N.A.S.S Dingwall Branch Information Page

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The Medical Management of AS

As yet, there is no cure for AS, therefore the emphasis must be on disease management. This is why patient education is so important. Most people with the condition take regular anti-inflammatory drugs to relieve the pain. These drugs are not habit-forming or addictive. The person must then carry out a regular exercise programme. In some cases daily, and for others twice a day. There is no doubt that not only do these exercises help to maintain mobility and posture of the spine, but they also assist in pain reduction. The patient, the doctor and the physiotherapist play a role in the management of the condition. The National Ankylosing Spondylitis Society is also playing an important role in the lives of an increasing number of people at this level. Firstly, through its growing number of branch organisations, where regular supervised physiotherapy is provided one evening after work. Secondly, the society has also produced a physiotherapy cassette tape and video film of a home-exercise programme. Not all people react in the same way to each different type of anti-inflammatory drug. Therefore your doctor might suggest that in time you try a few of them to find the most effective one for you. There are some which can be taken last thing at night to release the drug over a few hours. This will help to maintain pain control over a longer period to assist in a good night's sleep and less morning stiffness.

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Heat

In its various forms heat will help to relieve pain and stiffness. Many people find a hot shower or bath before bed and first thing in the morning will reduce pain and stiffness, especially if some stretching exercises are done at the same time. A hot-water bottle or electric blanket are used by many in bed. Some people also find that cold, when applied to an inflamed area, helps. For instance, a bag of frozen peas wrapped in folded tea towels (take care, as ice can burn).

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Surgery

Plays only a small part in the management of this condition. In most cases where surgery is involved it will apply to about 6% of people with AS who will go on to have a hip replaced (arthroplasty). These are very successful and will restore mobility and eliminate pain of the damaged joint. Rarely, surgery is involved in restoring a straighter posture of the spine and neck to people who have become stooped over. These people have difficulty in looking forward and seeing other people's faces, shop signs and door numbers, etc. They will also have difficulty in crossing the road.

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Corsets and Braces

Unfortunately these are still often prescribed by some doctors not familiar with the modern management of the condition. They very often make matters worse, as they hold the spine rigid. Not moving leads to not being able to move! These are a relic of the past when doctors wrongly thought that it was inevitable that all people with AS would automatically end up with a fused spine. The corsets therefore concentrated on maintaining a straight spine while the stiffening process took place.

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