Ankylosing Spondylitis vs Rheumatoid Arthritis: Symptoms, Causes, Effects and Severity

Joint pain is an all-too-common ailment, often presenting as discomfort, aches, and soreness in any of the body’s joints, including the knees, hips, elbows, or shoulders. This type of pain is a frequent complaint among the older population but can affect individuals of all ages. The impact of joint pain on a person’s lifestyle can be significant, leading to decreased mobility, increased dependence, and a reduced quality of life.

While joint pain is often dismissed as a natural part of aging, it’s essential to understand that it may signal a deeper, more serious health issue. A study highlighted that joint pain is often misdiagnosed, leading to improper treatment and potentially worsening the patient’s condition. Accurate diagnosis, therefore, plays a critical role in managing and treating joint pain effectively.

Arthritis, characterized by inflammation of one or more joints, is one of the most common causes of joint pain. Among the many types of arthritis, two forms—ankylosing – Ankylosing Spondylitis (AS) and Rheumatoid Arthritis (RA)—are particularly notable for their severe joint pain symptoms.

Ankylosing Spondylitis and Rheumatoid Arthritis: A Closer Look

Ankylosing Spondylitis and Rheumatoid Arthritis are two types of chronic inflammatory diseases that primarily affect the joints, causing pain and discomfort. Although they share some common symptoms, AS and RA have different causes and can present unique challenges for those affected by them.

Ankylosing Spondylitis (AS)

Ankylosing Spondylitis is a type of arthritis that mainly affects the spine, although it can also affect other joints. It is characterized by inflammation in the vertebrae, which can cause severe, chronic pain and discomfort. Over time, this inflammation can lead to the fusion of the spine, leading to a hunched-forward posture if left untreated.

The exact cause of AS is unknown, but it is believed to involve a combination of genetic and environmental factors. The HLA-B27 gene is often found in individuals with AS, suggesting a genetic predisposition.

Rheumatoid Arthritis (RA)

Rheumatoid Arthritis is a systemic disease that affects multiple joints in the body, causing inflammation in the lining of the joints (synovium). This inflammation can damage the joint and surrounding tissues, causing pain, swelling, and loss of function.

Although the exact cause of RA is unknown, it is known to be an autoimmune disorder in which the body’s immune system unintentionally targets its own tissues. Certain genetic and environmental factors, such as smoking and obesity, may increase the risk of developing RA.

So, while both AS and RA are chronic conditions that can significantly impact a person’s quality of life, understanding their differences is crucial for accurate diagnosis and effective treatment.

Differences Between Ankylosing Spondylitis and Rheumatoid Arthritis

It is worth noting that AS and RA are both types of arthritis, a broad term that covers around 200 conditions involving inflammation of the joints. However, AS is not a form of RA. They are distinct diseases with different causes, symptoms, affected areas, and treatment approaches.

Primary Areas Affected

AS primarily affects the spine and can cause the vertebrae to fuse together. This can lead to a rigid, inflexible spine and, in severe cases, create a forward-stooped posture. Conversely, RA usually affects several joints at once in a symmetrical pattern. This means if one hand or knee has RA, the other does too.

Symptoms

AS and RA share some symptoms, such as pain and stiffness, but there are differences. AS often causes pain in the lower back, buttocks, and hips, especially after periods of inactivity or in the morning. On the other hand, RA frequently results in tiredness, joint stiffness that is typically worse in the mornings and after inactivity, and tender, warm, swollen joints.

Progression

AS tends to begin in early adulthood and progress slowly. Over time, it can lead to a complete fusion of the spine, causing a loss of mobility. RA, however, can start at any age and often progress rapidly, causing joint damage and deformity within 1 to 2 years if not treated.

Severity and Potential Harm

Both conditions can significantly impact a person’s quality of life, but RA is often considered more severe due to its systemic nature. In addition to affecting joints, RA can cause major complications by affecting the skin, eyes, lungs, heart, and blood vessels, among other body systems. 

While AS is generally less severe, it can lead to debilitating conditions such as chronic pain, extreme fatigue, and decreased lung capacity if the disease progresses to the chest area.

Does Rheumatoid Arthritis cause Ankylosis and Deformity?

Yes, both ankylosis and deformity can develop in patients with rheumatoid arthritis (RA). This occurs due to the chronic inflammatory nature of the disease.

Ankylosis refers to the stiffness or fixation of a joint. In RA, the ongoing inflammation leads to erosion of the joint’s cartilage and bone, which results in joint space narrowing and malalignment. As the disease progresses, the body tries to repair the damaged joint by producing excess fibrous tissue or bone, leading to either fibrous or bony ankylosis.

Deformities in RA develop due to several factors. Persistent inflammation can weaken the joint capsule and surrounding structures, causing the joint to lose its shape and alignment. Additionally, tendon inflammation and damage can lead to deformities such as swan neck or boutonniere deformity in the fingers.

Treatment Approaches for AS and RA

Though Ankylosing Spondylitis and Rheumatoid Arthritis have different causes and symptoms, the treatment approaches for both conditions share some similarities. Both focus on managing symptoms, reducing inflammation, and improving quality of life. However, the specific treatments may vary based on the condition.

Ankylosing Spondylitis Treatment

Combinations of medication, physical therapy, and occasionally surgery are used to treat AS.

• Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) are usually the first line of treatment. If NSAIDs are not effective, the doctor might recommend TNF blockers or interleukin 17 inhibitors, which can reduce inflammation and slow the disease’s progression.
• Physical Therapy: Regular exercise can help keep the spine flexible and improve posture. A physical therapist can provide tailored exercises.
• Surgery: In severe cases, joint replacement surgery or surgery to straighten the spine may be necessary.

Rheumatoid Arthritis Treatment

RA treatment primarily involves medications, physical therapy, and sometimes surgery.

• Medications: These can include NSAIDs, steroids, disease-modifying antirheumatic drugs (DMARDs), and biologic agents. The choice depends on the severity of symptoms and the response to initial treatments.
• Physical Therapy: A physical therapist can provide exercises to keep joints flexible and suggest new ways to perform daily tasks, which can be challenging with joint pain.
• Surgery: If medications and physical therapy do not prevent or slow joint damage, surgery may be required to repair damaged joints.

While there is currently no cure for either condition, these treatments can help manage symptoms and prevent or slow down disease progression.

The Crucial Role of Early Intervention in RA and AS

As we conclude, it’s clear that both Ankylosing Spondylitis and Rheumatoid Arthritis present a unique set of symptoms that can significantly impact an individual’s quality of life. While both conditions are characterized by chronic inflammation and joint pain, the areas affected and the progression of the disease can vary greatly.

Understanding these differences is key for early detection and effective treatment planning. It underscores the importance of regular medical check-ups and open communication with your healthcare provider.

Remember, knowledge is power. Being aware of the distinct symptoms of AS and RA can help you or your loved ones seek timely medical intervention, potentially altering the course of the disease and improving overall health outcomes.