Being able to reach out to your doc whenever you need? Priceless.
“What’s recommended for patients with ankylosing spondylitis is that they maintain a good relationship with their doctor, particularly their rheumatologist,” says Themistocles Protopsaltis, MD, spine surgeon at NYU Langone Hospital.
Like other autoimmune conditions, ankylosing spondylitis (AS) occurs in a cycle of remission and relapses (often called a “flare”). Finding the right AS treatment to maintain remission can take a lot of guess-and-check work, and you and your doctor, or doctors, will need to have a lot of back and forth to get it right.
For example, you could be trying a medication for AS but not seeing results, meaning you’re unable to stay in remission. By not telling a doctor, you might continue to relapse and cause AS symptoms—and the disease may worsen or cause more damage to your body.
“Once the pain becomes more intense, then you’d want to visit the doctor more frequently so that they can modify and make sure that we’re keeping the disease at bay,” says Dr. Protopsaltis. “It might involve changing the medicines a little bit.”
Your rheumatologist isn’t the only doctor to have a good relationship with. When AS progresses, you might have fusion of the vertebrae, leading to a stiff and immobile spine. At this point, it might be time to develop a relationship with a spine surgeon.
A spine surgeon for AS can help advise if surgery is right for you, and if so, when it’s needed. Your spine surgeon can “make sure that the spinal alignment is being maintained throughout,” says Dr. Protopsaltis. These are done with annual or biannual X-ray checks.
The key is to keep your doctors in the loop. This can help address flares immediately, help you find the right treatment, and help prevent your condition from progressing or causing complications.
Dr. Protopsaltis is a surgeon specializing in orthopedic and spine surgeries at NYU Langone Health.
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It's really important to maintain a good
relationship with your rheumatologist.
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They can serve as a gatekeeper, letting
you know when medicines aren't working and
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when surgery might be necessary.
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And they can modify the regimen to make
sure that your function is optimized and
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your symptoms are at bay.
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What's recommended for patients with
ankylosing spondylitis, regular visits on
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a yearly basis if there's not a lot
of symptoms would be advisable.
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Once the pain becomes more intense
then you'd wanna visit the doctor
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It might involve changing
the medicines a little bit, or
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trying a different anti-inflammatory
medication, or disease modifying agent.
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Patients who take anti-inflammatories for
ankylosing spondylitis should always do
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this in conjunction with
a discussion with their doctor.
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So the doctor knows how long
that medication has been taken.
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If there are still symptoms
like joint pain and
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stiffness, then the doctor
might decide to add
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another disease modifying agent like
the rheumatologic line of medications.
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Patients with ankylosing
spondylitis should also have a good
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relationship with the spine surgeon.
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Because as their symptoms in the back and
the spine become more prominent,
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they may wanna check in
with the spine surgeon and
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make sure that the spinal alignment
is being maintained throughout.
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Unfortunately, patients with ankylosing
spondylitis can have a varying amount
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of pain, ranging from minor pain and
stiffness to quite severe pain.
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If it starts to interfere with your daily
activities, your ability to exercise and
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be healthy, your ability to get to and
from your job and function at your work,
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those are all signs that you should
probably check in with your doctor and
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see if there's something
else that can be done.
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Ankylosing spondylitis treatment. Atlanta, GA: Arthritis Foundation. (Accessed on June 6, 2019 at https://www.arthritis.org/about-arthritis/types/ankylosing-spondylitis/treatment.php.)Overview of ankylosing spondylitis. Van Nuys, CA: Spondylitis Association of America. (Accessed on June 6, 2019 at https://www.spondylitis.org/Ankylosing-Spondylitis.)