Also known as: Spondylitis and Spondyloarthritis
- Pain and stiffness are worse at night, in the morning, or when you are less active. The discomfort may wake you from sleep.
- The pain often gets better with activity or exercise.
- Back pain may begin in the between the pelvis and spine (sacroiliac joints). Over time, it may involve all or part of the spine.
- Your lower spine may become less flexible. Over time, you may stand in a hunched forward position.
- Swelling and pain in the joints of the shoulders, knees and ankles
- The joints between your ribs and breastbone, so that you cannot expand your chest fully
- Swelling and redness of the eye
- Slight fever
- Some NSAIDs can be bought over-the-counter (OTC). These include aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn).
- Other NSAIDs are prescribed by your provider.
- Talk to your provider or pharmacist before using any over-the-counter NSAID.
- Corticosteroid therapy (such as prednisone) used for short periods of time
- A TNF-inhibitor (such as etanercept, adalimumab, infliximab, certolizumab or golimumab)
- Psoriasis, a chronic skin disorder
- Inflammation in the eye (iritis)
- Inflammation in the intestine (colitis)
- Abnormal heart rhythm
- Scarring or thickening of the lung tissue
- Scarring or thickening of the aortic heart valve
- You have symptoms of ankylosing spondylitis
- You have ankylosing spondylitis and develop new symptoms during treatment
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:
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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. 2016;68(2):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:
- December 07, 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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