Ankylosing spondylitis is a type of arthritis that causes inflammation in the joints and ligaments of the spine.
It may also affect peripheral joints like the knees, ankles, and hips. Normally, the joints and ligaments in the spine help us move and bend. If you have ankylosing spondylitis, the inflammation in the joints and tissues of the spine can cause stiffness. In severe cases, this may cause the vertebrae (bones in the spine) to fuse (grow together). When the vertebrae fuse, it can lead to a rigid and inflexible spine. (For more information about the anatomy of the spine, see our Back Pain Health Topic.)
Many people with ankylosing spondylitis have mild episodes of back pain and stiffness that come and go. But others have severe, ongoing pain with loss of flexibility in the spine. In addition, other symptoms may develop depending on which other areas of the body are affected by the disease. Some people with ankylosing spondylitis develop eye disease (uveitis), skin disease (psoriasis), or gut disease (inflammatory bowel disease).
There is no cure for ankylosing spondylitis, but there are many treatment options to help control symptoms. Recommended therapies may include exercise, physical and/or occupational therapy to improve mobility and posture, and medications to help manage pain, control inflammation, improve posture and body position, and slow the progression of the disease. With treatment, most people with ankylosing spondylitis can have productive lives.
Anyone can get ankylosing spondylitis; however, certain factors may increase your risk for developing the disease. These factors include:
The most common symptom of ankylosing spondylitis is lower back and/or hip pain and stiffness. Over time, the symptoms may progress to other areas of the spine or body. The pain typically worsens during periods of rest or inactivity, which may cause some people to experience more pain during the middle of the night or after prolonged sitting. Usually, moving and exercise can help improve pain.
Symptoms of ankylosing spondylitis vary from person to person. Some people have mild episodes of pain that come and go, while others will have chronic, severe pain. The symptoms of ankylosing spondylitis, whether mild or severe, may worsen in “flares” and improve during periods of remission.
Because the disease can affect other areas of the body, other symptoms may develop and may include:
Researchers do not know the cause of ankylosing spondylitis. However, studies show that both genes and environment may lead to the development of the disease. Researchers know that the HLA-B27 gene increases the risk of developing ankylosing spondylitis, but this does not mean you will get the disease if you have the gene. Many people have the gene and never develop ankylosing spondylitis, which tells researchers that environmental factors also play a role.
Researchers continue to discover many other gene variations that may cause the disease; however, HLA-B27 is the primary gene known thus far that increases your risk for developing ankylosing spondylitis.
To diagnose ankylosing spondylitis, your doctor will ask you about your medical history and perform a physical exam. Your doctor may order imaging studies and lab tests to help confirm a diagnosis.
Your doctor may ask about your medical and family history, including questions such as:
A physical exam may include:
Your doctor may order imaging studies to help diagnose ankylosing spondylitis:
Your doctor may use both X-rays and MRIs to follow the progression of your disease.
There is no cure for ankylosing spondylitis; however, your doctor will work with you to help manage the disease. The goals of treatment include:
In most cases, treatment includes medication and physical therapy. Sometimes, people with severe disease need surgery to repair joint damage.
Most people with ankylosing spondylitis take medications, which may include one or more of the following:
Your doctor may recommend physical therapy to help:
A physical therapist can recommend the best sleeping positions and an exercise program. Because your symptoms may worsen when inactive or at rest, it’s important to stay active and exercise regularly.
If you have severe joint damage and you are unable to participate in your daily activities, your doctor may recommend surgery. Surgery is not for everyone. You and your doctor can discuss the options and choose what is right for you.
Your doctor will consider the following before recommending surgery:
Types of surgery may include joint repairs and joint replacements.
Rarely, some people may have surgery to correct or straighten the spine or repair fractures (breaks) in the vertebrae.
Diagnosing and treating ankylosing spondylitis may require a team of health care professionals. These may include:
Research shows that people who take part in their own care report less pain and make fewer doctor visits. They also enjoy a better quality of life.
Self-care can help you play a role in managing your ankylosing spondylitis and improving your health. You can:
Participating in your care can help build confidence in your ability to perform day-to-day activities, allowing you to lead a full, active, and independent life.
The following lifestyle changes and activities can help improve your ability to function on your own and maintain a positive outlook.
Source: https://www.niams.nih.gov/health-topics/ankylosing-spondylitis
Directory: (National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). Ankylosing Spondylitis. National Institutes of Health. )
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This information is for educational purposes only and should not replace professional medical advice. Always consult with your healthcare provider for diagnosis and treatment recommendations specific to your condition.
