A form of arthritis, bamboo spine can be a debilitating condition for those who have it. In this article, we’ll cover the basics surrounding bamboo spine, including what it is, how it is diagnosed, and whether or not a bamboo spine treatment exists.
What is bamboo spine?
Also referred to as ankylosing spondylitis, or AS, bamboo spine is a progressive type of inflammatory arthritis. It is part of a larger family of rheumatological conditions called spondyloarthritis. The various conditions in this family cause arthritis in the joints.
In general, cases of spondyloarthritis can be divided into two main categories: axial and peripheral. The axial type affects axial joints, such as those in the chest, spine, and hip. The peripheral type affects peripheral joints, such as those in the fingers, knees, and toes. Because ankylosing spondylitis affects the spine, it is usually classified as axial spondyloarthritis. Fewer than 1% of American adults suffer from some form of spondyloarthritis; AS specifically affects 0.2–0.5% of the U.S. population.
AS patients suffer from pain and stiffness caused by inflammation of the joints and ligaments of the spine. Over time, the stiffening worsens as the major stabilizing ligaments—the anterior and posterior longitudinal ligaments that run up and down the length of the spine, which are normally soft and pliable—calcify and convert to bone.
As the disease progresses, usually over the course of a few years (the length of time varies), all components of the spine—including the discs, facet joints, and ligaments—may autofuse (grow together) to the point where everything becomes one long length of bone. As a result, the spine becomes rigid and inflexible, unable to move at any point. Some with AS may also have difficulty breathing because the ribcage also fuses and cannot expand.
People who have a bamboo spine vs. a normal spine are likely to experience pain throughout their life; however, it tends to be more severe during the fusing process. Once the spine has completely fused, some of the pain diminishes, but the stiffness continues.
How is bamboo spine diagnosed?
There are a variety of factors to consider when making a diagnosis, including family history (it tends to run in families), lab testing (to determine the presence of genetic marker HLA-B27, which seems to markedly increase its risk of development), and X-rays.
Most AS patients develop severe stiffness and pain in their 20s; the condition is likely to be fully developed by the time they reach their 30s or 40s. AS and regular back pain may start in the same way, with what seems to be a muscle strain. However, the pain associated with AS arises from inflammation around the spine rather than trauma, and requires different treatment.
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Are there complications associated with bamboo spine?
There are two things to be aware of with regard to bamboo spine:
1. People with AS are at increased risk of spinal fractures.
Unlike normal bone, the bone that forms as a result of this condition is very brittle. It takes minimal trauma to break. That means a fall of any kind can more easily cause a fracture, potentially one that spans the entire width of the spine. While many spine fractures in a normal person are benign, a fracture in a bamboo spine could be dangerous and make the entire spine unstable.1
For someone with bamboo spine, an X-ray may not always show a fracture, but it’s important to know if one occurred. Unfortunately, fractures commonly get misdiagnosed as a strain or sprain in an ER or walk-in clinic. If you have a sudden increase in pain, it’s advisable to have an MRI. If a fracture does occur, the bone will heal itself eventually, but the patient must be kept in a stable position until that happens.
2. People with AS must be proactive about maintaining spinal alignment.
A complication of AS is that the spine may permanently fuse in a flattened or flexed position. Patients whose spine fuses in cervical flexion (chin to chest), for example, can no longer look straight ahead; they may also have trouble swallowing and experience greater difficulty performing basic functions. For that reason, AS patients are encouraged to maintain a neutral (straight) position. Avoid sitting in a chair for 14 hours a day, because the spine flattens out and stiffens in that position. Similarly, sleeping with a thick pillow flexes your neck; doing so over a period of months could cause your spine to become fixed in that position. Instead, keep moving. While movement won’t prevent permanent fusion, it can slow down the progression. More importantly, however, it encourages your spine to fuse in a more natural position.
If the spine does fuse in an abnormal position, some people with bamboo spine opt for surgery. During an osteotomy, a surgeon removes a wedge of bone, realigns the spine, and, using either hardware or an external brace, holds it in that position until the bone grows back together.2
Is there an effective bamboo spine treatment?
Nothing is capable of eliminating bamboo spine, but there are some treatments that can help relieve the pain and stiffness, and may, in some cases, slow down its progression. One is to participate in an exercise program consisting of strengthening and flexibility exercises, which have been shown to decrease pain and improve function in AS patients.3 Anti-inflammatory drugs are also sometimes used, as are TNF blockers (like Humira), which are biologic drugs that help regulate the amount of tumor necrosis factor in your body.4 (Too much TNF leads to inflammation.)
Bamboo spine is typically managed and treated by rheumatologists.
1 Olerud, C., Frost, A., & Bring, J. (1996). Spinal fractures in patients with ankylosing spondylitis. European Spine Journal, 5(1), 51-55.
2 Hoh, D. J., Khoueir, P., & Wang, M. Y. (2008). Management of cervical deformity in ankylosing spondylitis. Neurosurgical focus, 24(1), E9.
3 Uhrin, Z., Kuzis, S., & Ward, M. M. (2000). Exercise and changes in health status in patients with ankylosing spondylitis. Archives of internal medicine, 160(19), 2969-2975.
4 Haibel, H., Rudwaleit, M., Brandt, H. C., Grozdanovic, Z., Listing, J., Kupper, H., ... & Sieper, J. (2006). Adalimumab reduces spinal symptoms in active ankylosing spondylitis: clinical and magnetic resonance imaging results of a fifty‐two–week open‐label trial. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology, 54(2), 678-681.