What is Ankylosing spondylitis?

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Ankylosing spondylitis is an autoimmune disease that causes pain and stiffness in the back, neck, and sometimes hips and heels. It begins with inflammation around the bones in the spine or in some joints. Later, it can sometimes cause the bones in the spine to fuse together. Ankylosing spondylitis is one of a group of diseases called "spondyloarthritis."

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What are the symptoms?

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The most common symptom is pain and stiffness in the low back. This pain usually starts in early adulthood, usually before the age of 45, comes on slowly, lasts for more than 3 months, is worse after resting, such as first thing in the morning, feels better with movement.

 

The back might also become less flexible. This can make it harder to do things like bend forward to put on socks or shoes. It can also lead to a "hunchback" posture over time.

 

Pain or arthritis may involve other joints, such as the hips or shoulders, elbows, heels, or ribs, be accompanied by feeling tired and not well

 

In some cases, ankylosing spondylitis can lead to other problems, such as inflammation of part of the eye (“iritis" or "uveitis" and it causes eye pain and blurry vision), problems with the way the heart valves work, breathing problems. It is sometimes associated with inflammation of the inside of the intestines (called colitis).

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How is it diagnosed?

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Besides evaluating your symptoms, diagnosis is typically made with the help of blood tests (such as inflammation markers and HLA-B27 antigen test), Xray findings and sometimes MRI imaging.  

 

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How is it treated?

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Treatment depends on your symptoms and how severe your condition is. The goal of treatment is to relieve your symptoms, help you do your normal activities, and keep your condition from causing other problems.

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Exercise is an important part of treating ankylosing spondylitis. Some people work with a physical therapist (an exercise expert) to learn the best way to exercise. You might do stretches and gentle exercises to strengthen your muscles. It is especially important to work on your posture. That's because ankylosing spondylitis can cause the head to tilt forward in a "hunchback" posture. Special exercises can help prevent this.

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Treatment includes medications such as NSAIDs (ibuprofen like medications) as well as biologic medications (Enbrel, Humira etc) and other anti-rheumatic medications that can be prescribed and managed by you rheumatologist.