For a disease that affects 2.4 million Americans, we don’t hear enough about Ankylosing Spondylitis (AS), a painful and potentially debilitating disease. Could you be one of the millions?

What is Ankylosing Spondylitis?

A type of arthritis that primarily affects the spine, Ankylosing Spondylitis can also affect the hips, shoulders, pelvis, hands, feet, heels, neck, jaw and chest. Severe cases can affect the eyes, gastrointestinal tract, heart and other organs. It causes fatigue and sometimes mild-to-moderate anemia. Symptoms usually start in young adulthood.

"Ankylosing" means: "fusion" of the bone.

"Spondylitis" means: inflammation, stiffness and pain of the spine.  

Ankylosing Spondylitis causes painful inflammation of the joint capsule, ligaments and tendons that attach to bones. It is characterized by flare-ups when symptoms are severe, followed by remissions when symptoms are mild or absent. It's this waxing and waning affect that causes real damage. During remissions when joints are recovering, the healing process can lead to joint fusion and new bone formation. This can fuse the spine in a fixed, immobile way that sometimes causes forward-stooped posture. In severe and advanced cases, some patients are unable to raise or move their head and neck.

What Causes Ankylosing Spondylitis?

Scientists aren't sure, but they suspect that genetic factors are involved. A high percentage of people with AS have a gene called HLA-B27, which puts them at increased risk for developing the disease. It's more common in people with a family history of AS and those who have frequent gastrointestinal infections.

How is Ankylosing Spondylitis Diagnosed?

It's usually diagnosed by physical exam, especially when certain "hot spots" on the spine and other joints are painful, stiff and inflamed. No specific lab tests can diagnose it, but they can look for HLA-B27 (a normal gene found in 8 percent of the population. Only 2 percent will develop AS). X-rays, MRIs, and CT scans can look for joint inflammation and damage. The Spondylitis Association of America says the overall points taken into account when making an AS diagnosis are:

  • Onset is usually under 35 years of age.
  • Pain persists for more than 3 months
  • Back pain and stiffness worsen with immobility, especially at night and early morning.
  • Back pain and stiffness tend to ease with physical activity and exercise.
  • Positive response to NSAIDs (nonsteroidal anti-inflammatory drugs).

How is Ankylosing Spondylitis Treated? 

There is no cure for Ankylosing Spondylitis, but there are many treatments that make it easier to live with. As with other types of arthritis, successful treatment combines exercise, medication, rest, ice, heat, physical and occupational therapies. Some patients may need surgery to improve joint mobility.

If You Suspect Ankylosing Spondylitis...

Early cases can be difficult to diagnose since symptoms of AS mimic other types of arthritis and chronic pain conditions. Keep a journal of your symptoms and see your primary care physician or a rheumatologist. Be persistent until you find a diagnosis and treatment plan you're comfortable with.


Spondylitis Association of America

Ankylosing Spondylitis