Wednesday, June 15, 2016

Ankylosing Spondylitis: What Aging Adults Need to Know

Ankylosing SpondylitisAnkylosing spondylitis, or AS, is a form of arthritis which affects parts of the spine. It is characterized by the chronic inflammation of the sacroiliac joints and the spine. This inflammatory condition can cause the ligaments, joint capsules, tendons and some of the vertebrae that attach to your spine, to swell.

Over time, the swelling can lead to formation of excess bone and perhaps the fusing (a complete cementing together) of vertebrae also. This fusing causes pain and makes the spine become less flexible and could result in a hunched-forward posture. The forward curvature of the spine is known as kyphosis or alkalosis and it causes loss of the spine’s mobility. In case ribs are affected, it can be difficult to breathe deeply.

Ankylosing Spondylitis can sometimes affect other joints and different parts of the body. There are also several conditions related to AS which have many similar symptoms. Sometimes the eyes may become involved (known as Uveitis or Iritis), and rarely, the heart and lungs can be affected.

Physical Conditions Characterized by AS

The hallmark feature of Ankylosing Spondylitis is the involvement of the sacroiliac joints (SI) during the progression of the condition. The sacroiliac joints are situated at the base of the spine/lower back where the sacrum (bone directly above the tailbone) of the spine meets the iliac bones (bones located on either side of the upper-buttocks) of the pelvis. Chronic inflammation in these parts causes pain and stiffness in-and-around the spine, including the back and neck. The cause(s) of this condition are not yet known, although there is notion to be a causal link with a particular gene called HLA-B27.

The outlook for Ankylosing Spondylitis is highly variable. For some patients, the condition improves following an initial period of inflammation, while for others this condition may get progressively worse over time. Approximately 70% - 90% of patients with Ankylosing Spondylitis remain minimally disabled or even fully independent in the long term. But, there are people who eventually become severely disabled because the bones in their spine fuse in a fixed position and result in damage to other joints, like the hips or knees.

Who is Most Affected by Ankylosing Spondylitis?

Ankylosing Spondylitis can affect all age groups, male or female, old or young, including children, although it is more common in young men. It is 2 to 3 times more common in men compared to in women. In women, joints that are away from the spine are more often affected than in men. When it affects children, it’s known as juvenile Ankylosing Spondylitis. It’s most prone to begin in your late teens and 20s. AS is linked to the inherent genes but if your parents suffer from it it’s not clear-cut that you’ll develop it.

When to Seek Medical Advice for AS?

You need to see your doctor if you’ve persistent symptoms of Ankylosing Spondylitis. They will ask about the symptoms you’re experiencing, when they began and how long you’ve had them. If your doctor thinks you may have this condition, they’ll refer you to a rheumatologist for further exams and any necessary treatment.

How is Ankylosing Spondylitis Diagnosed?

Ankylosing Spondylitis Diagnosis
A rheumatologist is commonly the physician who will diagnose AS, since they are doctors specially trained in diagnosing & treating disorders which affect the joints, muscles, bones, tendons, ligaments, and connective tissue. A thorough exam will entail x-rays, personal medical history, and also a family history of Ankylosing Spondylitis, as well as blood work that will include a test for HLA-B27. These are all factors involved in making a diagnosis.

A physical examination will involve looking for sites of inflammation. Your doctor will check for pain & tenderness along your back, sacroiliac joints, pelvic bones, chest and heels. During the physical exam, a rheumatologist may also check for the restraint of spinal mobility in all directions and also for any restriction of chest expansion.

Blood testing

If your rheumatologist suspects Ankylosing Spondylitis, they may arrange blood tests in order to check for inflammation signs in your body. Inflammation in your joints and spine is one of the major symptoms of this condition. A blood test may sometimes show if there is inflammation in your body. You will possibly have one or more of the following tests:
  • Plasma viscosity (PV)
  • Erythrocyte sedimentation rate (ESR)
  • C-reactive protein (CRP)
  • Antinuclear antibody (ANA) test, for looking for evidence of an auto-immune condition
  • Rheumatoid factor, which rules out rheumatoid arthritis
  • Complete blood count, so as to check for anemia, a complication of chronic inflammation
  • HLA-B27, to see whether one has this genetic marker
These all test for inflammation, therefore they give similar information. Only 30% to 40% of patients with AS have inflammation that may be picked up in a blood test, and so in many cases the blood tests will be normal.

Your rheumatologist can carry out imaging tests in order to examine the appearance of your pelvis and spine. These are described below.


As the condition develops, an X-ray of your spine/lower back can show changes or damage to the sacroiliac joints and new bone-forming between the vertebrae, which are common signs of advanced Ankylosing Spondylitis. X-rays are NOT always helpful in the early stages.

MRI Scan

Another option is to use magnetic resonance imaging (MRI) scan to check for sacroiliac (SI) joint involvement. A MRI scan may highlight damage in your sacroiliac joints which might not show up on an X-ray. It could also show any inflammation of the-ligaments in the spinal region.

Ultrasound Scan

This can pick up inflammation of your body tissues (ligaments and tendons) attached to the bones.

Genetic Testing

A genetic blood test can confirm whether one has the HLA-B27 gene, found in most people with AS. Over 95% of Caucasian patients with Ankylosing Spondylitis test positive for the HLA-B27 marker.

