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Ankylosing Spondylitis

Ankylosing Spondylitis

More than 2.7 million people have ankylosing spondylitis but the average time to diagnoses is 7-10 years. One in 100 people in the U.S. have this disease, more than MS, cystic fibrosis and ALS combined. AS is a systemic disease that affects the whole body, not just the spine.

What is ankylosing spondylitis?

AS is a type of arthritis of the spine that causes inflammation between the vertebrae in the spine, and the joints between the spine and pelvis. AS is more common and more severe in men and has a h2 genetic component. Women are also affected but their symptoms are typically different than in men which makes diagnosis more difficult.

AS symptoms often begin in late adolescence or early adulthood (ages 17-45) but can occur in children. The disease progresses over time and results in the fusing of the vertebrae making it difficult to move and causing severe ongoing pain.

What are the symptoms of AS?

In the early stages of AS, there may be a mild fever, loss of appetite and general discomfort, pain and stiffness in the low back and buttocks on one or both sides. Over time the pain becomes chronic on both sides of the spine, lasts for several months and can spread up the spine into the neck. Many AS patients also have Crohn’s disease or irritable bowel disease.

The hallmark symptom of AS is involvement of the sacroiliac joint at the base of the spine. Pain and stiffness in the lower back and buttocks develop gradually over weeks or months. The pain tends to be a dull ache across the lower back; worse in the morning and at night. However, some people suffer inflammation and pain in the arms and legs, not the back, which makes diagnosis more challenging.

The inflammation, pain and tenderness can spread to other areas of the body including the ribs, hips and thighs, shoulders, hands, knees, ankles and feet. One third of patients experience eye inflammation called iritis or uveitis. In rare cases the lungs and heart can be affected. Other consequences include fatigue and mild to moderate anemia.

Symptoms and onset vary from person to person.

What causes AS?

Inflammation in the joints and tissues of the spine that cause severe, chronic pain and discomfort. In the worst cases, new bone is formed in the spine causing sections of the spine to grow together or fuse into a fixed position resulting in a rigid spine. Symptoms of back pain and stiffness vary among patients and can remit and resurface or be mild while others suffer more severe pain and stiffness.

Who is at risk for developing AS?

People with a family history of AS, a positive test for a genetic marker called HLA-B27 and have frequent gastrointestinal infections.

How is AS diagnosed?

Your Ortho Illinois Rheumatologist will review your medical history including any family history of AS, and conduct a physical exam, order x-rays, and blood tests, and imaging studies.

What are the treatments?

There is no cure, but people can lead productive lives and symptoms can be managed with medications and new research shows that some medications may prevent or slow worsening of the disease. Regular exercise and medication can manage pain, control inflammation and improve posture and body position. Dietary modifications may help.