Logan Steele
Ankylosing spondylitis (AS) is a type of arthritis that causes inflammation in certain parts of the spine. It can lead to osteoporosis, which can result in spinal fractures. AS can also cause inflammation in the eye, aortic valve, and intestinal tract. While AS is not known to cause herniated disks, it can cause muscle spasms and cramping, particularly in the neck, hips, and upper back.
| Characteristics | Values |
|---|---|
| Muscle Cramps | Spasms in spinal muscles cause pain and limitation of motion. Muscle relaxants are used to decrease muscle pain and tightness. |
| Symptoms | Back pain, stiffness in the lower back and hips, neck pain, fatigue, pain in the Achilles tendon, plantar fascia, and chest. |
| Complications | Compression fractures, heart problems, uveitis, osteoporosis, herniated disks, costochondritis, pleurisy, cauda equina syndrome, hypoparathyroidism, IBS, IBD, and eye inflammation. |
| Causes | The exact cause is unknown, but genetics and the HLA-B27 gene are thought to play a role. |
| Treatment | NSAIDs, DMARDs, exercise, and maintaining maximum motion of the skeleton. |
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What You'll Learn
Muscle spasms and cramping
Ankylosing spondylitis (AS) is a type of arthritis that causes inflammation in certain parts of the spine and large joints, resulting in stiffness and pain. It can also lead to osteoporosis, which can result in spinal fractures. As the disease progresses, new bone forms as part of the body's attempt to heal, causing sections of vertebrae to fuse together. This fusion results in a loss of flexibility and can lead to a hunched posture.
In addition to joint pain and stiffness, muscle spasms and cramps are also commonly reported symptoms of AS. These spasms can occur in various parts of the body, including the neck, hips, upper back, and shoulders. The muscles alongside the spine can go into spasm, magnifying the discomfort and further limiting mobility. In some cases, muscle spasms in the neck and upper back can lead to neurological pain, tingling, and burning sensations in the spine, as well as numbness in the arms.
The exact cause of AS is unknown, but genetic factors are believed to play a significant role. The HLA-B27 gene is commonly found in individuals with AS, although not everyone carrying this gene will develop the condition. There is currently no cure for AS, but treatments can help manage symptoms and slow the disease's progression. Medications such as NSAIDs (anti-inflammatory drugs) and muscle relaxants can be used to reduce pain and stiffness. Maintaining physical activity and working with a physical therapist can also help improve quality of life by reducing pain and promoting good posture.
It is important to note that muscle spasms can also be associated with other conditions, such as hypoparathyroidism, which can present with similar symptoms to AS. Therefore, a thorough medical evaluation, including diagnostic imaging and laboratory tests, is crucial for an accurate diagnosis and appropriate treatment plan.
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Pain management
Ankylosing spondylitis (AS) is a type of arthritis that causes inflammation in certain parts of the spine. It can also affect the hips, neck, shoulders, ribs, and other areas. AS can cause significant pain and stiffness, and in some cases, muscle spasms and cramps. While there is no cure for AS, various treatments can help manage symptoms and slow the progression of the disease.
Medications
Medications play a crucial role in managing the pain associated with ankylosing spondylitis. Doctors often recommend non-steroidal anti-inflammatory drugs (NSAIDs) as a first-line treatment option. If NSAIDs are ineffective or insufficient, your doctor may prescribe corticosteroids, which can be administered through injections, eye drops, or pills. Corticosteroids help reduce swelling and inflammation and provide temporary relief. However, they are typically not prescribed frequently due to their potential to damage soft tissues and bones.
In cases of severe pain that does not respond to NSAIDs or other treatments, opioids may be considered. Additionally, muscle relaxants can be prescribed to alleviate painful muscle spasms, improve stiffness, and facilitate easier movement and exercise.
Biologic medications are another option for pain management in AS. These drugs target specific parts of the immune system to reduce inflammation. Examples include anti-TNF drugs and interleukin-17 (IL-17) blockers, such as secukinumab (Cosentyx) and ixekizumab (Taltz).
Exercise and Physical Therapy
Regular exercise is an essential component of pain management in ankylosing spondylitis. Working with a qualified physical therapist can help strengthen the muscles supporting the spine, improve flexibility, and reduce pain. Your physical therapist can design an exercise program tailored to your needs, which may include strength training, stretching, hydrotherapy, posture training, and deep-breathing exercises.
Lifestyle Modifications
Making lifestyle changes can also help manage pain and improve your overall quality of life. Maintaining a healthy weight is important, as extra pounds can put additional pressure on your spine and joints. While there is no specific diet recommended for AS, incorporating foods with anti-inflammatory properties, such as those high in omega-3 fatty acids (like salmon), may be beneficial.
Practicing good posture is crucial. While hunching over may provide temporary relief from back pain, it strains the spine and can lead to a hunched posture over time. It is important to maintain a straight back and keep your workstation set up to promote good posture. Taking frequent breaks and moving around, especially if you sit for long periods, can also help alleviate pain and stiffness.
Alternative Therapies
In addition to conventional treatments, some individuals explore alternative therapies to manage pain. For example, deep meditation has been reported to help cope with AS and reduce pain.
Support Groups
Connecting with local support groups and the arthritis community can be beneficial. These groups provide opportunities to exchange tips, share concerns, and encourage each other through the challenges of living with ankylosing spondylitis.
