Ankylosing Spondylitis: Causes and Treatment

Written by Medicover Team and Medically Reviewed by Dr Mohammad Irfan , Rheumatologists

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Ankylosing spondylitis (AS), also called axial spondyloarthritis, is a long-term inflammatory condition that can cause the bones in the spine (vertebrae) to fuse over time. This fusion reduces spinal flexibility, leading to stiffness and a hunched posture. When the ribs are involved, it may become challenging to take deep breaths, affecting overall comfort and mobility.

Ankylosing spondylitis is a form of arthritis that causes persistent inflammation in the spine.
The sacroiliac joints, found between the lower spine and the pelvis, become inflamed in ankylosing spondylitis.
One of the initial signs of ankylosing spondylitis is sacroiliitis or inflammation in the joints.
Inflammation commonly affects the joints between the vertebrae and the bones that form the spinal column, a condition known as spondylitis.
Some individuals with ankylosing spondylitis experience severe, ongoing back pain, hip pain, and stiffness.

What Are the Symptoms of Ankylosing Spondylitis?

Ankylosing spondylitis symptoms often arise gradually over months or years and fluctuate with time. One of the early signs of ankylosing spondylitis that might keep you awake is lower back stiffness and pain, especially in the morning and at night. It is also possible to experience pain in the large joints, including the hips and shoulders.

stiffness in the lower back or hips, especially in the mornings
Poor posture/stooped shoulders/hunched-over posture
Loss of mobility in the lower back
Neck pain and fatigue.

What Are the Causes of Ankylosing Spondylitis?

Ankylosing spondylitis has no known specific cause. The inflammation can lead to new bone formation, which can lead to fusion and lasting injury. However, doctors are still unclear about why AS patients have this persistent inflammatory reaction. Both hereditary and environmental factors may contribute to AS.

What Are the Risk Factors of Ankylosing Spondylitis?

Ankylosing spondylitis can affect anyone, but it's more common in certain groups of people.
Over 80% of people diagnosed with AS are under the age of 40, with most being diagnosed around 30.
Mens are more likely to develop ankylosing spondylitis than womens.
Having a close family member, especially a biological parent, with AS increases your risk.
People with conditions like Crohn's disease, ulcerative colitis, or psoriasis are also more likely to develop ankylosing spondylitis.

When to See a Doctor for Ankylosing Spondylitis?

Consult a rheumatologist if you have persistent lower back pain, morning stiffness, or reduced spinal flexibility lasting more than three months. Early diagnosis and treatment can help control inflammation, relieve symptoms, and prevent permanent joint damage.

Persistent back pain: Seek medical advice if lower back or buttock pain lasts longer than three months, especially if it improves with exercise but not with rest.
Morning stiffness: Stiffness lasting more than 30 minutes after waking may indicate inflammatory back disease.
Reduced spinal flexibility: Difficulty bending, twisting, or maintaining an upright posture should be evaluated.
Joint pain and swelling: Pain or swelling in the hips, shoulders, knees, or other joints requires medical assessment.
Eye inflammation: Seek immediate care if you develop a painful red eye, blurred vision, or sensitivity to light, as these may indicate uveitis.
Chest pain or difficulty breathing: Reduced chest expansion or pain while taking deep breaths should be evaluated promptly.
Worsening or persistent symptoms: Consult your doctor if symptoms continue despite treatment or interfere with daily activities.

Find Rheumatologists for Ankylosing Spondylitis Treatment Near You

Doctor for Ankylosing Spondylitis in Kurnool

How is Ankylosing Spondylitis Diagnosed?

Ankylosing spondylitis is diagnosed through a combination of medical history, physical examination, imaging studies, and laboratory tests. Early diagnosis is important to begin treatment, reduce inflammation, and prevent long-term joint damage.

Medical history: The doctor asks about chronic back pain, morning stiffness, family history, and other symptoms such as eye inflammation or joint pain.
Physical examination: A rheumatologist evaluates spinal flexibility, posture, chest expansion, and tenderness in the spine and joints.
X-rays: X-rays of the sacroiliac joints and spine can reveal joint damage, bone fusion, or other characteristic changes.
MRI scan: Magnetic resonance imaging (MRI) detects early inflammation in the sacroiliac joints and spine before changes appear on X-rays.
Blood tests: Tests such as HLA-B27, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) help support the diagnosis and assess inflammation.
Assessment of symptoms: The diagnosis is based on a combination of clinical findings, imaging results, and laboratory tests, as no single test confirms the condition.
Differential diagnosis: Other causes of chronic back pain and inflammatory arthritis are ruled out before confirming ankylosing spondylitis.

