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Ankylosing means fusing together, while spondylitis refers to inflammation of the vertebrae. Ankylosing spondylitis (AS) is a chronic, painful rheumatic disease which primarily involves the spine, but can affect other joints, tendons and ligaments, as well as the eyes, lungs, and heart. It is a form of arthritis. What happens to individuals with AS is that the tendons and ligaments which attach to the bone become inflamed, leading to some bone erosion. After the inflammation subsides, the bone heals and some new bone grows, restricting movement. With time, the bones of the spine can fuse together or the spine can become curved (see kyphosis, scoliosis, and kyphoscoliosis).

AS typically strikes between the mid teens and the early thirties. It is three times more common among males than females, and women's symptoms are milder and harder to diagnose. In men, AS tends to be centred in the spine and pelvis; in women, the pelvis, hips, wrists, and ankles; in children, hips, knees, and ankles. The symptoms of AS are slow and gradual onset of back pain and stiffness, early morning stiffness and pain, and particularly persistence of these symptoms for more than three months. So it's slow, steady, gradual, and chronic, not something that comes quickly or in short sporadic attacks.

AS is not life-threatening and can usually be managed effectively, though living with chronic pain is of course difficult. The main treatment for AS are non-steroidal anti-inflammatory drugs (NSAIDs) taken orally to reduce inflammation and relieve pain and stiffness. Regular exercise and being careful of body posture and position will help control the effects of the disease, while keeping the spine immobile, for example with a brace, is contraindicated.

The cause of AS is not yet known, but there does seem to be a genetic marker, a gene called HLA-B27, which almost all AS sufferers have. It can be passed on to offspring, but only about 15% of those who inherit the gene will actually develop AS. AS affects about 1% of the American population, and is more common among whites than blacks.

My brother developed AS about twenty years ago, in his mid-twenties. Because of his AS, his spine is now fused and he has had cataract surgery. He moves awkwardly, but he does move! He continues to garden, ride his bike, play ultimate frisbee, go kayaking in Belize, and do all the other things that he normally did, just more slowly and carefully. He has learned to manage his condition quite well, as do most people with this disease.

There are a number of good websites on AS which I drew on in my research. They include:

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