Definition
Ankylosing spondylitis is an inflammation in the joints and tissues of the spine. The bones in the spine may also grow together. This leads to stiffness and problems moving the spine.
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Risk Factors
This problem is more common in men. It often starts in people who are 20 to 30 years of age.
Other things that may raise the risk are:
- Having other family members with ankylosing spondylitis
- Having a marker on HLA-B27 gene
Symptoms
Problems may be mild to severe. The main problem is pain and stiffness in the lower back and where the back and hip meet. The pain may also spread down the legs.
Other problems may be:
- Pain that is often worse at night
- Stiffness that is worse in the morning
- Pain that gets better with activity
- Pain and stiffness in other joints
- Chest pain
- Eye pain, eyesight changes, or increased tearing
Less common symptoms may be:
- Lack of energy
- Lack of hunger
- Weight loss
- Fever
- Numbness
- Blood in the urine
Diagnosis
The doctor will ask about your symptoms and health history. A physical exam will be done. It will focus on the spine.
Blood tests may be done to check for the HLA-B27 gene marker.
Images of the joints may be taken. This can be done with:
Treatment
There is no cure. The goal of treatment is to manage symptoms and prevent them from worsening. Choices are:
- Medicines to ease pain and inflammation, such as:
- Over the counter or prescription nonsteroidal pain relievers
- Corticosteroids
- Disease-modifying antirheumatic drugs (DMARDs)
- Regular exercise and physical therapy to promote strength, flexibility, and range of motion
People who are not helped by these methods may need surgery. A hip or joint replacement may be done to ease pain and promote movement. Spinal surgery may also be needed to improve posture.
RESOURCES
Arthritis Foundation http://www.arthritis.org
Spondylitis Association of America http://www.spondylitis.org
CANADIAN RESOURCES
The Arthritis Society http://www.arthritis.ca
Canadian Spondyloarthritis Association http://www.spondylitis.ca
References
Ankylosing spondylitis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/ankylosing-spondylitis. Accessed February 16, 2021.
Ankylosing spondylitis. Spondylitis Association of America website. Available at: http://www.spondylitis.org/About-Spondylitis/Ankylosing-Spondylitis. Accessed February 16, 2021.
Ankylosing spondylitis. University of Washington Orthopedics and Sports Medicine Department website. Available at: http://www.orthop.washington.edu/?q=patient-care/articles/arthritis/ankylosing-spondylitis.html. Accessed February 16, 2021.
Sieper J, Poddubnyy D. Axial spondyloarthritis. Lancet. 2017 Jul 1;390(10089):73-84.
Revision Information
- Reviewer: EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM
- Review Date: 12/2020
- Update Date: 02/16/2021