Ankylosing Spondylitis

What is Ankylosing Spondylitis?

Ankylosing spondylitis is a type of inflammatory arthritis that primarily affects the spine. It causes inflammation in the joints between the vertebrae, which are the small bones that make up the spinal column. Over time, this inflammation can cause the vertebrae to fuse together, reducing flexibility in the spine.

The condition typically starts in early adulthood, usually before age 45. It often begins with pain and stiffness in the lower back and hips, especially in the morning or after periods of inactivity. The inflammation can also affect other joints, tendons, and ligaments throughout the body.

Ankylosing spondylitis is a chronic condition that requires ongoing management. Early diagnosis and treatment can help reduce symptoms and slow disease progression. Many people with this condition lead active, fulfilling lives with proper care and lifestyle adjustments.

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Symptoms

Chronic lower back pain and stiffness, especially in the morning
Pain that improves with movement and exercise
Pain in the hips, shoulders, and other joints
Fatigue and tiredness
Reduced flexibility in the spine
Difficulty taking deep breaths if ribs are affected
Eye inflammation, causing pain and sensitivity to light
Stooped posture as the condition progresses
Pain where tendons attach to bones, especially in the heels

Symptoms typically develop gradually over several months. Some people experience mild symptoms that come and go, while others have more severe, continuous pain. The condition affects each person differently.

Causes and risk factors

The exact cause of ankylosing spondylitis is not fully understood, but genetics play a major role. Most people with this condition carry a gene called HLA-B27. However, having this gene does not mean you will develop the condition. Only about 1 to 2 out of every 100 people with HLA-B27 actually develop ankylosing spondylitis. Researchers believe other genetic and environmental factors work together to trigger the disease.

Risk factors include being male, as men are diagnosed more often than women. Having a family history of the condition increases your risk significantly. The condition usually begins between ages 17 and 45. Certain infections may trigger the disease in people who are genetically susceptible, though this connection is still being studied.

How it's diagnosed

Diagnosing ankylosing spondylitis involves several steps. Your doctor will review your symptoms and medical history, then perform a physical exam to check spine flexibility and pain points. Blood tests can help support the diagnosis by checking for inflammation markers and the HLA-B27 antigen. Tests for interleukin 17 levels may also help assess disease activity.

Imaging tests like X-rays and MRI scans are important for seeing changes in the joints and spine. X-rays can show fusion of the vertebrae in later stages, while MRI scans can detect early inflammation before damage appears on X-rays. Talk to a doctor about specialized testing if you have symptoms of ankylosing spondylitis.

Treatment options

Regular exercise and physical therapy to maintain flexibility and posture
Nonsteroidal anti-inflammatory drugs to reduce pain and inflammation
Biologic medications that target specific parts of the immune system
Disease-modifying antirheumatic drugs for some patients
Heat therapy and cold packs for pain relief
Proper sleep positioning to prevent spinal deformity
Smoking cessation, as smoking worsens symptoms
Maintaining good posture throughout daily activities
Swimming and stretching exercises to improve spine mobility
Working with a rheumatologist who specializes in inflammatory arthritis

Frequently asked questions

The main cause involves genetics, particularly the HLA-B27 gene. Most people with ankylosing spondylitis carry this gene, though not everyone with the gene develops the condition. Environmental factors and other genes likely play a role in triggering the disease in susceptible individuals.

There is currently no cure for ankylosing spondylitis. However, the condition can be effectively managed with proper treatment. Early diagnosis and consistent treatment can reduce symptoms, slow disease progression, and help maintain quality of life.

The HLA-B27 blood test checks for a genetic marker associated with ankylosing spondylitis. About 80 to 95 percent of people with the condition test positive for HLA-B27. However, the test alone cannot diagnose the condition, as many healthy people also carry this gene without developing the disease.

Regular exercise is one of the most important treatments for ankylosing spondylitis. Physical activity helps maintain spine flexibility, reduces stiffness, and improves posture. Swimming, stretching, and low-impact exercises are particularly beneficial for managing symptoms.

Most people with ankylosing spondylitis do not end up needing a wheelchair. With early diagnosis and proper treatment, many maintain good mobility throughout their lives. Staying active, following treatment plans, and working with healthcare providers helps preserve function and independence.

Morning stiffness happens because inflammatory processes are more active during rest periods. Lying still overnight allows inflammation to build up in the joints and spine. Movement and activity help reduce this stiffness by promoting blood flow and reducing inflammatory fluid buildup.

Yes, ankylosing spondylitis can affect areas beyond the spine. The condition may cause inflammation in the eyes, heart, lungs, and bowels. Some people develop inflammation where tendons attach to bones, particularly in the heels and hips.

A healthy diet may help reduce inflammation and support overall health. Some people find that an anti-inflammatory diet rich in vegetables, fruits, fish, and whole grains helps manage symptoms. Maintaining a healthy weight also reduces stress on the spine and joints.

Visit your rheumatologist regularly to monitor disease activity and adjust treatment as needed. Most people need checkups every 3 to 6 months when the condition is stable. More frequent visits may be necessary during flares or when starting new medications.

Stress can trigger symptom flares and increase pain perception in people with ankylosing spondylitis. Managing stress through relaxation techniques, adequate sleep, and regular exercise may help reduce symptom severity. Many people find that stress management improves their overall disease control.