LifeSystems Chiropractic - Chiropractor in Singapore

Ankylosing spondylitis (AS) is a condition where the spine becomes inflamed and stiff, causing it to lose its normal shape. Sometimes it affects other joints in the body, such as the hips, knees and ankles. A clinical study of 150 patients in Singapore with ankylosing spondylitis (AS) and reviews recent developments locally with regards to the condition. The patients were predominantly males (ratio 7:1) and Chinese. The onset of disease is usually in the early twenties and it take about years before diagnosis was made. AS patients have abnormal cholesterol levels and lower bone mineral density compared to healthy individuals. This is a test to request if you are seeing your doctor for this condition is to ask for the blood tests such as HLA-B27 may be used as a genetic marker. Together with x-rays it is a reliable diagnosis to confirm if you have ankylosing spondylitis and looking for some form of relief..

Ankylosing spondylitis (AS) is a systemic rheumatic disease that involves chronic inflammation of the spine and the sacroiliac joints. It is more common in men than in women, with age predominance in the third decade of life. Chronic inflammation may lead to fusion of vertebral bodies and ankylosis of the spine, producing pain and decreased mobility. Inflammation also may affect other joints and organs, with possible involvement of the eyes, heart valves, lungs, and kidneys. AS may cause lower back pain that can spread and be felt in the buttocks and thighs, lower back stiffness. Other symptoms include tiredness, weight loss and a mild fever. The pain and stiffness are usually worse early in the morning and after resting, but improve with exercise as the day progresses. Because the spine loses its normal shape, people may find their back becomes bent forwards. This can make walking and moving around painful and difficult.

Most commonly our patients come in with symptoms that begin as decreased flexibility in the spine and stiffness associated with pain in the sacroiliac joints or joints on both side of the lower back. Your medical doctor usually prescribe NSAID's or pain killers to give relief and if that does not work they will give you antirheumatic medications including steroids, methotrexate, and sulfasalazine. As a chiropractor, the best form of AS relief you can do on your own is for you to include some form of exercise that include movement such as Tai Chi, Pilates, Yogo, Swimming and in my opinion anything to get your body moving to give you improved functional quality of life. In older patients with ankylosing spondylitis, fractures are common, and surgical treatment of thoracic or cervical injuries may be necessary. Fractures in older patients with ankylosing spondylitis must be considered highly unstable and should be treated with caution.

Questions and Answers on Chiropractic and Ankylosing spondylitis (AS)

Question 1:

Hi, Dr Lim, i'm turning 35 this year and I've just been diagnosed with suspected Ankylosing Spondylitis, by doctors at Singapore General Hospital, SGH and Changi General Hospital, CGH.
A very recent X ray taken show that 2 of my lower back spine has bone growth over the cartilage. This causes my back to be very stiff and I cant' bend forward. Just wondering, can Chiropractic eliminate the stiffness?
I may need to obtain all the reports from SGH.
Currently I'm on Declofenac prescribed by my rheumatalogist.
I was told that the blood test was negative but all other symptoms, xrays and MRIs shows AS. So, indeed, chiropratic can help reduce my stiffness?

Answer: Have u had any recent infection especial viral or allergic to any foods? Also not all AS patients have pain. Do you experience any pain?
The results depend on how serious your condition. Some of our patients have to use drugs by rheumatalogist to help and slow down the disease progression.  Often increase in dosages or change in medication is necessary later on.
Diagnostic testing demonstrates an elevated erythrocyte sedimentation rate during active phases of the Ankylosing Spondylitis disease, a negative antinuclear antibody, and rheumatoid factor. HLA-B27 haplotype is present in 60%-90% of Ankylosing spondylitis (AS) patients compared to only 4%-8% of normal controls.*
Standard chiropractic spine mobilization can help some to help relief the stiffness but does not fix the problem. No one is addressing the root cause here which in my opinion is an inflammatory process trigger by an event or a process. The above labs mentioned including hs-CRP, ESR are helpful.

We help our patients who have AS via spine mobilization and design a nutritional protocol to slow down the inflammatory process. In addition, we recommend our patients to follow an aggressive strengthening program to maintain posture (prevent kyphosis) and build muscle strength in areas of affected joints.

One of patients say swimming really helps him and when they don't move it's can feel quite bad. Hope this helps you and I wish I have a happier answer for you.

References:

* Wright D. Juvenile rheumatoid arthritis. In: Morrissy RT, Weinstein SL, eds. Lovell and Winter's Pediatric Orthopaedics. 5th ed. Philadelphia, Pa: Lippincott-Raven; 2003:427-435.

Question 2:

Can MRI and CT scan be used as an alternative form of diagnosis apart from xray? If yes, what are the differences?

Answer:
X-rays are usually sufficient together with labs a mentioned to diagnose Ankylosing Spondylitis, AS.
Chronic inflammation may lead to fusion of vertebral bodies and ankylosis of the spine, producing pain and decreased mobility. Inflammation also may affect other joints and organs, with possible involvement of the eyes, heart valves, lungs, and kidneys. MRI and CT may be used for further investigation.
I know sometimes not all the puzzle seems to fit your condition. I had one patient who does not have stiffness but have x-rays to show they have AS, but his main complaint is feeling hot or heat all over his body. The disease does not follow the text book.