Ankylosing Spondylitis
What is ankylosing spondylitis?
Ankylosing spondylitis (AS) is a condition where your spine becomes inflamed and stiffened so that walking and moving around is difficult and painful. Your spine loses its normal shape and may cause you to become bent forward and you may find straightening your back difficult. Joints such as your hips and knees and less commonly your chest, eyes and heart may be affected.
Who gets ankylosing spondylitis?
About 1 in 100 people in the UK develop AS and it is most common in young men. Women can also be affected. AS often improves as you get older.
What causes ankylosing spondylitis?
The cause is not known but some people have an inherited blood type that makes it more likely that they will get the condition. Certain circumstances, such as bowel infections, may cause AS to develop in people with this inherited blood type.
What are the symptoms of ankylosing spondylitis?
As usually starts with an ache in your buttocks, the back of your thighs and your lower back and can last for weeks or months at a time. Some people with AS feel generally unwell, with fever and night sweats, and may lose weight.
The pain and stiffness in your back is worse after resting and improves with exercise. So, the stiffness is at its worst when you wake in the morning and wears off
during the day. There is also more pain and stiffness after long periods of sitting, for example after a long car journey.
Some people will occasionally have chest pain where the ribs join the spine or the breastbone. This can make it painful to move your chest when you exercise or even when you breathe.
About 1 in 3 people with AS will get an inflamed, painful and red eye (acute iritis) which can make it difficult to see for a short while.
Some patients with AS are more likely to develop other medical conditions including psoriasis (a skin disease), bowel problems and in rare cases, heart problems.
Will I need any tests?
Your doctor will ask you about your symptoms and may examine your back, some of your joints and listen to your heart. Blood tests can confirm the inflammation in your spine and joints. You are likely to need an X-ray of your
Can ankylosing spondylitis be treated?
Back and breathing exercises can be suggested by a physiotherapist to help keep your spine and joints mobile. Staying active and exercising regularly are a vital part of keeping this condition under control. Your doctor may suggest you see a physiotherapist.
Anti-inflammatory medicines prescribed by your doctor can treat the inflammation and will help relieve the pain and stiffness. They may need to be given in quite high doses to be effective and some of these can cause indigestion or other problems. Any problems should be reported immediately to your doctor.
Surgery and X-ray treatment are occasionally needed in serious cases.
If you develop a painful red eye, see your doctor urgently. You may need a course of eye drops and probably assessment by a hospital specialist to treat the problem.
What is the long-term outlook for this condition?
The outlook is generally good. Nearly 90 per cent of patients are able to continue working full-time and only 1 in 20 develop severe spinal problems.
- Exercising when you get out of bed can reduce early morning stiffness.
- Protect your spine and joints from injury. Even a simple fall may cause a fracture. Loose flooring or poor lighting may be dangerous.
- Take up a non-contact sport such as swimming or yoga to keep your back and joints supple.
- Breathing exercises may reduce pain in your chest.
- Acupuncture or massage may ease neck pain but you should avoid neck manipulation.
- A firm bed and well-designed chairs may reduce pain in your hips.
- To help prevent pain and bleeding, do not take antiinflammatory medicines on an empty stomach.
- Special shoe insoles may ease pain in your feet.
Further information:
Arthritis Research Campaign |
National Ankylosing Spondylitis Society |