Q: I am a 25 years old male suffering from back pain for the last six years. I was treated with physiotherapy 5 times and took Alamin forte capsule for some years. I underwent MRI scan and found that I was suffering from hip arthritis. Now, I have pain in the groin. I am unable to lie down and sleep. I was tested positive for HLA B-27. Now, I am taking these medicines - Saaz DS thrice a day, Folic acid once at night, Oncotrex 5 (only on Sundays 1-0-2) and Idrofos 150 once per month. Please suggest.

A:You seems to have developed a autoimmune disease which affects mainly the axial skeleton including the entire vertebral column starting from Sacroiliac joints, a joint where vertebral column get attached to the pelvic bones. This disease is called Ankylosing spondylitis and it has tendency to cause the severe inflammation in the joints of vertebral column and also the hips and shoulders and later joints of limbs can also be affected. But before confirming this diagnosis, other causes like joint infections and other diseases needs exclusion. Final diagnosis is to be made by a trained Rheumatologist and that too based on the facts and evidences as it has long term personal and socioeconomic implications.

There have been innumerable occasions when people were initially diagnosed with ankylosing spondylitis turned out to be a case of Tuberculosis or other chronic infection and vice versa is also true. Once the diagnosis is confirmed then you should know few facts about the disease: It tends to fuse the backbone into inflexible bamboo like structure over years. This stage reaches fast if you do not move your spine and do not exercise regularly.

So take anti inflammatory drugs to reduce pain and inflammation and must exercise, move your joints forwards, backwards, sideways, turn sideways within your limits of movements. Swimming is the best exercise to ward off the deformities. In your case the medicines which you are taking, perhaps are not working. Meet a rheumatologist, perhaps he will suggest you the biologics, a new class of immunomodulating agents which everybody can not afford. As far as your question, it is curable or not, yes, if it is Ankylosing spondylitis, it is incurable, but do not despair, so many other illnesses are also not curable, but rest assured that inflammation can be adequately controlled and mobility of spine can be maintained for a long period of time and that you can live with it comfortably with appropriate guidance and management and also with a small dose of high morale and positivity. Final word is that you must exercise even if you have pain, best done in the morning after taking pain killer and a soothing hot bath and be under supervision of a rheumatologist.