Joint disorders | June 22, 2017 | Author: Naturopath
Ankylosing spondylitis (AS) is an autoimmune condition affecting mostly the spine. It is an inflammatory condition that causes stiffness usually in the joints of the lower spine and where it attaches to the pelvis, the sacroiliac joint, but it can also affect the hips, neck, shoulders, eyes, lungs and bowel. This condition affects men more than women and usually between the ages of 15 to 45. It is marked by stiffness, back pain and immobility.
Autoimmune diseases are often from unknown causes but they can have a genetic component, in this case the gene HLA-B27 is considered responsible. This can mean if someone else in your family has AS your chances of getting it are greater, but doesn’t mean you will get AS. The exact cause of AS and what triggers it to develop is unknown. Autoimmune diseases become active usually from a misguided or inappropriate response by the immune system in the body. In ankylosing spondylitis the immune system starts attacking the joints, causing inflammation and resulting in abnormal bone growth around the joint structure. This then causes pain and stiffness and in severe cases, can cause the bones to fuse together and become immovable.
Studies have found a correlation between Crohn’s disease (CD) and AS, sharing some common clinical, genetic (the HLA-B27 gene), and microbiological components, namely Klebsiella pneumoniae microorganisms. Based on many studies it is suggested this could be the trigger for AS and CD. Klebsiella thrive in a high starch environment, so by reducing the amount of starch in the diet could potentially remove this organism and reduce the symptoms of the disease.
Like most autoimmune diseases they can settle for a while and then suddenly flare-up. Environmental causes are suspected to be responsible for triggering the initial development and then maybe the following flare-ups. This can include stress and environmental toxins along with diet and bowel issues.
There is no easy diagnosis. It is usually based on persistent lower back stiffness, pain and tightness in the chest over a certain period of time.
X-ray and/or MRI of lower back for inflammation of the sacroiliac joint, blood test for inflammatory markers will indicate inflammation but not necessarily from SA,
Gene testing for HLA-B27 gene some of the common diagnostic criteria.
There is no cure for AS, treatment is aimed at reducing inflammation and pain and keeping flexibility.
Conventional treatment involves pain relieving and anti-inflammatory medications, including corticosteroids, disease-modifying anti-rheumatic drugs (DMARDs) and biological disease-modifying anti-rheumatic drugs (bDMARDs or biologics).
Exercise is considered one of the most important aspects of treatment for AS. Exercise keeps joints and muscles flexible, encourages circulation and can keep the spine mobile. Physiotherapist can suggest different types of exercise to strengthen the back, encourage movement in the spine and help to reduce pain.
Practice good posture
Don’t smoke smoking is obviously bad for your health anyway but if you have AS the effect on the lungs and breathing can be a real issue.
Starch is not easily digested or absorbed and can remain intact by the time it reaches the colon, where it can be broken down by the Klebsiella microorganism that thrives on this food. Reducing starch in the diet can basically starve this organism reducing its effects on the body. Most carbohydrate foods contain different forms of starch, some more than others and certain foods have been found to be tastier for the Klebsiella microorganism.
A little experimenting is needed here on how much to remove or restrict to make a difference.
AS Ankylosing Spondylitis is an inflammatory arthritic condition, natural therapies suggestions are aimed at reducing joint inflammation and supporting stress, general health and well-being.
Fish Oil is well known as an anti-inflammatory for arthritic conditions but a study on it for AS found in large doses (4.55grams 3 times daily in supplement form) was able to reduce the activity of the disease.
Turmeric (Curcuma longa) Many studies have suggested the curcumin (active ingredient) from turmeric may be helpful to reduce inflammation due to its ability to block pro-inflammatory pathways in most chronic diseases.
Turmeric in combination with and Boswellia serrata has been shown to be more efficient than a standard dose of a selective COX-2 inhibitor in the treatment of osteoarthritis.
A recent meta-analysis found enough evidence for the use of turmeric as a therapeutic option in arthritis.
Boswellia (Boswellia serrate). A Cochrane systematic review concluded that preparations from BS were helpful in reducing pain in osteoarthritis with minimal side effects. Citing two high-quality and two moderate-quality studies demonstrating superiority compared to placebo in reducing pain and increasing functionality of joints.
Ginger (zingiber officinale) may help in its anti-inflammatory action. Ginger is well indicated for arthritic conditions. The active ingredients gingerols, shagoals and paradols in ginger root have been credited with its many of the anti-inflammatory actions. Incorporate fresh or dried ginger regularly in the diet and choose a supplement form when pain relief is needed.
White willow (Salix alba) has anti-inflammatory, analgesic and anti-rheumatic properties and is suggested for any systemic connective tissue disorders marked by inflammation -arthritis/rheumatism and muscular problems. It has been approved by commission E as an anti-rheumatic agent.
Probiotics. Saccharomyces boulardii is a specific strain that may help in the elimination of Klebsiella pneumoniae microorganisms from the bowel and reduce digestive inflammatory mediators. Combine this with a low starch diet.
Heal and seal the gut with slippery elm or aloe vera juice.
B group vitamins for energy, digestion, stress and nervous system support
The herbs chamomile (matricaria recutita) and passionflower (passiflora incarnata) may be useful to help with stress and aid sleep.
Magnesium bath can help reduce tension in the body especially muscles and tendons. Have a relaxing bath before bed to help with sleep. Magnesium is available as a topical spray or roll on for muscular relief.
Gut-mediated and HLA-B27-associated arthritis: an emphasis on ankylosing spondylitis and Crohn's disease with a proposal for the use of new treatment. https://www.ncbi.nlm.nih.gov/pubmed/21955846
The link between ankylosing spondylitis, Crohn's disease, Klebsiella, and starch consumption https://www.ncbi.nlm.nih.gov/pubmed/23781254
Supplementation of omega-3 fatty acids in patients with ankylosing spondylitis https://www.ncbi.nlm.nih.gov/pubmed/17062435
[Role of omega-3 polyunsaturated fatty acids in diet of patients with rheumatic diseases] https://www.ncbi.nlm.nih.gov/pubmed/18651052
Curcumin: an orally bioavailable blocker of TNF and other pro-inflammatory biomarkers https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3753829/
Phytomedicine in Joint Disorders https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5295114/