back would ascend up the entire spine. He also noticed a cracking sound in the neck. His spine was completely stiff and was not able to bend his neck as well as back. He was not able to sleep on account of the pain at night. The pain and stiffness would be worse on waking up in the morning. Painkillers provided him a temporary relief in the pain, which would return back after its effects, waned off. On account of the pain he was forced to sit still and would become irritable due to it. The effects of his complaints showed up on his work front. His optimum work capacity had gone down. He was on the medications Sazo (Sulfosalazine i.e. DMARDs) and Etoshine (etoricoxib i.e. NSAIDs) 120 mg.

After a detailed case taking session with Dr. Gajanan Dhanipkar, he was started with homeopathic medications. Over the next few weeks of taking the homeopathic medications he was almost 80 % better in all his complaints. The pain in the lower back as well as the neck markedly reduced. The stiffness reduced as a result of which his range of movement at the neck improved. He did not have to compulsory sit still as before. His sleep improved and his moods got better. The painkillers gradually reduced within three months of treatment. The improvement was very characteristic for this condition.

In homeopathy we consider and treat the person as a whole. The treatment is based on the patient’s physical, emotional and pathological complaints together. After a complete analysis and physical examination a most suitable homeopathic medication is selected which matches with the patients symptoms and complaints. Medications are selected on the basis of symptom similarity. In both the above cases after a thorough study of the case and the patient as a person, the most suitable homeopathic medication was prescribed and both the patients did very well overall. Not only was there a relief in their physical complaints but a mental shift was also observed. Homeopathy can help improve the overall quality of life of the individual.

In conclusion, I would like say ‘knowledge is awareness and awareness is power’. The more we are aware of the conditions we are facing and what homeopathy can do to heal them, the more powerful we are.

Easy back exercises-

  1. Stand with the heels and back against the wall. Make sure that the back and the heal touch the wall surface. Try to push the head back towards the wall, hold for 5-8 seconds and relax. Repeat again. Start with 5 initially and increase to 10 gradually over time.
  2. Stand with feet apart, place the hands on the hips and turn from the waist to look behind. Keep the knees and feet facing the front. Hold on for 5 seconds and repeat on the other side. Repeat 5 times on each side.

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