Ankylosing spondylitis is a chronic inflammatory arthritis that primarily affects the spine and the sacroiliac joints. It is also known by the name Marie- Strumpell disease or Bechterew’s disease and commonly affects males in their 20s-30s.

Ankylosis means fused bone and spondylitis means inflammation. The disease progresses gradually and causes pain and stiffness in the regions affected.

Ankylosing spondylitis is an autoimmune disorder. The exact cause of the origin of the disease is unknown, but persons with this disease have a strong relation with histocompatibility antigen HLA-B27.

Signs and Symptoms.

Ankylosing spondylitis usually affects men more than women (male: female ratio – 3:1). The signs and symptoms of the disease are:

1. Low back extending to buttocks and posterior The pain is sudden onset, increased by inactivity, and relieved by movement.
2. Early morning stiffness.
3. Pain on the peripheral joints affected such as sacroiliac joints, shoulder joints, etc.
4. The low back ache ascends slowly and affects the whole spine.
5. Pleuritic chest pain is experienced when the thoracic skeleton and intercostal muscle insertions are affected.
6. Pain at the insertion of tendons and ligaments into the bones usually manifests at the heels, sacroiliac joint (iliac crests, ischial tuberosities), etc.
7. Anterior uveitis, inflammation of the GI tract, fibrosis of the upper lobe of the lungs.
8. Fever, severe fatigue, and weight loss.
9. As the disease advances the spine and chest become rigid.
10. In the last stages, the spinal fracture can occur even from a minor injury that leads to spinal cord trauma.

Investigations

In Ankylosing spondylitis, the Erythrocyte Sedimentation Rate and C-Reactive Protein values are raised in inflammatory conditions. Variation in the value of the HLA-B27 gene increases the risk of the disease. HLA-B27 gene test will be positive in persons having Ankylosing Spondylitis.

X-ray and MRI investigations show changes in the bone and structures related to it. Ankylosing Spondylitis can also be diagnosed by Modified New york Criteria(1984).

1. History of inflammatory back back pain.
2. Limitation of motion of the lumbar spine in sagittal and frontal planes.
3. Limited chest expansion, relative to standard values for age and sex.
4. Definite radiographic sacroiliitis.

Ankylosing Spondylitis in Ayurveda.

In Ayurveda, Ankylosing Spondylitis can be included under the group of diseases named Amavata. The dosha vitiated along with ama (toxins formed by improper digestion in the body) get lodged in the sacroiliac joints and lumbar spine and give rise to the disease.

The symptoms like:

1. Stiffness (stabthada).
2. Pain associated with inflammation (saruja sopham).
3. Fatigue (dourbhalya).
4. Inflammatory problems of the GI Tract (vidvibhantham).
5. Cardiac problems (hridgraha).

The above symptoms of Amavata can be correlated to the disease Ankylosing Spondylitis.

The disease Dandaka explained by Acharya Charaka can also be correlated to Ankylosing Spondylitis. This vitiated Vata dosha causes stiffness of the joints like the head, neck, spine, and pelvis making them immovable.

Management of Ankylosing Spondylitis in Ayurveda.

In Ayurveda, the management of Ankylosing Spondylitis aims at the removal of accumulated toxins and correction of the vitiated Dosha. The removal of accumulated toxins can be corrected by certain Ayurveda therapies like:

1. Herbal oil massage (Abhyanga).
2. Different fomentation (swedana) procedures like podi kizhi, ela kizhi, and manal kizhi.
3. Dhanyamla dhara.
4. Lepanam and poultice (upanaham) with rasnadi, kottamchukkadi, and grihadhoomadi choornam.
5. Medicated Purgative therapy (virechana) using certain medicated supplements.
6. Medicated enemas (vasthi) which includes vaitharana vasti, ksheera vasti, yapana vasti, etc according to the condition of the patient.

Internal ayurvedic medicinal supplements must be administered along with the therapeutic procedures as a pain management treatment.

Dietic inclusions and exclusions

Diet included	Diet excluded
· Barley, red rice, horse gram.	· Curds, jaggery, milk.
· Drum stick, bitter gourd, pointed gourd.	· Fish.
· Ginger and garlic in buttermilk.	· Black gram flour.
	· Mutually incompatible foods.
	· Food that is heavy to digest.

 Lifestyle Modifications.

• Take light food and avoid excess oily foods.
• Ensure proper evacuation of bowels.
• Practice pranayamas such as nadi shodana, bhramari.
• Practice yogic exercises like paschimottasana, bhujangasana, pavanamuktasana.
• Avoid sleeping during day time.
• Apply heat on the areas where pain and stiffness are felt.
• Avoid the use of heavy pillows.
• Maintain normal sleeping postures.

Conclusion

At Ayurclinic, we are providing a very effective treatment methodology based on the classical texts of Ayurveda. Our treatment is usually long-term and requires regular follow- ups. The treatment process involves a series of purification procedures or Detoxification through Panchakarma therapies. Panchakarma treatments by Virechana, Vasti and Kativasti, Kizhi, and Dhara are almost mandatory for treatment of Ankylosing Spondylitis and can be provided based on the severity of the disease along with the administration of Ayurveda medicines, Lifestyle correction, and diet recommendations.

Strict diet restrictions along with life style modification are essential parts of our Ayurveda therapy. Following proper diet as per advised by our ayurvedic doctors not only helps in recovering fast but also in prevents further worsening of the condition. Yoga therapies are also recommended to maintain the tone of the muscles.

If you wish to discuss about any specific problem, you can consult our specialists @ +61 3 9078 2940 or Book a Free Consultation with us.