Ankylosing spondylitis is a chronic type of arthritis that can lead to the fusing of some of the vertebrae in the spine. When the vertebrae fuse together, the result is a rigid or less flexible spine, causing numerous issues including breathing problems if the ribs are involved. The disease may develop over a period of months or years, and it affects more men than women. There is no known cure, but treatments are available that can minimize the symptoms.
Signs and symptoms of ankylosing spondylitis may include stiffness or pain in the lower back and hips, especially, first thing in the morning and after extended periods of inactivity. Patients may also experience neck pain or fatigue. Symptoms may come and go or may worsen over time. This problem is most common in the sacroiliac joint (the joint that connects the pelvis and the base of the spine), the vertebrae in the lower back, the cartilage between the ribs and breastbone, and the shoulder and hip joints.
Experts have been unable to pinpoint a specific cause although genetic factors do appear to play a role. It is known that most patients with ankylosing spondylitis carry the HLA-B27 gene. However, not everyone with this gene will develop the disease. Ankylosing spondylitis appears to affect more men than women and onset typically occurs in early adulthood or late adolescence.
When to seek medical attention
See your doctor if you have pain in your lower back that began suddenly and seems to be worse in the morning or pain that wakes you up in the early morning hours. This type of pain requires a medical evaluation particularly if it worsens with rest and improves with exercise. If you develop light sensitivity, blurred vision, or other eye problems, see an ophthalmologist immediately.
Ankylosing spondylitis can eventually lead to serious health problems if untreated. Some of these complications include eye inflammation, compression fractures, or even heart problems. Monitoring and treatment can minimize your chances of developing severe complications.
Diagnosis and treatment
When you see your doctor, they will likely ask you to bend in different directions to evaluate your range of motion. They may also ask you to breathe deeply to see if you have trouble expanding your chest. You will probably need to undergo imaging tests such as x-rays or MRIs to check for changes in your bones or joints. There are no specific lab tests that can identify this disorder, but specific blood tests can look for markers of inflammation.
Treatment of ankylosing spondylitis is aimed at relieving symptoms. Anti-inflammatory medications are commonly used; if they aren’t helpful, some patients find relief with biologic medicines such as an interleukin 17 inhibitor or a tumor necrosis factor blocker. Physical therapy, staying active, heat or cold, maintaining good posture, and – in rare cases – surgery may also help.
Patients with ankylosing spondylitis may experience periods of remission and relapse throughout their lives. Most people with this disease live productive lives in spite of their diagnosis. Speak with your doctor about any concerns you have and how you can best manage your symptoms.