Flares of ankylosing spondylitis: identification and management

Ankylosing spondylitis (AS) is a type of arthritis that primarily affects the spine, causing inflammation and pain. People with AS often experience periods of increased disease activity that they may refer to as flare-ups.

AS can cause symptoms such as lower back, pelvis, and hip pain. These symptoms may appear or worsen during flare-ups. When flare-ups occur, a person can find relief by following the steps in their treatment plan.

It’s usually not possible to prevent all flare-ups, but a person can take steps to reduce their frequency and severity.

Doctors will often classify AS flare-ups as localized or generalized.

If a person is experiencing a localized flare, they will have symptoms that affect one area of ​​the body. They may notice pain and immobility in the affected area, as well as a general feeling of fatigue.

Generalized flare-ups are more severe than localized flare-ups and affect the body more. A person with a generalized AS flare may notice joint burning, muscle spasms, and flu-like symptoms, in addition to pain and immobility in the affected areas of the body.

Evidence suggests that AS rashes are common. For example, in a 2017 study, participants reported experiencing, on average, at least one 2-week flare per month. An older 2010 study of 134 people with AS found that 70% had weekly flare-ups.

Symptoms of AS flares can vary from person to person and flare to flare.

However, symptoms a person may experience as a result of AS flare-ups include:

  • fever
  • fatigue
  • stiffness and pain in the back
  • joint pain, often in the rib cage, shoulders, hips, or knees
  • enthesitis, which is swelling and pain of the connective tissue
  • depression or anxiety

Other Common Symptoms may include:

  • eruption
  • loss of appetite
  • weightloss
  • changes in vision or eye pain
  • difficulty breathing deeply
  • abdominal pain
  • loose stool

Managing AS flares often involves following an individual treatment plan. A person living with AS should work with a doctor to develop a treatment plan that helps them minimize flare-ups and manage disease progression.

Common treatments for AS flares include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs): This type of medication, which includes ibuprofen and naproxen, can help reduce inflammation and pain. It is usually the first line of treatment.
  • Organic Products : Doctors often use these drugs, which directly target AS, when NSAIDs aren’t effective in managing symptoms and flare-ups.
  • Gentle exercise: Low-intensity forms of exercise, such as yoga, can help improve symptoms and prevent stiffness and pain in the spine and joints.
  • Therapeutic massage: Although this therapy can be effective in some cases, it may be best to avoid it during a flare-up.
  • Transcutaneous Electrical Nerve Stimulation (TENS): TENS uses electrical impulses to block nerves from transmitting signals to the brain, which helps reduce pain.
  • Hot or cold therapies: Hot and cold therapies can help reduce swelling and relieve pain.

A person can take steps to help prevent AS flare-ups. These include:

  • To manage stress: A person can try meditation, exercise, therapy, or other methods to deal with stress.
  • Try alternative pain relief methods: If medical treatments are not entirely effective in relieving the pain, a person may find that other methods, such as deep breathing or mindfulness, help with this symptom.
  • Exercising regularly: In particular, endurance and strength routines can help a person manage pain during a flare-up.
  • Pausing at the start of a push: A person may need time off from school, work, or household chores to help reduce the physical burden that can make a flare-up worse.

Often a person cannot stop a flare from happening, even if they use the above methods. It is important to follow a doctor’s recommendations for treating flare-ups when they occur.

Ankylosing Spondylitis Flare Triggers

Experts do not fully understand the exact cause of AS. There are proof suggest that the HLA-B27 may increase the risk of AS, but not everyone with this gene will develop the disease.

Likewise, it is unknown what causes flares. However, a person may be able to identify certain factors that often lead to flare-ups. For example, illness, injury, or emotional health can all have an influence.

Sometimes flare-ups can be due to treatment-related factors, such as a change in medication dosage, delayed dosing, or other adjustments to a person’s treatment plan.

Experts also suspect that stress may play a role in causing flare-ups. Taking steps to reduce stress can help people reduce the frequency of their AS flare-ups.

Flares can occur regularly in people with ankylosing spondylitis. They can cause pain and stiffness in the spine and other joints, as well as symptoms in other parts of the body, such as the eyes. Some people with AS may also experience fatigue and depression.

Managing flares often involves following a treatment plan that a doctor helped create. A person can take steps to help minimize the frequency and severity of flare-ups, such as engaging in regular physical activity, managing stress, and avoiding known triggers.

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