Joining or stiffening of the vertebrae is termed as ankylosing spondylitis in short. It results in inflammation of vertebral bones of spine. Degeneration of spine, pain, loss of motility are some of the problems that crop up in a person suffering from AS. Though in majority of patients, we see degenerative changes in the spine, there are also many cases where AS has affected the hip joints.

Causative factors of AS-

(1) Idiopathic- that means the exact cause still remains unknown.
(2) Autoimmune- Various studies and evidences point to the fact that ankylosing spondylitis is an autoimmune disease.
(3) Hereditary- Though definite evidence is lacking, many studies suggest that positive family history makes the person more vulnerable to develop AS.

Signs and Symptoms of Ankylosing Spondylitis-

(1) Usually the onset of development of pain and motility affections is insidious.
(2) Gradually pain and stiffness in back, buttock region, hips, etc develops
(3) Undue fatigue is many times presenting symptom in these patients.
(4) Usually the patient complains of morning stiffness that gets better ad the day advances or once he begins moving around
(5) Weight loss has been observed
(6) Anorexia, malaise, etc can develop with more and more stiffening
(7) One can elicit tenderness over the sacro-iliac joint
(8) Restricted movements over the period of time
(9) Patient walks with bent back
(10) Chest expansion limited
(11) Rigidity of spine and joints results in curved spine gradually if left unattended
(12) Rarely in very advanced cases, aortic incompetence due to valvular calcification and recurrent respiratory (chest) infections are noticed
(13) On X-ray spine, one can see narrowing of joint space, haziness of joint margins, and eroded and sclerosed margins.
(14) In unattended cases, one can see ossification of intervetebral discs, squaring of vertebrae, bridging of joint cavity, and new bone formation.

Homeopathic Management of Ankylosing Spondylitis-

As we have seen earlier, homeopathy is an individualistic and holistic science. It acts wonderfully in patients of AS, especially when they are considered as unique individuals with characteristic signs and symptoms. Treating ankylosing spondylitis just on the basis of common signs and symptoms of the disease homeopathically is a disaster. In this treatment module, you might get some initial relief of symptoms but as no long term goal is set, the symptoms will most probably relapse, perhaps with much more intensity.

That’s why it is must to consider the totality of symptoms in every individual and treat accordingly. No wonder many stalwart homeopaths discourage the use of patent homeopathic remedies for treating ankylosing spondylitis. The patents usually contain group of remedies thought to be useful for AS. However, this certainly does not go along the lines of homeopathic principle. And unless homeopathic treatment is given along the lines of its principle, it will not give desired results. Therefore, complete history of the patient should be taken including the important causative factors behind his problem, his mental sphere of looking at the disease and otherwise, and then the treatment should be started depending upon the totality.

Obviously, for acute pain management, a homeopath might need a few remedies to look into, during the course of constitutional therapy. Here is a list of important remedies one should remember while treating AS-

1. Calcarea phos-
- Rheumatic pains in neck and lumbar region
- Dullness of head brought on by slight drought of air
- Right to left pain in neck, crampy variety
- Least effort brings on backache
- Upper back pain associated with sharp pains in sacrum and coccyx
- Soreness in uterine region
- Thin spare subjects with tall frame
- Shining bright eyes
- Anemic
- Worse by cold, wet winds, mental exertion, loss of fluids
- Better by lying down

2. Silica-
- Stiffness of nape of neck with occipital headache
- Indurated feeling and actual swelling in axillae, groine, back, below chin, etc (lympthatic swelling)
- Stitching pains between hips
- Coccyx painful as after a carriage ride
- Painful to pressure
- Weak, paralytic pain in back, lumbar region
- Curvature of vertebrae
- Nervous, irritable patients with pale face, lax muscles
- Tendency to catch cold that stiffens the back too but warmth causes burning in back
- Lots of sweating
- Deficient nutrition
- Worse by draft of cold air, change of moon, night, mental exertion, checked foot sweat
- Better by warm wraps, profuse urination

3. Rhus tox-
- Stitching tearing pain in back and lumbar region
- Always sore lumbar region, slightly better after walking
- Paretic muscular states
- Spinal ligaments are affected and fibrous joints
- Restlessness associated with pain; cannot sit in one position for long
- Sensation of dislocation in spine
- Crawling sensation in back between shoulder blades
- Pain in back causes numbness and pricking pains in limbs
- Pain in lumbar region and coccyx almost always associated with pain in thighs
- Legs feel as if made of wood
- Dreams of huge labor, work; wakes up fatigued
- Worse by rest washing of parts, uncovering, after midnight
- Better by continued motion, wrapping up the part, rubbing

4. Kali carb-
- Early morning aggravation of pain in back or lumbar region (typical 3am aggravation)
- Whatever happens in body, first thing to get affected is back; usually develops some kind of dull pain
- Stabbing pains in lumbar region
- Back and legs give way, paretic states
- Heavy feeling in back and legs
- Edematous swelling of foot (especially left) with lumbar affections
- Fixed ideas, absolutely conscientious and trustworthy person
- Wakes every day same time in early morning around 3am
- Worse by cold, loss of fluids, exertion, winters
- Better by warmth, sitting with elbows on the knees, open air

5. Symphytum-
- Etiological factor may lie in some kid of fall or fractured bone, etc
- Pain in back ‘since that last fall’; also from sexual excesses
- Psoas abscess
- Actual caries of spinal bones
- Pricking pains in lumbar region and coccyx
- Pain of nervous origin
- Worse from any type of injuries

6. Hypericum-
- Nerve injury or pain leads to spinal pain and then gradually the bones are involved
- Extremely painful, sore parts
- Painfully sensitive spine
- History of injury or surgery (spinal anesthesia) may be there
- Changes in spine noticeable after delivery of child
- Cannot sit for long, legs feel lame
- Furry feeling in feet with lumbago
- Aching in bones
- Limbs feel detached
- Worse by jar, exertion, motion
- Better by bending back