Women's Day: What Women with Ankylosing Spondylitis Should Know

Ankylosing Spondylitis is a form of arthritis that attacks the spine. It's a chronic pain condition that can cause severe inflammation to the vertebrae to fuse, leading to mobility issues and other complications. While the disease affects both men and women, women experience different symptoms than men, which can complicate the diagnosis process. 

Dr. Pradip Kumar Sarma, Head of the Dept of Rheumatology and Clinical Immunology, Excel Care Hospital, said, “In females, the disease tends to be milder which lead to delay in diagnosis or even misdiagnosis.They usually report more nocturnal back pain which delays the right treatment of the disease. Usually patients consult doctors in their 2nd or 3rd decade, where as it is believed that this disease starts in the teens. Women suffer from pain more than male and seem to be insufficiently treated. Pain in the chest and upper back is three times more common in females than males. Additionally, widespread back & peripheral joint pains are more common among females.”

Here are some key facts about Ankylosing Spondylitis in women:

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• It takes longer for women to get the correct diagnosis
  Ankylosing Spondylitis is often wrongly diagnosed as chronic back pain caused by minor trauma, bad posture, or poor body mechanics. If you go to a general practitioner, 90 percent of women at some point or another go in complaining of lower back pain, therefore it's difficult to differentiate between the mechanical and inflammatory pain among women. 
• Women have less radiographic damage but more disability
  As per, The Spondylitis Association of America, women tend to have less joint damage that can be seen on an X-ray than men; however, they tend to experience more symptoms, such as increased fatigue, pain, and limitations in mobility¹. This may be linked to gender and how they react to inflammation in ankylosing spondylitis or how they respond to medications used to treat the condition. 
• Pregnancy and childbirth requires discussions with the doctor
  Ankylosing spondylitis is typically diagnosed in people younger than 40, with as many as 80% people developing their first symptoms before the age of 30², pregnancy and childbirth is an issue many women need to discuss with their doctors. In a study of women with axSpA published in June 2018 in the journal Rheumatology, researchers found that disease activity and pain were highest during the second trimester.³
• Ankylosing spondylitis can affect emotional health
  While symptoms such as pain and physiological limitations may affect both men and women, the condition may be more likely to trigger feelings of guilt in women. Women may feel guilty when they are not able to function at the level they expect from themselves, which in turn may lead to anxiety and depression and other forms of emotional impact. “Mind-set is very important if suffering from Ankylosing Spondylitis. Diagnosis of AS should not lead to panic; yes it is a chronic disease which need long term treatments; but many treatment options are available and a normal life is completely possible with this disease now a days. Having a positive outlook toward life goes a long a way in better treatment outcome.”, added Dr. Sarma.

Getting the right treatment and guidance

With all these above facts, it is very important to be aware of AS and its probable impact on your body. Frequent interaction with the Rheumatologist, sharing progress on the symptoms and following a medicine schedule even during the symptom-free period is the key to stopping the progression of the disease. 

There are advanced treatment options available such as biologics that help slow down the structural damage progression caused by AS, preventing bone fusion and in many cases preventing new bone formation. On this Women's' Day, let us appeal to all women to watch out for chronic back pain that lasts for more than three months and to consult a Rheumatologist on time. All AS patients should adhere to lifestyle modifications and treatments prescribed by the doctor. Remember, untreated or uncontrolled AS may create complications and should not be ignored.

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