UK Premiership footballer Rory Delap, renowned for his devastating throw-in, has joined forces with a number of football heroes across Europe to support 'Back in Play', a European wide campaign to reach young men and women and raise awareness of ankylosing spondylitis (AS), a poorly understood condition which can affect the lower back.

AS is a type of inflammatory arthritis, characterised by low back pain and stiffness, which is most common in young men1,2. The symptoms can be subtle and are often overlooked or confused with common back pain or sports injuries meaning it can take as long as 3-11 years to be accurately diagnosed3.

The campaign, supported by the Ankylosing Spondylitis International Federation (ASIF,) kicks off today with the launch of the Back in Play website. The site is home to an addictive football game with a competitive European league, which tests a player's throw-in skills whilst highlighting the symptoms of AS that can differentiate it from other back pain. In addition to watching a throw-in master class from Rory Delap, visitors to the site can review the AS symptom checklist compiled by ASIF, find out more information about the condition via patient and doctor interviews and links to patient support groups.

The Stoke City player, whose flexibility and back strength is key to his enviable skill, believes Back in Play can help raise awareness of this relatively unknown condition and its symptoms. Lending his personal support to the initiative, Delap comments: "Most football fans will not have heard about AS, yet the stats show up to 1 in 200 will have it." Reflecting on the importance of early diagnosis and treatment he continues: "It is understandable that some of the symptoms like lower back pain are often written off as a sports injury or bad posture, however there are some key subtleties such as the pain getting better with exercise and painful, red eyes, that can indicate AS. Test your throw-in skills with the game and check out the symptoms at the same time."

Most commonly, but not exclusively found in young men, AS symptoms typically start in the late teens and early twenties, causing severe, chronic pain and discomfort1,4. "A lack of awareness of the condition and the gradual onset of symptoms means that it can take years for sufferers to get an accurate diagnosis, I believe 15 years in my own case," said Seoirse Smith, President of the Ankylosing Spondylitis International Federation (ASIF). "I know from personal experience that the earlier the condition is diagnosed the better the outcome for the patient. If AS is not correctly diagnosed or treated, over many years, the spine can become rigid as it may fuse together, and fixed in a bent position making it increasingly difficult to move around freely and undertake day-to-day activities with ease."

Although there is no cure for AS, Professor Désirée van der Heijde, from the Department of Rheumatology at the Leiden University Medical Center in Leiden, The Netherlands, says patients can be managed effectively. "There are a number of treatment options available to help reduce the pain and stiffness experienced by sufferers, from traditional anti-inflammatory drugs which are usually the first line of treatment, to the newer biologics." She concluded, "In addition to taking medication, maintaining a good posture and a regular exercise routine has also been proved to be beneficial."

About AS

The first symptom people with AS typically experience is a dull pain in the lower back that comes on gradually over time. The pain is generally felt deep in the buttock and/or in the lower back (lumbar) regions and is accompanied by morning joint stiffness in the same area that lasts for a few hours1. These symptoms can improve with exercise, however return when at rest. The pain becomes persistent and is usually worse at night disturbing sleep1.

AS varies between individuals in the way it progresses and symptoms will differ in severity, however most patients will experience flare-ups of inflammation periodically2. Disease progression can lead to fusion of the spine; causing loss of mobility and loss of function making it increasingly difficult for the individual to move freely and carry out their usual daily activities1,3,4.

Although AS is a form of arthritis which primarily affects the spine, other joints and organs of the body can also be affected such as the hips, shoulders, knees, eyes, lungs, bowel, skin and heart4. One key symptom which can help differentiate AS from other conditions is uveitis an inflammation of part of the iris within the eye; and conjunctivitis which causes red, gritty and painful eyes4.

In Europe it is thought that approximately 1 in 200 people suffer from AS5,6,7. However, the exact prevalence of AS is not known due to wide geographical variations seen within the population. Prevalence estimates range from 0.1 to 1.4 per cent3,5.

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Pfizer created and funded Back in Play. Back in Play is supported by the Ankylosing Spondylitis International Federation (ASIF) which was established in 1988 with the core premise that the better informed the patient, the better the outcome for them. ASIF now has member societies from 26 countries including many across Europe. http://www.asif.rheumanet.org

To play the game and find out more information on the campaign, ankylosing spondylitis and the treatments available, visit http://www.back-in-play.com

1. Sieper J. et al. Ankylosing spondylitis: an overview. Ann Rheum Dis. 2002;61(Suppl III):iii8-iii18

2. Living with AS website.http://www.livingwith.co.uk/Portals/11/as/ZENB2547e%20-%20Patients%20Guide%20to%20AS.pdf. Last accessed March 2010

3. Elyan M, Khan MA. Diagnosing ankylosing spondylitis. Rheum. 2006:33 (Suppl 78):12-23

4. National Ankylosing Spondylitis Society. Guidebook for `Patients: A Positive Response to Ankylosing Spondylitis. March 2007

5. Sieper J, Braun J. (2009) Clinician's Manual on Ankylosing Spondylitis, London: Current Medicine Group

6. Braun J. et al. Ankylosing spondylitis. Lancet 2007; 369:1379-90

7. Akkoc N, Khan MA. Overestimation of the prevalence of ankylosing spondylitis in the Berlin study: comment on the Braun article by Braun et al (letter). Arthritis Rheum 2005;52:4048-9

Source:
Fanny La Monica
Pfizer