Ankylosing spondylitis is a chronic condition that causes inflammation of the spine and joints. In the long term, particularly if left untreated, it can also cause the bones of the spine to become fused together.Ankylosing spondylitis is not yet fully understood, so it is unclear exactly what causes the inflammation, although a gene called HLA-B27 may be involved. Ankylosing spondylitis usually first appears in people in their 20s, with very few cases developing in those over the age of 45. It is also more common in men than in women. Although the causes are not clear, the impact of this condition is well understood.
Inflammation occurs in the spine and other affected joints. This inflammation can damage the joints as well as causing symptoms such as pain and swelling. It can also result in ankylosis, when the bones of the spine become fused.
Back pain and stiffness that improves with exercise rather than with rest is one of the most characteristic symptoms of ankylosing spondylitis. Other parts of the body may also suffer from pain and swelling. The ribs, hips and knees are most likely to be affected. Extreme tiredness or fatigue is also common in people who have ankylosing spondylitis.
All of these symptoms tend to develop gradually over months or years, sometimes disappearing only to reappear again. In some people, the symptoms can get better over time, but in others, they can grow worse.
If you are experiencing these types of symptoms, you should seek advice from your GP, who will recommend that you see a rheumatologist if they suspect that you may have ankylosing spondylitis. Your rheumatologist will probably want to conduct some blood tests to assess the amount of inflammation in your body, and may also want to order some imaging tests, such as X-rays, to check the condition of your joints and spine, and to look for any signs of ankylosis.
If the tests show inflammation of the sacroiliac joints at the base of your spine and your symptoms match, a diagnosis of ankylosing spondylitis will usually be made, and your treatment can begin.
The treatment for ankylosing spondylitis aims to relieve the symptoms and slow down or stop the progression of the disease. Ankylosing spondylitis cannot be cured, and the damage done to the spine and other joints can’t be reversed, so it is important that the condition is spotted as early as possible.
In some cases, it may be possible to correct severe damage to the spine or joints through surgery, but this is rare. Ankylosing spondylitis is more commonly treated with medication, which can help to relieve pain and inflammation. Patients with ankylosing spondylitis will also benefit from carefully designed exercises and physiotherapy to help relieve pain and improve flexibility.
Most people whose ankylosing spondylitis is treated can remain active, but in some cases, particularly if treatment hasn’t been started early, the spine and joint damage can lead to serious mobility problems. Other complications, such as spinal fractures and osteoporosis can also occur, so anyone with ankylosing spondylitis needs to be closely monitored by their doctors.