What are the Treatments and Medications for Ankylosing Spondylitis?

The symptoms, age, and overall health will all affect how you are treated. The severity of the ailment will also be a factor. Treatment aims to lessen discomfort and stiffness, avoid abnormalities and preserve a normal lifestyle as much as possible. Treatment options include:

Non-steroidal anti-inflammatory drugs (NSAIDs) to treat inflammation and discomfort
Tumor-necrosis-factor blockers (biologic drugs) to lessen oedema and inflammation
DMARDs (disease-modifying antirheumatic medications) to reduce inflammation and manage AS include sulfasalazine.
Using corticosteroids for a brief period to lessen inflammation.
Using muscle relaxants and painkillers for a brief period to alleviate extreme pain and muscle spasms.
Surgery to remove a section of the thickened and hardened bone, repair a joint, or insert rods in the spine.
Maintaining proper posture
Regular exercising, especially back muscle strengthening routines.

Ankylosing Spondylitis Self-care and Management

Some things you do daily can help you feel better.

Schedule some time every day, even a few minutes for an activity like swimming which improves the symptoms
Maintain a healthy weight to reduce the stress on your joints. A diet rich in omega-3 fatty acids may be of assistance. If you believe particular meals may cause changes in how you feel, look for trends.
Avoid smoking because people who smoke frequently experience symptoms that worsen with age.
Do massage, yoga, meditation, and counselling to reduce stress.
While using cold on inflamed areas, apply heat to stiff joints and tight muscles.

Your health is everything - prioritize your well-being today.

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Complications of Ankylosing Spondylitis

Suffering from Ankylosing spondylitis can lead to other health issues and complications including:

Bone deformities: New bone growth can fuse the vertebrae, limiting spinal flexibility.
Compression fractures: Weakened bones may fracture, resulting in a stooped posture.
Eye inflammation (uveitis): A common side effect, causing eye pain and sensitivity to light.
Heart problems: Inflammation can affect the aorta, leading to aortic valve disease.
Amyloidosis: In rare cases, protein buildup in organs like the heart and liver can occur.

Dos and Don'ts in Ankylosing Spondylitis:

Ankylosing spondylitis (AS) is accompanied by pain and inflammation in the spine and pelvis. Additionally, this condition can lead to the growth and fusion of spinal segments, which causes stiffness and immobility. Although there is no permanent cure for AS, you can control your symptoms with medicines. So following the below do's, and don'ts can help you manage it.

Do's	Don'ts
Exercise regularly.	Avoid taking medicines as prescribed regularly.
Avoid a sedentary lifestyle	Fall for fad diets
Avoid poor posture	Drink too much alcohol.
Eat a well-balanced diet	Use thick pillows while sleeping
Avoid chronic stress	Lift heavy weights.

To fight this condition, take care of yourself and keep yourself strong internally while seeking adequate medical care.

Citations

https://www.ncbi.nlm.nih.gov/books/NBK470173/

Frequently Asked Questions

1. Is there a permanent cure for ankylosing spondylitis?

Currently, there's no permanent cure. However, treatments like medication, physical therapy, and lifestyle changes can help manage symptoms.

2. What exercises should be avoided for ankylosing spondylitis?

High-impact exercises like running or jumping, and those involving extreme bending or twisting of the spine, should be avoided.

3. What is the best exercise for managing ankylosing spondylitis?

Low-impact activities such as swimming, walking, cycling, and gentle stretching exercises like yoga or tai chi are beneficial.

4. Is ankylosing spondylitis considered an autoimmune disease?

Yes, it's classified as an autoimmune disease where the body's immune system attacks its tissues, leading to inflammation, particularly in the spine and pelvis joints.

5. What is the life expectancy for individuals with ankylosing spondylitis?

Although it can affect quality of life, ankylosing spondylitis typically doesn't impact life expectancy. With proper care, individuals can expect a normal lifespan.