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India’s young forces silently engulfed by Ankylosing Spondylitis (AS)

  • The prevalence of AS in India is currently around 1.65 million and is estimated to grow at an annual growth rate of 2.95% to reach 2.0 million in 2028. 2-3 lakhs of AS patients in Kolkata alone
  • Men are two to three times more likely to get ankylosing spondylitis than women.
  • Almost 90% of patients reported varying degrees of impact on work productivity.
  • About 69% of the patients had received an incorrect clinical impression before consulting a Rheumatologist

While everyone is cooped at home working long hours, a silent back pain can be more than just what it seems. If your back pain lasts for over 45 minutes every morning, it could be Ankylosing Spondylitis, also known as AS. The prevalence of AS in India is currently around 1.65 million and is estimated to grow at an annual growth rate of 2.95% to reach 2.0 million in 2028. Currently 2-3 lakh AS patients reside in Kolkata. The condition usually occurs in young adults in their 20s or 30s. The symptoms vary individually – in some cases the symptoms might be mild and ignored by the patients as “just back pain.” Over time, this results in fusion of the spine in abnormal positions leading to deteriorating quality of life.

AS is an irreversible, inflammatory and autoimmune disease that affects the joints of the spine, reducing its flexibility, damaging the posture and posing the risk of loss of mobility. Its symptoms are often observed in men who are at the peak of their educational and professional careers. Men are more likely (two to three times) to get ankylosing spondylitis. AS has a huge physical impact and psychological stress on patients which can disrupt every aspect of their life and its quality. Almost 90% of patients reported varying degrees of impact on work productivity. In fact, patients with long-term AS are at an increased risk of spinal fractures and osteoporosis which eventually leads to severe nerve damage.

Dr. Syamasis Bandyopadhyay, Rheumatologist, Apollo Gleneagles Hospital, Kolkata says “Basis our clinical observation, there are usually 250 cases of AS referred to us every month, with about 2-3 lakh people suffering from AS in Kolkata. With AS symptoms mimicking ‘just back pain,’ we usually see patients late in the course of the disease. Delayed diagnosis remains a significant problem with the time gap between symptom onset and diagnosis being 6-7 years. However once diagnosed, patients have access to several treatment offerings. The advent of biologics has also revolutionised AS patient care. Such treatments not only reduce inflammation and disease progression, but have also shown to spur greater adherence, which is key to successful management. Along with appropriate treatment protocol, patients should maintain a healthy dietary regimen and exercise regularly, which we are observing a positive uptick in amongst our own patients.”

People tend to initially approach an orthopedic or general physician for their back pain and tend to overlook AS symptoms, which often results in misdiagnosis. This is a key challenge wherein the concerned medical expert may not refer the individual to a specialist, which in this case is a rheumatologist who can determine AS diagnosis. About 69% of the patients had received an incorrect clinical impression before consulting a Rheumatologist. More than half of patients are observed to visit at least 2–3 specialists for their symptoms before consulting a Rheumatologist.

Though AS is an irreversible disease, it is manageable through the right treatment and lifestyle modifications.

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