Ankylosing Spondylitis: Growing Bone Equals Growing Pain

Most forms of inflammatory arthritis lead to a loss of bone. With ankylosing spondylitis, it's the opposite.

Everyday Health—February 4, 2014

Three years ago, it would have been almost impossible for Boris Nunez to get down and play with his son Adonis. He was in too much pain.

“I couldn’t sleep, sometimes I cried,” he says. “I was frustrated, I didn’t know what was wrong.”

A former Marine, Nunez was not a man who cried easily.

But the pain, which started in his back and hips, moved into his shoulders, knees, toes, and hands and became so bad he could barely lift his infant son. He had to quit his job as a dealer at a nearby casino.

“I became handicapped,” he said. “I realized I really needed help.”

 It was not until he landed at New York’s Hospital for Special Surgery in the care of Susan Goodman, MD, that Nunez was able to declare victory over his pain.

Dr. Goodman, a rheumatologist specializing in inflammatory forms of arthritis, very quickly diagnosed Nunez with ankylosing spondylitis, or AS, which she says differs profoundly from other forms of inflammatory arthritis: “What happens with this disease is that though it starts with inflammation at the edges of the vertebrae, as you treat the inflammation… you get this proliferating bone growth and that’s totally different from other forms of inflammatory arthritis, in which the inflammation causes erosion and loss of bone.”

She says the new bone growth leads to “a profoundly stiffening condition” of the spine.

Less than two months after his diagnosis, Nunez’s pain was under control, and he regained considerable flexibility. Dr. Goodman measures the flexion in his lower spine with a measuring tape as he bends over to touch his toes – now that he can.

She gauges the condition of his upper spine while he stands with his heels against the wall; the disease stiffened his spine enough before he came under her care that he is unable to touch the back of his head to the wall.

Though that damage cannot be undone, she hopes his current medication and improved mobility will stop the disease from progressing.

Goodman suspects Nunez had ankylosing spondylitis for many years, as it is hard to distinguish the symptoms from other forms of back pain, especially for a tough military man who was used to pain from physical duress and living in uncomfortable conditions. “It’s typical in that he constantly attributed his symptoms to something else.”

Regular exercise is key now. Nunez does yoga stretches in the few quiet moments he can find between toy car races with lively Adonis, balancing that with calisthenics for strength. And he can enjoy climbing with his son in the playground and even picking him up.

Nunez credits the military with making him a “fighter,” which helped him to combat his illness. That assessment is shared by Dr. Goodman whose own son is a marine as well.

“I think you’ve done well because — in a good way — you’re an extremely stubborn guy and you’re an extremely hard worker,” she tells him. “It’s a very good thing.”

Read the full story at everydayhealth.com

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