Overview of Lumbar Spondylitis

Ankylosing spondylitis is a type of arthritis that can cause long-term back pain.

It most commonly affects the lower spine. When it affects your lower back, it’s sometimes referred to as lumbar spondylitis. This term can also refer to any degenerative changes in your lower spine, such as those caused by osteoarthritis.

In this article, we use the term specifically to refer to ankylosing spondylitis of the lower spine.

Lumbar spondylitis can lead to a limited range of motion in your back. It can also cause problems with other joints, such as your ribs, shoulders, or hips. Symptoms typically develop in early adulthood, but they can also develop in teens or children.

Read on to learn everything you need to know about lumbar spondylitis.

Lumbar spondylitis symptoms can vary between people. They tend to onset slowly over months to years.

The main symptoms are lower back pain and stiffness. Your upper back or neck may also be affected as the condition progresses.

Your pain may:

• get better with exercise but stay the same or get worse with rest
• be worse in the morning and evening
• wake you up at night
• be felt around your buttocks
• improve with warmth, such as in a warm shower

Pain can range from mild to debilitating. Symptoms tend to flare up and then go through periods where they’re reduced or disappear completely.

Other symptoms

Other potential symptoms include:

• pain, stiffness, and warmth in joints, such as the:
  • ribs, which may cause problems with deep breathing
  • shoulders
  • knees
  • hips
• enthesitis, pain where a bone connects to a tendon
• abdominal pain and diarrhea
• loss of appetite
• weight loss
• fatigue
• uveitis, which can cause:
  • vision changes
  • eye pain
  • light sensitivity

Learn more about ankylosing spondylitis symptoms.

Researchers do not fully understand why some people develop ankylosing spondylitis. It’s thought that genetic and environmental factors both play a role.

People who have the HLA-B27 gene seem to be at an increased risk. More than 90% of people with lumbar spondylitis have this gene. However, most people with this gene never develop lumbar spondylosis.

Other risk factors for lumbar spondylitis include:

• family history
• age, with most people developing symptoms before age 45
• having Crohn’s disease
• being assigned male at birth, occurring about two times more often in males (however, it’s believed that AS has been under-recognized and under-diagnosed in biological females)

Learn more about ankylosis spondylitis risk factors.

Lumbar spondylitis can compress your spinal cord and lead to neurological symptoms like chronic lower back or leg:

• pain
• numbness
• tingling
• weakness

In rare cases, it can also cause loss of bowel control or loss of bladder control.

Other complications can include:

• reduced joint mobility
• increased fracture risk
• increased risk of cardiovascular disease

Lumbar spondylitis does not have a cure, but a combination of natural remedies, medications, and sometimes surgery can help you slow its progress.

Natural remedies and lifestyle modifications

Natural remedies or lifestyle modifications that may help you manage your symptoms include:

• physical theory, which may include:
  • posture exercises
  • strengthening exercises
  • stretches and mobility work
  • massage
• exercising regularly
• focusing on having good posture
• using assistive devices like walkers or canes
• minimizing your stress levels
• eating a nutritious, balanced diet that includes foods like fruits, vegetables, whole grains, and lean protein
• quitting smoking (this can be difficult, but a doctor can build a cessation plan that works for you) or not starting

Learn more about natural remedies for ankylosing spondylitis.

Medications

A doctor may recommend or prescribe the following types of medications:

• nonsteroidal anti-inflammatory drugs like ibuprofen or celecoxib
• biologic medications like TNF inhibitors to modify immune system activity
• janus kinase inhibitors if your condition does not respond to other treatments
• corticosteroids to decrease inflammation and help with pain (these are used sparingly due to their cumulative side effects)

Surgery

Because of potential complications, surgery is performed infrequently. Your doctor may recommend surgery if you have trouble with daily activities or neurological complications. Some of the most commonly performed surgeries include:

• Laminectomy: A laminectomy involves removing a part of the vertebra called the lamina to decompress your spine.
• Spinal osteotomy: A spinal osteotomy is a procedure that’s used to correct structural abnormalities in your spine.
• Spinal fusion: Spinal fusion is a procedure where two or more of your vertebrae are permanently fused together.
• Hip joint replacement: A hip joint replacement involves replacing the ball, socket, or ball and socket of your hip joint with an artificial replacement.

Learn more about ankylosing spondylitis surgery.

It’s a good idea to contact your primary healthcare professional if you have persistent symptoms that may be a sign of lumbar spondylitis. If your doctor suspects ankylosing spondylitis, they may refer you to a doctor called a rheumatologist who specializes in joints for further evaluation.

It’s also a good idea to visit your doctor if you’ve previously been diagnosed with ankylosing spondylitis and you notice a change in your symptoms.

Lumbar spondylitis can be difficult to diagnose. Doctors will typically consider your personal and family medical history, conduct tests, and order a number of tests to help them make a diagnosis, including:

• performing a physical exam, which might include:
  • examining your joints
  • watching your movement
  • checking for rib stiffness by having you breathe deeply
• blood tests to check for inflammation and to see if you have the HLA-B27 gene
• imaging, such as:
  • X-rays
  • magnetic resonance imaging (MRI)
  • ultrasound

You may receive an ankylosing spondylitis diagnosis if you have inflammation in the joints between your lower back and pelvis and at least one of the following symptoms:

• lower back pain that improves with exercise and gets worse with rest
• limited movement in your lower back
• limited ability to expend your chest compared to what would be expected for your age and sex

Lumbar spondylitis generally has a good outlook. There’s no cure and symptoms tend to progress, but in most instances, the condition responds to conservative treatment. Your doctor may recommend surgery if you have neurological complications.

Receiving an early diagnosis can potentially help limit damage to your joints and improve your outlook.

Ankylosing spondylitis is sometimes referred to as lumbar spondylitis when it affects your lower spine. It’s a type of arthritis that can lead to spinal pain and loss of mobility.

Lumbar spondylitis does not have a cure, but most people can manage their symptoms with conservative treatments.

Your doctor may recommend surgery if you develop neurological or other disabling complications.