You may think your back pain and spasms are the result of an injury, but it could be ankylosing spondylitis. Here's what to look for to see if you should get tested.
What Is Ankylosing Spondylitis?
Ankylosing spondylitis (AS) is a type of arthritis that typically affects the vertebrae in the lower spine. The disease is marked by inflammation of the areas where ligaments and tendons attach to the bone. Repeated damage and healing causes the inflammation to progress, which can result in the vertebrae fusing together.
Other joints can also be affected, including the ribs, the pelvis, and the heels. The inflammation may also affect one or both eyes, causing pain and blurred vision.
AS is an autoimmune disease, and its true cause is unknown. But there are some risk factors that seem to play a role, including:
- age: typically those in their late teens and early to mid-adulthood are affected
- gender: males are more likely to be diagnosed
- heredity: especially the presence of a genetic marker called HLA-B27
- history: of gastrointestinal (GI) infections
It’s important to understand that you can develop AS even if you don’t have these risk factors. And if you have many of these risk factors, you may never develop AS. Some people may just be genetically inclined to contract the disease. However, if you suffer from frequent bacterial infections, this infection could travel to the spine and lead to AS.
The first symptoms are usually pain and joint stiffness in the lower back and hips, as well as the ribs, shoulders, and the back of the heel. This pain and stiffness usually improves with exercise, and then worsens with rest. Symptoms may disappear for some length of time, and then return.
When to Call the Doctor
You may be wondering if that pain in your lower back is something to be worried about. It’s time to call your doctor if you notice one or more of these symptoms:
- You have begun feeling pain and stiffness in your lower back and/or pelvic area, especially if it’s worse in the morning, or at other times of rest.
- Exercise lessens your pain.
- These symptoms have come on gradually, but have lasted for at least three months.
- The pain wakes you up during the night and prevents you from sleeping.
- Certain medications called nonsteroidal anti-inflammatory drugs, like ibuprofen and naproxen, help your symptoms.
- You notice pain in your ribcage, and it’s difficult or painful to draw a full breath.
- One or both of your eyes are red, swollen, and/or painful.
- You notice blurred vision and extreme sensitivity to light.
Diagnosing AS can be difficult, as symptoms can mimic those of other disorders. Early on, problems may not even show up on scans.
It will be helpful if you keep a journal of your symptoms, because your doctor will probably want to know when and where you have pain, what activities make it worse or better, and when the symptoms started. This can help your doctor to determine the right set of diagnostic tools for you, which may include:
- health questions, covering many of the topics listed in the previous section
- physical exam to pinpoint “hotspots,” or areas of pain and inflammation
- mobility testing, to see how well you’re able to bend and twist
- blood tests, to check for the genetic marker HLA-B27 and for inflammation markers
- X-ray or MRI to look for inflammation in the sacroiliac joint
The truth is, you won’t know if you have AS without a full checkup from your doctor. If you’re worried, it’s important to talk to your doctor about all your symptoms and what they could mean. Even though there’s no cure for AS, there are a range of treatment options that can help you feel better, and continue to lead a full life.