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Exercise and posture
Exercising muscles affected by AS, such as those in the back, shoulders, neck, buttocks, and hips, can help improve mobility. The Spondylitis Association of America (SAA) recommends four types of exercise: stretching, strengthening, range of motion, and deep breathing exercises.
Stretching exercises improve flexibility and reduce muscle stiffness, swelling, and pain. Examples include:
- Lying on your stomach with your legs behind you, slowly propping yourself up on your elbows so your chest is off the ground. If possible, straighten your arms and hold for 10 to 20 seconds. Repeat 3-5 times.
- Standing with your back against a wall, with your feet shoulder-width apart. Slowly slide your back down the wall until your thighs are parallel to the floor. Hold for 5 to 10 seconds, repeating 3-5 times.
Strengthening exercises improve muscle performance and support good posture. These exercises focus on the core muscles—the abdominal and back muscles that act like a "corset" to support the spine. An example of a strengthening exercise is:
Starting in a standing position with your feet flat on the floor and your forearms on a counter. Move to a harder version by kneeling on a mat with your forearms on the ground, pushing your legs out behind you, and balancing on your toes. Squeeze your stomach and buttocks muscles to hold your body in a straight line, keeping your neck in line with your spine. Hold for 5 seconds and repeat 3-5 times.
Range of motion exercises improves flexibility and reduces stiffness, swelling, and pain. They are often done as warm-up exercises before sports.
Deep breathing exercises can help prevent breathing problems associated with ankylosing spondylitis. Take 3 to 4 deep breaths several times a day, focusing on pulling air deep into your chest as you inhale and exhaling slowly.
It is recommended that you consult a doctor or physical therapist to design an exercise plan that suits your individual needs.
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Treatment options
While there is no cure for ankylosing spondylitis, there are many treatment options to help control symptoms and possibly slow the progression of the disease. Treatment options include:
Exercise
Regular physical activity can reduce stiffness and prevent ankylosing spondylitis from worsening. Exercise can help improve pain, which is often worse during periods of rest or inactivity. A physical therapist can suggest specific stretches and exercises to help strengthen the muscles that support the back and spine.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
Over-the-counter NSAIDs, including ibuprofen and naproxen, can ease pain and inflammation. NSAIDs are aspirin-like drugs that can decrease pain, fever, and inflammation. They have anti-inflammatory and pain-relieving properties when given in larger doses over the long term.
Biologic Disease-Modifying Anti-Rheumatic Drugs (DMARDs)
Biologic DMARDs are prescription medications that reduce inflammation and pain. They might also prevent ankylosing spondylitis from worsening.
Corticosteroids
Corticosteroids are prescription anti-inflammatory medications. Cortisone shots are injections of corticosteroids directly into the affected joints. Corticosteroid eye drops and dilating eye drops may help in the short-term treatment of inflammation of the eyes.
Muscle Relaxants and Opioid Analgesics
Muscle relaxants and opioid analgesics are used for brief periods to relieve severe pain and muscle spasms.
Surgery
If the hips become eroded or fixed in a bent position, surgery to replace the joint can relieve pain and restore function. Surgery can also be used to place rods in the spine or remove parts of the thickened and hardened bone.
Maintaining Correct Posture
Maintaining correct posture is important in preventing the stooped posture that can result from ankylosing spondylitis.
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Complications and related conditions
Ankylosing spondylitis (AS) is a type of arthritis that causes inflammation in certain parts of the spine and large joints, resulting in stiffness and pain. While muscle spasms and cramps are not directly mentioned as a symptom of AS, several patient accounts describe experiencing muscle spasms and cramping/twitching, particularly in the neck, hips, and upper back. Spasms in the spinal muscles can cause pain and limit motion.
AS patients are at a high risk of osteoporosis, which can result in compression fractures of the spine. Vertebrae fractures can put pressure on and injure the spinal cord and nerves. The inflammation associated with AS increases the risk of heart disease, and the disease can cause problems with the aorta, the largest artery in the body. The inflamed aorta can distort the shape of the aortic valve, impairing its function.
AS can also lead to eye inflammation, or uveitis, causing rapid-onset eye pain, blurred vision, and sensitivity to light. This is a common complication, affecting around 25% of patients. AS patients are also at a higher risk of inflammatory bowel disease (IBD), including ulcerative colitis and Crohn's disease. Irritable bowel syndrome (IBS) is found in about 30% of AS patients, with women being at a higher risk.
A rare complication of AS is cauda equina syndrome, which causes severe low back pain, as well as numbness in the low back, buttocks, groin, and legs. This requires urgent surgery and is considered a medical emergency.
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Frequently asked questions
Ankylosing spondylitis (AS) is a type of arthritis that causes inflammation in certain parts of the spine. It can cause bones in the spine to fuse together, resulting in immobility and a hunched posture.
Early symptoms of AS include back pain, stiffness in the lower back and hips, neck pain, and fatigue. Other symptoms may include eye inflammation, heart problems, and bowel issues such as irritable bowel syndrome (IBS).
Yes, muscle cramps and spasms are commonly reported by people with ankylosing spondylitis, particularly in the neck, hips, and upper back. The spasms can cause intense pain and affect mobility.
Treatment options for muscle cramps in AS patients include muscle relaxants, anti-inflammatory drugs (NSAIDs), and physical therapy to maintain spine mobility. Baclofen has been recommended by naturopaths as a non-habit forming option to ease muscle tension.
