How To Detox The Healthy Way

Ankylosing spondylitis is an inflammatory arthritic disease or spondyloarthropathy, classified with reactive arthritis, bowel disease arthritis and psoriatic arthritis. The underlying relationships between these diseases are complex but they are connected by enthesitis (inflammation of the ligament/bone junctions) and by possession of the HLA B27 gene on white blood cells. The enthesitis process at the joint edges can cause fibrosis and then ossification of the area (bone formation).

AS is the commonest of the spondyloarthropathies and its occurrence varies with the occurrence of the HLA B27 gene in the population, AS being less common in the tropics and more common in northern European countries. 0.1 to 1.0% of people are affected but this varies with latitude and is more common in white people. About 1-2% of people with the HLA B27 gene actually develop AS but this becomes 15-20% likelihood if they have a first degree relative with the disease.

AS occurs more often in males, with a 3:1 ratio, but females may suffer much milder disease or have minor symptoms which are not diagnosed. AS is a disease of young men, with most presenting before they are 40 years old, and 10-20% presenting with the disease before they are 16. On average people get the symptoms of the disease around 25 years old and are rarely diagnosed when over 50 years of age. The condition is often missed initially as it presents as low back pain so it is important to take a proper history. A useful question is “how does your back feel when you wake up” and AS patients will all say “very stiff”.

Ankylosing spondylitis has similarities but distinct differences from the much more common low back pain:

Morning back stiffness lasting half an hour and often longer Back pain improved with exercise Back pain worsened with rest Night pain later on in the night Other joints may be affected Fatigue is common Active inflammatory disease can cause systemic affects such as unwellness, weight loss or fever

A significant reduction in the ranges of spinal motion is usually recorded by the physiotherapy examination of an AS patient, with a flattened lumbar curve and an accentuated thoracic kyphosis. Later involvement can include reduced neck ranges of motion and reduced chest excursion from involvement of the rib joints. Peripheral inflammation at insertion sites occurs in about one third of patients, the commonest sites being the insertion of the tendo Achilles on to the calcaneum and the insertion of the plantar ligament in the foot. These areas cope with large mechanical loads which may be why they more commonly occur.

The physiotherapist initially notes the postural changes which have occurred in an AS patient such as any spinal deformities, round shoulders, bent knees or an increased cervico-thoracic curve and poking chin posture. The physio will record ranges of movement of the spine and include the neck, thorax and lumbar ranges, also assessing any peripheral joints which may be affected. Any entheses which are reported as painful are palpated to confirm the presence of an inflammatory process, and if the AS is very active then the physiotherapist might also find effusions in the joints, perhaps with a feeling of unwellness, night sweats and poor rest.

Initially a physiotherapist might treat an active, inflamed site such as the tendo Achilles insertion using ultrasound, ice and gentle stretching, with foot problems responding to insole use. Whole spine exercises are taught with encouragement to get to the end of the movements, concentrating on antigravity movements including extension of the lumbar and thoracic spine, rotation of the thorax and neck retraction and rotations. To counter the typical spinal deformities, patients are taught to rest in good positions such as flat on a firm surface with only one pillow and lying prone. Pool therapy is very popular and effective and patient education is vital to maintain therapy over time.

Have you been experiencing stabbing pains in your lower back? Is bending over, turning round, or rolling over into your bed even difficult for you? If this is the case, you might have a sacroiliac joint inflammation, and that is one pain in the back you would gladly do your Christmas holidays without.

Now, you might be wondering what the sacroiliac joints even are. They are two ‘L-shaped’ joints are situated at the lower back, between the pelvic ilium and the sacrum (the small wedge-shaped bone at the bottom of your spine), and are held in place by various muscles and ligaments. Their function is to enable you to move your pelvis - sacroiliac joints get pulled and twisted along the pelvic girdle whenever you move your lower back.

When one of the joints gets inflamed, sharp pains may arise in the lower back, buttocks, and sometimes the thighs. This can happen either when one of the joints gets stuck, or when one half of the pelvis is constantly being pushed backwards and forwards.

While the more severe forms of sacroiliitis tend to emerge with aging, the minor infections of the sacroiliac joint and the surrounding ligaments are quite common. The primary causes of sacroiliitis are degenerative arthritis, or osteoarthritis of the spine (because the disease often erodes the sacroiliac joints); injury caused by sudden impact or damage to the pelvic region; and pregnancy (because the pelvis is forced to stretch to allow for childbirth). Sacroiliitis is treatable, however, so do not worry. Just be sure to visit an osteopath as soon as you become aware of any of the symptoms.

The most common symptoms of sacroiliac joint inflammation are: - Restricted hip movement (making it difficult to turn around or roll over in bed) - Having a stiff lower back after extended periods of remaining still or sedentary (i.e. after long car journeys), or when getting up in the morning - Having trouble bending down - Experiencing pain during sexual intercourse - Sharp pains in your thighs when moving your legs in a specific way (swinging them over the bed or out of the car)

If you recognize any of these symptoms in your own situation, be sure to visit someone with an in-depth knowledge about the sacroiliac joint, such as an osteopath. To minimize your discomfort temporarily, you are advised to: - Wrap a damp tea towel around an icepack and place it on the painful area for 10-minute intervals, over the course of a half hour, for up to three times a day. - Sleep on your side at night (not your back or stomach) - Place a pillow between your knees while you are in a sedentary position or when lying down. This should take some of the pressure off your pelvis.

While sacroiliac joint inflammation can be a real pain in the back, osteopaths can help cure the problem effectively through a combination of physical therapeutic techniques and anti-inflammatory medication. So as long as you visit your osteopath and nurture your body, you should be fit and healthy for the upcoming holiday season.