Clinical Features of Ankylosing Spondylitis

Abstract

SUMMARY Since there is no cure for ankylosing spondylitis, the primary objectives of treatment are to relieve pain, prevent spinal deformity, and maintain functional capacities of the patient. The following regimen is available: Rest periods, Dependent upon the severity of the disease process. Postural instruction promoting the maintenance of a straight spine in bed, at home and at work. Physical therapy modalities such as braces and exercise programs to be utilized and re-evaluated at frequent intervals. Drug therapy: salicylates are the most simple, safest cheapest of the anti-inflammatory drugs with analgesic effect as well. Phenoxyphen (Darvon) is frequently used as and adjunct o salicylate therapy. Phenylbutazone (Butazolidin) has been the most successful drug used in recent years in the treatment of ankylosing spondylitis and response to small doses of this drug has been most impressive. The average dose is 100–200 mg per day and it may be required only intermittently. Indomethacin in various doses ranging from 100–200 mg a day has been advocated but there seems to be less uniform benefit from this drug than with phenylbutazone. Corticosteroids may be helpful, particularly. In control of peripheral joint involvement when it given intra-articularly. Systemic corticosteroid therapy, however, is limited to cases where iritis is a controlling factor since the spondylitis itself has a poor response to this drug. Severe types of disease and those resistant to this form of therapy have on occasion responded to selective localized irradiation, but this modality has been used less frequently than in previous years. Surgery: At present, surgical rehabilitation has been confined to a few subjects severely deformed by the ravages of this disease and this topic has been discussed recently by Law.3