Treatment of Ankylosing Spondylitis

Currently, there’s no known cure for Ankylosing Spondylitis, but there are treatments and medications available to manage the pain and swelling, and also reduce symptoms. In most cases, Ankylosing Spondylitis treatment will entail a combination of:
    Ankylosing Spondylitis Treatment
  • Physical exercises carried out in groups or individually to reduce pain and stiffness.
  • Medication to help relieve pain and ease inflammation – like painkillers and a type of drug known as anti-TNF medication; NSAIDs (nonsteroidal anti-inflammatory drugs) and second line medications (also known as next stage of medications called DMARDS (disease modifying anti-rheumatic drugs) such as Sulfasalazine, Methotrexate and Corticosteroids treat the pain and stiffness linked to spondylitis.
  • Physiotherapy – whereby physical methods, like massage and manipulation, are employed to improve comfort as well as spinal flexibility. It also involves applying heat to tight muscles and stiff joints to help reduce pain and soreness. Also, applying cold to inflamed parts can help reduce swelling. Showers and hot baths can also help offer relief.
In severe cases of AS, orthopedic spine surgery can be a treatment option in the form of joint replacements, especially in the knees and hips. Surgery may sometimes be needed to correct severe bends in the spine or repair significantly-damaged joints, but this is uncommon.

Alternative treatment options such as massage and use of a TENS unit (electrical stimulator for pain relief) can also be considered. Maintaining a balanced diet and healthy body weight can also aide in treatment of Ankylosing Spondylitis.

5 Casual Cycling Clothing Ideas for Summer

With such a wide spectrum of cycling clothing options, it can be difficult to find cycling jerseys, bibs, and shorts that are casual but still of performance-grade quality. Many cyclists appreciate a more subtle and casual style without all the logos, graphics, and colors. And yet, most cyclists are unwilling to sacrifice quality of style.

There are some products out there that strike a balance with quality and casual-style. Below we offer five casual cycling clothing ideas for summer riding.

Paris-Roubaix Cycling Jersey 
Paris-Roubaix Casual Cycling Jersey

Offering a classic-vintage style that's both functional and casual, the Paris-Roubaix Cycling Jersey from is tailored from premium-quality fabrics with superior moisture-wicking features to ensure it feels comfortable. The design behind the Paris-Roubaix cycling jersey is simple and original, highlighting the former French cycling team, Alcyon, which was active on the professional cycling scene from 1906 to 1955.

Keeping it both casual and functional, the Paris-Roubaix cycling jersey features three pockets in the back, a hidden YKK full length zipper on the front, and 4-way stretch mesh side panels fitted with raglan sleeves to increase airflow. Check out this vintage cycling jersey as well as many other casual cycling clothing at

Jura Merino Jersey 
Jura Merino Casual Cycling Jersey

The Jura Merino Jersey is made entirely of merino wool. This casual cycling jersey has three buttoned pockets located at the back, a stylish neck, some springy merino cuffs and waistband. This casual riding jersey is very comfortable and trendy.

The Jura Merino Jersey comes in short sleeves to cater for the ambient heat experienced in the months of summer. This jersey is able to be personalized with your name, name of a club, logo of an institution, a charity event logo, a company logo etc. Designed in the UK, you can learn more about Jura and the Merino Jersey at

Endura Single Track Lite Jersey 
Endura Single Track Lite Jersey

Endura Single Track Lite Jersey is made of cotton fabric and has an antibacterial finish to keep odors at bay. It has a concealed full-length zipper whose sole purpose is to provide maximum ventilation during riding. The Endura Single Track Lite Jersey is designed with a discreet zipped media pocket at the back.

This jersey’s design incorporates backpacks and hydration packs. The Endura Single Track Lite Jersey is made more attractive with panel details, but the casual style is still retained. Last but not least, this amazing hot weather jersey is equipped with sunglasses wipes. Check it out at

The Milk Bar Jersey 

The Milk Bar JerseyThe The Milk Bar Jersey is of very high quality and is endowed with an ultra-modern look. It's a well-balanced cycling jersey as it never gives the showy or overly branded impression. It has a serious race-cut design and his made of very light wool that is carefully blended with side mesh panels.

Around the rear there are 3 medium sized pockets and a silicon gripper that runs the whole length of the back panel. The Milk Bar Jersey generally has a classic feel due to the modern materials used and the modern cut incorporated in its design. You can see the complete Milk Bar kit at

Rapha Brevet Jersey

Rapha Brevet Jersey Casual Cycling
Rapha's Brevet Jersey is manufactured from breathable and insulating Sportwool fabric. It has two-high visibility stripes around the chest area; one is in pink and the other in a stylishly perforated Schoeller type of fabric. The cuffs to the jersey have a hi-vis trim and the right arm of the jersey has a reflective armband. The rear of the jersey has a reflective tab.

The Rapha Brevet Jersey also has a state of the art water-resistant zipped chest pocket and three humongous cargo pockets. There is a zipped valuable pocket at the rear of the jersey. These features among others give it a modern and stylish look. See this casual cycling jersey at Any of these casual cycling clothing ideas are sure to give you a memorable summer that is nice and elegant as they have the creative designs to show for it.