What is it?

What is ankylosing spondylitis?

Ankylosing spondylitis is a type of arthritis that causes inflammation in certain parts of the spine. Over time, this inflammation in the joints and tissues of the spine can cause stiffness. In severe cases, this may cause the bones in the spine to grow together, which can lead to a rigid spine that is difficult to bend.

Many people with ankylosing spondylitis have mild episodes of back pain and stiffness that come and go. But others have severe, ongoing back pain and stiffness. Other symptoms also may develop if other areas of the body are affected by the disease, such as:

  • Hips.
  • Ribs.
  • Shoulders.
  • Knees.
  • Ankles.
  • Feet.
Who gets it?

Who gets ankylosing spondylitis?

Anyone can get ankylosing spondylitis; however, certain factors may increase your risk for developing the disease, such as:

  • Family history and genetics. If you have a family history of ankylosing spondylitis, you are more likely to develop the disease.
  • Age. Most people develop symptoms of ankylosing spondylitis before age 45.   
  • Sex. Men are more likely to have ankylosing spondylitis than women.
  • Other conditions. People who have Crohn’s disease, ulcerative colitis, or psoriasis may be more likely to develop the disease.
What are the symptoms?

What are the symptoms of ankylosing spondylitis?

The most common symptom of ankylosing spondylitis is lower back and/or hip pain and stiffness. Over time, the symptoms may move to other areas of the spine. The pain typically gets worse during periods of rest or inactivity, such as during the middle of the night or after sitting for a long time. Usually, moving and exercise can help pain get better. 

Some people with ankylosing spondylitis have mild episodes of pain that come and go, while others will have long-lasting, severe pain. If you have ankylosing spondylitis, whether mild or severe, you may have times when the symptoms get worse (flares) and other times when the symptoms improve (remission). 

The disease can affect other areas of the body. Other symptoms may include:

  • Pain, stiffness, and inflammation in other joints.
  • Difficulty taking deep breaths if the joints connecting the ribs are affected.
  • Vision changes and eye pain.
  • Feeling very tired.
  • Loss of appetite and weight loss.
  • Skin rashes.
  • Abdominal pain and loose bowel movements.
What causes it?

What causes ankylosing spondylitis?

No one knows the cause of ankylosing spondylitis. Studies show, however, that both genes and things in our environment may lead to the development of the disease.

Is there a test for it?

Is there a test for ankylosing spondylitis?

There is no single test for ankylosing spondylitis. To see if you have the disease, your doctor may:

  • Ask you about your medical and family history.
  • Perform a physical exam.
  • Order x-rays and other tests.
How is it treated?

How is ankylosing spondylitis treated?

Although there is no cure for ankylosing spondylitis, your doctor will work with you to help manage the disease. The goals of treatment include:

  • Ease symptoms.
  • Help you keep good posture.
  • Keep the disease from progressing, or slow its progress.

Treatment can include:

  • Medications to help with pain and inflammation.
  • Physical therapy to:
    • Help with pain.
    • Strengthen muscles.
    • Improve or keep good posture.
    • Keep your joints flexible.  
  • Surgery, if you have severe joint damage.
Who treats it?

Who treats ankylosing spondylitis?

Diagnosing and treating ankylosing spondylitis may require a team of health care professionals.  These may include:

  • Rheumatologists, who specialize in arthritis and other diseases of the bones, joints, and muscles.
  • Dermatologists, who specialize in conditions of the skin, hair, and nails.
  • Gastroenterologists, who specialize in conditions of the digestive system.
  • Mental health professionals, who help people cope with difficulties in the home and workplace that may result from their medical conditions.
  • Nurse educators, who specialize in helping people understand their overall condition and set up their treatment plans.
  • Occupational therapists, who teach ways to protect joints, minimize pain, perform activities of daily living, and conserve energy.
  • Ophthalmologists, who specialize in conditions of the eye.
  • Orthopaedic surgeons, who specialize in treatment and surgery for bone and joint diseases.
  • Physiatrists (physical, medicine, and rehabilitation specialists), who supervise exercise programs.
  • Physical therapists, who help improve joint function.
  • Primary care doctors, such as a family physician or internal medicine specialist, who coordinates care between the different health providers and treats other problems as they arise.
  • Psychologists or social workers, who help with psychosocial challenges caused by medical conditions.
Living With It

Living with ankylosing spondylitis

You can play a role in managing your ankylosing spondylitis and improving your health. You can:

  • Learn about the disease and its treatments.
  • Talk with your health care team.
  • Reach out for support when you need it.

The following can help you live with ankylosing spondylitis and keep a positive outlook.

  • Exercising is important and can help:
    • Maintain healthy and strong muscles.
    • Keep your joints flexible and make it easier for you to move.
    • Lower pain.

Your doctor may recommend low-impact exercises, such as water exercise programs. Talk to your health care providers before beginning any exercise program.

  • Practicing good posture can help you stand straighter and feel less pain.
  • Using support devices such as a cane or walker to help you move around safely, keep you stable, and lower pain.
  • Monitoring symptoms for any changes or new symptoms. This can help you and your doctor manage your pain.
  • Coping with stress by doing deep breathing, meditating, or listening to quiet sounds or music, and trying movement exercise programs, such as yoga and tai chi.
  • Managing your mental health by talking to your doctor, mental health professional, friends, family, or an online or community support group about your disease.
  • Eating a healthy diet because keeping a healthy weight reduces stress on painful joints.
  • Not smoking, because when you smoke and have ankylosing spondylitis, the disease is worse. In addition, smoking:
    • Lessens the effect of your treatment.
    • Can change your lung function if you have the disease in the chest or ribs.
    • Makes it more likely for your disease to progress.
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