Ankylosing spondylitis is a long-term type of arthritis. It most commonly affects the bones and joints at the base of the spine where it connects with the pelvis.
These joints become swollen and inflamed. Over time, the affected spinal bones join together.
Causes, incidence, and risk factors
The cause of ankylosing spondylitis is unknown. Genes seem to play a role.
The disease most often begins between ages 20 and 40, but it may begin before age 10. It affects more males than females.
The disease starts with low back pain that comes and goes. Low back pain is present most of the time as the condition progresses.
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.
Your lower spine becomes less flexible. Over time, you may stand in a hunched forward position.
Other parts of your body that may be stiff and painful include:
- The joints between you ribs and breastbone, so that you cannot expand your chest fully
- Swelling and pain in the joints of the shoulders, knees and ankles
Swelling of the eye
Fatigue is also a common symptom.
Less common symptoms include:
- Loss of appetite
- Slight fever
- Weight loss
Signs and tests
Tests may include:
CBC ESR(a measure of inflammation) HLA-B27 antigen(which detects the gene linked to ankylosing spondylitis)
- X-rays of the spine and pelvis
- MRI of the spine
Your doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce swelling and pain.
- Some NSAIDs can be bought over-the-counter (OTC), such as aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn).
- Other NSAIDs are prescribed by your health care provider.
- Talk to your health care provider or pharmacist before using any over-the-counter NSAID.
You may also need stronger medicines to control pain and swelling, such as:
- Corticosteroid therapy (such as prednisone)
- TNF-inhibitors (such as etanercept, adalimumab, infliximab, golimumab)
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. Symptoms may come and go at any time. Most people are able to function unless they have a lot of damage to the hips.
Rarely, people may have problems with:
- Abnormal heart rhythm
- Scarring or thickening of the lung tissue
- The aortic heart valve
- Inflammation in the large intestine (
Calling your health care provider
Call your health care provider if:
You have symptoms of ankylosing spondylitis
You have ankylosing spondylitis and develop new symptoms during treatment