This treatment was once commonly used for newly diagnosed patients. It was undoubtedly effective, especially in pain control. It is now seldom used, since there is an increased risk of leukaemia, although this risk is very small. Most rheumatologists only now use this form of treatment in exceptional circumstances.
Pay special attention to the position of your back when at work, trying to avoid stooping. If you sit at a desk or work-bench pay attention to the height of yourseat. Try and move your spine regularly, straighten it out and stretch it by sitting tall and pulling your shoulders back. A job that allows a mixture of sitting, standing and walking is ideal. A rest is helpful at the end of the working day, especially for those who have a heavy or tiring job. Lying horizontally for twenty minutes is excellent, as it helps to counteract the forward stooping posture of the spine. Some people with AS have found it necessary to make adjustments to their working lives. However, for many the opportunities for change are not always available. It might, however, be useful to show your employer this booklet if you are thinking of discussing a job change within the company.
When this condition is active your health as a whole often suffers. Many people lose weight and find that they get unusually tired, anaemic and can getdepressed. You need a good nourishing diet and plenty of rest. Your doctor can give you iron tablets for the anaemia. However, one needs plenty of protein found in meat, fish and pulses. Fruit and vegetables are sources of vitamins and milk will supply calcium. There are many books on diet and arthritis. They tend to contradict one another and are generally unhelpful, except to their authors and publishers!
AS is virtually confined to the people who inherit the cell marker HLA B27. This antigen is confined to approximately 8% of the British population with slight variations among the rest of Europe. About 96% of people who have AS have inherited B27. However, it is important to remember that there are far more people with B27 who never get AS. There are families where one brother and sister might both have inherited B27 from a parent but only one of them may develop AS. This is sometimes noticed in identical twins. Present evidence suggests that if rheumatologists minutely examined all people with B27 (in other words 8% of the population) they would find sub-clinical signs of the condition in approximately 10% of those individuals. Many of these cases are so mild they would never be diagnosed. This fact has emerged in the days immediately following the discovery of the HLA B27 in 1973. People who have AS often ask if they should have their children tissue-tested for HLA B27. The answer is that it should not be done, as the chances of the child inheriting the B27 gene is 50%. However, the chances of the child developing the condition in a diagnosable form is only 1 in 3 of those with B27 or 1 in 6 of all the children. However, we recommend that any child with knee, hip or back symptoms should go to their family doctor. The doctor should be reminded that the child has a parent who has ankylosing spondylitis. If he or she is unimpressed with this information, a gentle hint that referral to a rheumatologist might be required would be appropriate.