Health Do you have a problem youd like answered? If so, write to us at: Inspire magazine, 1 Cambridge Technopark, Newmarket Road, Cambridge CB5 8PB or email inspire@versusarthritis.org Ask the doctor Whether its a health niggle or emotional problem, Inspires DR SARAH JARVIS gets straight to the point Q My brother has ankylosing spondylitis, and I have very similar symptoms. I started getting back pain when I was 28 and, like him, I find it much worse after I rest. But my GP tells me ankylosing spondylitis almost always affects men. Is there a similar condition that affects women? Name and address withheld FIND OUT MORE For further information on DMARDs, go to versusarthritis.org/dmards Read more about ankylosing spondylitis at versusarthritis. org/ankylosing-spondylitis Dr Sarah Jarvis answers: For many years, it has been assumed that ankylosing spondylitis (AS) was almost exclusively a mans condition. The classic symptom is inflammatory back pain low back pain that comes on gradually, radiates into your buttocks, is worse in the morning, improves with exercise, and is often very responsive to non-steroidal antiinflammatory drugs, such as ibuprofen or naproxen. It typically starts before the age of 45, and has to last for at least three months before a diagnosis can be made. Other conditions that are often seen alongside AS include uveitis (painful inflammation of the eye); inflammatory bowel disease (the two main types are ulcerative colitis and Crohns disease), and psoriasis. The classic X-ray features of ankylosing spondylitis include inflammation of the sacroiliac joints, which connect your pelvic bone with the base of your spine, and changes in your spine. These changes can lead to a so-called bamboo spine, because it can look like pieces of bamboo on an X-ray. It often runs in families. In recent years, it has become clear that AS is part of a spectrum. Were now recognising a condition called axial spondyloarthritis, which includes people with AS and others with similar symptoms, but doesnt show up on X-rays. Interestingly, there are more women than men with axial spondyloarthritis without X-ray features, and their symptoms are just as severe. Given your family history and your symptoms, I suggest you ask your GP for a referral to a specialist, who should be able to organise blood tests and imaging to help make a diagnosis. Disease-modifying anti-rheumatic drugs (DMARDs) reduce pain, swelling and stiffness by slowing down the condition and its effects on the joints. These drugs may help if you do have this condition. Ask the expert CLAIRE GASCOIGNE is Helpline Advisor for Versus Arthritis Q I have been diagnosed with arthritis and Im worried about work. Can my employers treat me differently? Rachel, 36 Claire answers: If you have a health condition, you have defined rights set out in law, which means you should be treated fairly by your employer. Employers are legally obliged to support their employees under the Equality Act 2010 or the Disability Discrimination Act in Northern Ireland. This is to protect people from discrimination. Your employer has a legal obligation to make reasonable adjustments to your working environment and practices. This is to make sure your condition doesnt prevent you from doing your job to the best of your ability. Reasonable adjustments can include changing your duties, providing special equipment, or altering your working hours. However, this depends on your individual needs and circumstances. A referral to your occupational health department can be very helpful in finding out which adjustments you need. An employers obligations to meet reasonable adjustments is a longterm one, so if your condition changes and makes any new aspects of your working life difficult the situation should be reassessed. Speaking to your employer or manager about a health condition can be daunting, but it can also be really helpful. To find out more, call the free Arthritis Helpline on 0800 5200 520. Were open weekdays from 9am to 8pm. You can also call if youd like a chat with one of our helpline advisors, whether its about your condition or something else.