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Ankylosing Spondylitis: Much More Than Back Pain

Ankylosing spondylitis is a form of arthritis caused by inflammation of the joints.

Patients often begin experiencing painful symptoms in early adulthood, including aches and stiffness in the lower back and hips. These are often the worst after periods of inactivity or immediately after waking up.

Unlike typical back pain one might experience from injury or spending too many hours in a chair, ankylosing spondylitis can affect other joints, particularly joints in the spine at the lower back and pelvis. The hip and shoulder joints can also be affected as well.

The vertebrae in the back are of particular concern because, if left untreated, these joints can fuse together. This can cause a person to have a hunched over posture and may affect a person’s ability to breathe.

While many patients endure these painful symptoms for up to 10 years before receiving a proper diagnosis, those who work with their doctors to find proper treatment experience a much greater quality of life.

Experts agree that ankylosing spondylitis and other related diseases can run in families, so if you have relatives with a history of immune problems, you may be more likely to develop ankylosing spondylitis.

If you’re experiencing lasting pain for more than three months that feels worse in the morning and better with movement, you should talk to your doctor about ankylosing spondylitis as the potential cause of your symptoms.

Your doctor will perform a physical exam and ask you about your symptoms and whether you have a history of injuries in the affected joints. Your doctor may order imaging tests, such as an X-ray or MRI, to get a better look at what’s causing your pain. You can also expect a simple blood test to check for signs of inflammation, as well as to rule out other potential illnesses.

Your family doctor may initially diagnose you with inflammatory back pain, and refer you to a rheumatologist, a doctor who specializes in medicine related to joints and autoimmune diseases. As ankylosing spondylitis is not associated with mechanical issues that occur with injury-related back pain, it cannot be simply remedied with surgery and requires other therapies.

While scientists continue to look for a cure for ankylosing spondylitis, there are many effective therapies that can relieve pain, improve dexterity, and delay advanced complications, such as joint damage.

Doctors often rely on drugs to reduce the painful and destructive joint inflammation with ankylosing spondylitis. These include nonsteroidal anti-inflammatory drugs, known as NSAIDs, and TNF, or tumor necrosis factor, blockers. TNF blockers are part of class of medications called biologics that suppress aspects of the body’s inflammatory response and may slow the progression of ankylosing spondylitis.

Many patients also benefit from regular exercises with a physical therapist. Patients often find that stretching and rage-of-motion exercises, such as yoga or pilates, can help relieve pain, increase flexibility in joints, and improve physical strength.

Ankylosing spondylitis may be a lifelong condition, but it doesn’t have to be a life-limiting one.

Working closely with your doctor about latest treatments and making smart lifestyle choices can help keep painful symptoms at bay so you can live your life as you see fit.

To learn more about Ankylosing Spondylitis, take a look at the information we have here at Healthline or make an appointment with your doctor.

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.

Risk Factors

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.

Early Symptoms

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.

Diagnosis

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.