Can structural damage be prevented in ankylosing spondylitis?

I have long wondered if the understanding howAnkylosing Spondylitis progresses has been correct. It seems I have had good cause to wonder. I came across the following article and thought I'd share:

Can structural damage be prevented in ankylosing spondylitis?

Sieper, Joachim

Abstract

Purpose of review: Current treatment of ankylosing spondylitis such as non-steroidal anti-inflammatory drugs and tumor necrosis factor (TNF)-blockers have shown a good efficacy on sign and symptoms. However, it is less clear whether and how structural damage, determined mainly by new bone formation, can be prevented. Recent progress of the research addressing this question is presented here.

Recent findings: Although treatment with non-steroidal anti-inflammatory drugs over a 2-year period seem to retard growth of syndesmophytes this is not the case in patients treated with TNF-blockers over the same time. First data have been raised on whether new bone formation is coupled to (previous) inflammation or whether these two processes are uncoupled, which are not yet finally conclusive. A better understanding of the interaction between inflammation and new bone formation on the molecular level indicate that inflammatory molecules such as TNFα inhibit osteoblasts and that a TNF-blockade induces new bone formation. Thus, TNF-blockers can only be expected to prevent new bone formation if this is coupled to inflammation and if inflammation is treated early enough. Studies on bone biomarkers in ankylosing spondylitis patients support the view that suppression of inflammation induces new bone formation.

Summary: Future research has to clarify whether structural damage can best be prevented by early and effective treatment of inflammation or whether new bone formation has to be targeted additionally.

http://journals.lww.com/co-rheumatology/Abstract/2009/07000/Can_structural_damage_be_prevented_in_ankylosing.6.aspx

Read more...

Bite the Bullet and Keep on Moving!

Ok, so it’s been a few weeks since my diet mishap and things are just about back to normal. I can at least function each day without brain fog and have been able to start a routine back; it’s a good feeling.

Currently, my SI joints are giving me fits. They have been calm for quite a while, but after a short period of inactivity they’ve decided to rear their ugly heads again. Feels like a knife is twisting around in circles in the joint, so I’m sure there’s some bone scrubbing going on – lucky me. Staying focused on my task at hand though, keeping stretched and staying active!

Read more...

Asinine Decisions

For the most part, I can hold my own. I can read what my body says; I know the warning signs; and I adjust my activity to accommodate what my body “needs”. Like I said … “for the most part”.

Recently however, things have been fairly brutal. My afternoons are pretty much pain free, my evenings are pretty much pain filled, and my mornings are pretty much spent in a drug stupor trying to recover from stronger meds. On top of that, I missed a morning dose of daily meds which hasn’t help matters in the least.

Looking back over the past two weeks, I’ve tried to see what I possibly could have done to mess myself up. Understand that I know one doesn’t necessarily need to have done anything; however, I think this may be the case for my current dilemma.

Over the past two years, I significantly changed my diet. I have never been an unhealthy eater; I generally don’t care for chips, cookies, cake, candy, or ice cream. My nemeses are cheeses and batter fried meats. But to better accommodate a fitness regime I have going; I completely weaned myself off caffeine, severely cut down on processed carbs, and all but cut out meat entirely.

Then, the other night, while out to eat with some friends, for some asinine reason, I ordered prime rib … oh man it was so incredibly good; and so began my demise. I couldn’t be happy with just the prime rib. The next day, while feeling like garbage, I had my husband grill rib eyes. That was 3 days ago, and I still feel like I have the energy of a turnip, but at least I don’t still feel like I have the flu.

I suppose that idea I’ve been toying with to become a vegetarian just became clearer.

Read more...

My Story

In the spring 1998, after the birth of my second son, I knew something was wrong – really wrong. I couldn’t run, walk, clean, or run errands without winding up flat on my back for the next several days. In the beginning my thoughts were, “geez, it sure is taking me a long time to bounce back.” Being a generally active individual, I had a hard time coming to grips with the fact that I couldn’t do much of anything; and as time marched on, I became aware that something was amiss. So, I sought help.

We lived in a relatively small town, with limited specialist; and those who did practice were of the older, “wiser” variety – the ones who refuse to believe there may be another way and everything you say is all fabricated in your head. Shuffled from doctor to doctor, I was pumped full of medications that treated symptoms rather than causes. As a result I gained 90lbs in 4 months.

In the fall of 2000, we moved to Atlanta. By this time, getting out of the bed was a chore so I spent most of my time there. My frustration was at an all time high. New doctors still didn’t seem to have any answers and the never ending cycle seemed to pick up exactly where it left off.

In 2002, I was referred to my current rheumatologist. At last I had a doctor who actually listened to everything I had to say. (What a concept!) She took me off all medications (the majority of which were useless) and we started from scratch. Various medications were tried to alleviate pain while we searched diligently for a diagnosis. Finally, in 2004 tests were conclusive – it was Ankylosing Spondylitis.

I was so angry. Years of searching – hoping – to find something, anything! And it never once occurred to me that whatever it was couldn’t be fixed. I was devastated. After a few months, I conceded that I could finally get the treatment I needed.

It’s been 5 years since my diagnosis, and it wasn’t the end of the world. I am now able to halfway function as a human being. With the help of yoga, TNF inhibitors, muscle relaxers, and NSAIDs; one couldn’t look at me and notice anything wrong with me. I still have my limitations. My right SI joint in almost completely fused and the left is on its way. My spine, though still flexible, still rages at me when push the boundaries. Lifting isn’t the greatest idea, and neither is stooping. And I’m limited to about an hour walking; even less standing still.

What I have learned through all this is movement is the single best thing I can do – movement in moderation. No sitting too much, no standing too much; but a good variation of twisting, moving, flexing, and stretching. In the beginning, movement caused greater pain; but after much persistence and continuous repetition, the pain did ease. Most days are good, others are a struggle; but as long as there is movement in my body, I am triumphant.

Read more...