Ankylosing spondylitis (AS) is a long-term type of arthritis. It most commonly affects the bones and joints at the base of the spine where it connects with the pelvis.
These joints become swollen and inflamed. Over time, the affected spinal bones join together.
The cause of ankylosing spondylitis is unknown. Genes seem to play a role.
The disease most often begins between ages 20 and 40, but it may begin before age 10. It affects more males than females.
The disease starts with low back pain that comes and goes. Low back pain is present most of the time as the condition progresses.
Other parts of your body that may be stiff and painful include:
Fatigue is also a common symptom.
Less common symptoms include:
Ankylosing spondylitis may occur with other conditions, such as:
Exams and Tests
Tests may include:
Your health care provider may prescribe drugs (NSAIDs) to reduce swelling and pain.
You may also need stronger medicines to control pain and swelling, such as:
Surgery may be done if pain or joint damage is severe.
Exercises can help improve posture and breathing. Lying flat on your back at night can help you keep a normal posture.
The course of the disease is hard to predict. Most people are able to function unless they have a lot of damage to the hips. Treatment with NSAIDS often reduces the pain and swelling. Treatment with TNF inhibitors appears to slow progression of the spine arthritis.
Rarely, people may have problems with:
When to Contact a Medical Professional
Call your health care provider if:
Callhoff J, Sieper J, Weiß A, et al. Efficacy of TNFa blockers in patients with ankylosing spondylitis and non-radiographic axial spondyloarthritis: a meta-analysis. Ann Rheum Dis. 2014. PMID: 24718959 www.ncbi.nlm.nih.gov/pubmed/24718959.
Inman RD. The spondyloarthropathies In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 265.
Sieper J, van der Heijde D, Landewé R, et al. New criteria for inflammatory back pain in patients with chronic back pain: a real patient exercise by experts from the Assessment of SpondyloArthritis international Society (ASAS). Ann Rheum Dis. 2009; 68:784. PMID: 19147614 www.ncbi.nlm.nih.gov/pubmed/19147614.
Yu D, Lories R, Inman RD. Pathogenesis of ankylosing spondylitis and reactive arthritis. In: Firestein GS, Budd RC, Gabriel SE, et al, eds. Kelley's Textbook of Rheumatology. 9th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 74.
Review Date: 1/20/2015
Reviewed By: Gordon A. Starkebaum, MD, Professor of Medicine, Division of Rheumatology, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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