Ankylosing spondylitis (AS) is a chronic form of arthritis. It mostly affects the bones and joints at the base of the spine where it connects with the pelvis. These joints can become swollen and inflamed. Over time, the affected spinal bones may join together.
AS is the main member of a family of similar forms of arthritis called spondyloarthritis. Other members include psoriatic arthritis, arthritis of inflammatory bowel disease and reactive arthritis. The family of arthritis appears to be quite common and affects up to 1 in 100 people.
The cause of AS is unknown. Genes seem to play a role. Most people with AS have positive HLA-B27.
The disease often begins between ages 20 and 40, but it may begin before age 10. It affects more males than females.
AS starts with low back pain that comes and goes. Low back pain becomes 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 such as 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. Over time, signs and symptoms of AS flareup (relapse ) and quiet down (remission.) Most people are able to function well unless they have a lot of damage to the hips. Joining a support group of others with the same problem may often help.
Treatment with NSAIDS often reduces the pain and swelling. Treatment with TNF inhibitors appears to slow progression of the spine arthritis.
Rarely, people with ankylosing spondylitis may have problems with:
When to Contact a Medical Professional
Call your health care provider if:
Callhoff J, Sieper J, Weiß A, Zink A, Listing J. Efficacy of TNFa blockers in patients with ankylosing spondylitis and non-radiographic axial spondyloarthritis: a meta-analysis. Ann Rheum Dis. 2014;4:1241-1248. PMID: 24718959 www.ncbi.nlm.nih.gov/pubmed/24718959. Accessed February 11, 2016.
Ferri FF. Ankylosing spondylitis. In: Ferri FF ed. Ferri's Clinical Advisor 2016. Philadelphia, PA: Elsevier; 2016:121-122.
Hu SS, Ananthakrishnan D. Ankylosing spondylitis. In: Herkowitz HN, Garfin SR, Eismont FJ, Bell GR, et al, eds. Rothman-Simeone The Spine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 35.
Reveille, JD. Epidemiology of spondyloarthritis in North America. Am J Med Sci. 2011; 341(4): 284-286 PMID: 21430444 www.ncbi.nlm.nih.gov/pubmed/21430444.
van der Linden SM, Baeten D, Maksymowych WP. Ankylosing spondylitis. In: Firestein GS, Budd RC, Gabriel SE, Mclnnes IB, O'Dell JR, eds. Kelley's Textbook of Rheumatology. 9th ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 75.
Ward MM, Deodhar A, Akl EA, et al. American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network. 2015 recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis. Arthritis Rheumatol. 2015;9:282-298. PMID: 26401991 www.ncbi.nlm.nih.gov/pubmed/26401991. Accessed February 11, 2016.
Werner BC, Feuchtbaum E, Shen FH, Samartzis D. Ankylosing spondylitis of the cervical spine. In: Shen FH, Samartzis D, Fessler RG, eds. Textbook of the Cervical Spine. Philadelphia, PA: Elsevier Saunders; 2015:chap 28.
Review Date: 1/16/2016
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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