[Dolore]Preventing Ankylosing Spondylitis and Quitting Smoking Is Better Than Genetic Tests-Ming Pao Health Net

[Ming Pao News]Do many people suffer from back pain, thinking that it is caused by poor posture? If you are under the age of 45 and continue to have back pain, plus you wake up in the morning with lower back stiffness, be careful, you could get ankylosing spondylitis.

Ankylosing spondylitis is a disease of the immune system. In addition to back pain and stiffness, the original vertebrae merged into one, affecting range of motion.

Chen: Chen Suhuai (specialist in family medicine, sanatorium and hospital)

Tanning: Tan Haopei (rheumatology specialist)

Ignore back pain and spinal fusion without looking back?

Question: Is back pain only caused by poor posture, just a small problem?

Chen: Depending on the condition of the back pain, the doctor will consider many factors, such as the duration of the back pain. If it occurs recently, it could just be a sprain caused by exercise or poor posture. The condition will improve rapidly; if your back pain has been maintained for a period of time, then consider whether you have ankylosing spondylitis, cancer, or viral infection (such as tuberculosis). Also, if the patient’s spine is constricted and compressed by the nerves due to trauma or degeneration, it will cause paralysis and weakness of the limbs and even incontinence. You should immediately go to a specialist for follow-up. These problems can be very serious. Take ankylosing spondylitis as an example. If the patient’s spine is merged into one, it can cause difficulty standing and walking, and cannot be reversed and should never be taken lightly.

Pain in the buttocks, swelling in the knee due to spondylitis?

Question: How to know if back pain is caused by ankylosing spondylitis?

Chen: Back pain can be divided into mechanical back pain (mechanical back pain) and inflammatory back pain (inflammatory back pain). The former is caused by poor posture, muscle and joint fatigue, while ankylosing spondylitis is an inflammatory back pain.

Mechanical back pain will recover within a few weeks with more rest, but inflammatory back pain usually lasts 3 months or more and is particularly painful when the body is still and is more likely to wake up in the middle of the night. Morning stiffness is a typical symptom of ankylosing spondylitis, meaning patients who wake up in the morning will feel stiffness in the joints and will maintain it for 30 minutes or more.

Ankylosing spondylitis can also have other symptoms. Since the site of the disease is the sacroiliac joint, that is, the joint between the pelvis and the coccyx is inflamed, the patient will also experience pain in the buttocks. The condition can also affect inflammation in surrounding joints, such as the hip joints and knees. The affected joints can swell, become inflamed, or have water. Additionally, approximately 40% of patients will experience inflammation of organs other than the joints, such as inflammation of the eyes, skin, intestines, and cardiovascular system. After consultation and examination, if the patient is suspected of having ankylosing spondylitis, the doctor will refer the patient to a rheumatologist for evaluation and treatment.

Do most males get sick before age 45?

Question: With the HLA-B27 gene, can you get ankylosing spondylitis?

Tanning: Ankylosing spondylitis is a disease of the immune system and the cause is unclear. Males are more common, with a male to female ratio of about 3 to 4: 1. Most patients are young men. Symptoms usually appear in adolescence or early adulthood, rarely appearing at the age of 45. About 3 people in Hong Kong suffer from ankylosing spondylitis for every 1,000 people. About 90% of patients have the HLA-B27 gene, and those with this gene are at increased risk of the disease. About 7% of the Hong Kong population carries the HLA-B27 gene, fortunately the incidence of these people is only 2%. Research believes that in addition to genes, there are environmental stimuli that induce ankylosing spondylitis, such as infection or dysbiosis of the gut microbiota. Additionally, patients with psoriatic arthritis (commonly known as psoriatic arthritis), inflammatory bowel disease, and iritis may also have symptoms of spondyloarthritis.

Are x-rays easy to miss early on?

Q: How is ankylosing spondylitis diagnosed?

Tanning: If back pain persists for more than 3 months and the patient is under 45, characteristics of back or joint pain will be evaluated, family history and other related symptoms will be evaluated. If your doctor suspects ankylosing spondylitis, further tests will be arranged. Patients should be diagnosed with x-rays and MRIs, as ankylosing spondylitis affects the sacroiliac joints first. X-rays of the pelvis can determine if the sacroiliac joints are constricted, eroded, or fused; but X-rays may not be able to detect the initial symptoms of the disease It may be necessary to rely on a highly sensitive and specific MRI to detect inflammation of the sacroiliac joints to avoid delaying the disease.

Furthermore, a blood test for the HLA-B27 gene is also one of the benchmarks; other inflammatory indices such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) can determine the degree of disease activity. The doctor combined the above information and made a diagnosis based on the International Diagnostic Standard Score.

Does that mean you’ll get sick?

Q: Can genetic testing prevent ankylosing spondylitis?

Tanning: Ankylosing Spondylitis Is Hereditary If you have the HLA-B27 gene and your family has close relatives with the disease, your risk of the disease increases to 20%. However, although the HLA-B27 gene is a reference value for diagnosis, it is not recommended to undergo genetic testing indiscriminately as the incidence rate is only 2%.

On the other hand, studies have confirmed that smoking greatly increases the possibility of damaging the spine and joints, and high-risk people must quit smoking.

Additional information: Biological agents cannot be cured