Q: I am 27 years old and was diagnosed with ankylosing spondylitis about 5 years ago. It started off as pain in my hip area, both sides but usually one at a time. It then moved to my upper back and for the past couple of months has really affected my chest. It is so painful at times that I just do not breathe, hold my breath for as long as I can and breathe only when I have to. It has been particularly intense for the past two weeks and my nights are particularly bad. If I get up for any reason then I just cannot go back to sleep as the pain is unbearable. I used to take painkillers, first Nimesulide and now Torrox, but I am just tired of being at the mercy of painkillers and so have been avoiding them. I am watching my weight and am physically active and exercise everyday. What is it that I am doing wrong and what is it that triggers this pain, as I go without pain for weeks and then suddenly wake up one day with this unbearable pain? What are the safest painkillers to take without ruining some other organ of my body in the process? Please help.

A:As you have already mentioned that you have ankylosing spondylitis, your symptoms are also typical of that disease. It is disease that comes through a gene called HLA B27 that is situated on chromosome number 6. Persons with this gene have a high chance of developing this serious rheumatic disease. In short it has nothing to with what you do or do not do, it is simply God-given and it is part of your body. But, the good news is that there are some exciting new developments in the drug treatment of this disease that is NOT well known to most of the doctors. For this you will have to contact a rheumatologist with experience of treating this disease with some of the most effective recent medicines.