Ankylosing spondylitis

Ankylosing spondylitis is a rheumatic condition characterised by inflammation in the joints, particularly of the pelvis and the spine, causing the vertebrae to become increasingly stiff and eventually fuse together.

The exact cause of ankylosing spondylitis is unknown, but heredity certainly plays a part. The condition usually manifests itself around the age of 25 and almost always before the age of 45.

It affects 0.1 per cent of the population. It is important that the diagnosis is made as early as possible. In particular, keeping active is very important to prevent joints from becoming fixed in an incorrect position. It appears that women usually experience a less severe course of symptoms, which means that the condition is often diagnosed more quickly and at an earlier stage in men, and the diagnosis is therefore frequently missed in women.

• 60 per cent experience pain and stiffness in the lower back and pelvis, particularly in the early morning;
• 40 per cent suffer from heel pain.

Morning stiffness and back pain disappear after movement or when taking a warm bath.

In 60 per cent of cases, symptoms begin with stiffness in the lower back or pain in the heels. The joints in the back become stiffer, leading to further symptoms and potentially causing the vertebrae to become completely locked in place. At a later stage, inflammation may even develop in the shoulder region and the hips. This makes movement more difficult and painful. Staying active is therefore essential to ensure that the joints are less likely to fuse together.

As back pain and heel pain are generally very common amongst the Dutch population, a diagnosis of ankylosing spondylitis is often missed at an early stage. It usually takes 10 years for the diagnosis to be made.

Ankylosing spondylitis is currently treated with anti-inflammatory drugs and exercise therapy. In addition, effective medicines have recently become available that can also effectively alleviate the symptoms, and research is underway into other medicines.

Once a joint has become fixed, there is little that can be done; you can imagine that if a joint fuses in the wrong position, this causes many problems and can even be disabling. Optimising alignment and posture through a good, sturdy shoe combined with a bespoke podiatric insole helps to distribute the load as effectively as possible, thereby enabling you to move as pain-free as possible.

• Make sure you wear sturdy (walking) shoes (see shoe advice for further details);
• Keep active, but make sure you do so in a healthy way;
• Have your foot posture checked and optimised by a podiatrist.