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Ankylosing Spondylitis

Ankylosing spondylitis (AS) is a chronic inflammatory condition that primarily affects the spine, causing pain, stiffness, and potentially leading to fusion of the vertebrae. This condition belongs to a group of arthritis known as spondyloarthritis, which also affects other joints and tissues in the body. The disease may damage the joint between the spine and the hipbone. This is called the sacroiliac joint. It may also cause bony bridges to form between vertebrae in the spine, fusing those bones. Bones in the chest may also fuse.

Symptoms of Ankylosing Spondylitis

The hallmark symptom of ankylosing spondylitis is inflammatory back pain, which typically starts gradually and worsens over time. Other common symptoms include:
  • Stiffness: Especially in the morning or after periods of inactivity.
  • Reduced Mobility: Difficulty bending or turning the spine.
  • Fatigue: Often due to chronic inflammation.
  • Pain in other joints: Such as hips, shoulders, and knees.
  • Eye Inflammation: Known as uveitis, which can cause eye pain and sensitivity to light.

Causes and Risk Factors

The exact cause of ankylosing spondylitis is unknown, but it is believed to involve a combination of genetic and environmental factors. Up to 90% of individuals with AS carry a specific genetic marker called HLA-B27, although not everyone with this marker develops the condition. Other risk factors include a family history of AS or other spondyloarthritis conditions.

Diagnosis

Diagnosing ankylosing spondylitis can be challenging as its early symptoms can mimic other conditions. Medical professionals need to rely on clinical experience, detailed history and clinical evaluation, imaging tests and blood tests to detect inflammation and also the presence of genetic markers.

Treatment Options

While there is no cure for ankylosing spondylitis, treatments aim to alleviate symptoms, prevent complications, and improve quality of life. Common treatment approaches include:
  • Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation. Disease-modifying drugs and biologic therapies may be prescribed in more severe cases.
  • Physical Therapy: Exercises to maintain flexibility, posture, and strengthen muscles.
  • Lifestyle Modifications: Good posture habits, regular exercise, and smoking cessation can help manage symptoms and maintain spinal health.
  • Surgery: In rare cases, surgery may be considered to correct severe spinal deformities or joint damage.