Also known as: Ankylosing Spondylitis (Axial Spondyloarthritis)
Ankylosing spondylitis is a chronic inflammatory arthritis primarily affecting the spine, causing pain, stiffness, and potentially fusion of vertebrae over time.
Ankylosing spondylitis affects approximately 0.1-1.4% of the population, with a significant diagnostic delay averaging 7-10 years. It predominantly affects young men, with onset typically between ages 15-40.
The hallmark is inflammatory back pain — insidious onset, worse at night and morning, improving with activity. This distinguishes it from mechanical back pain which worsens with activity.
HLA-B27 is present in 90% of patients but also in 8% of the general population, so it is not diagnostic alone. Early treatment with biologics can prevent spinal fusion.
People with Ankylosing Spondylitis often experience the following symptoms.
Gradual onset, worse at rest and night, morning stiffness lasting 30+ minutes, improvement with exercise.
Inflammation where tendons and ligaments attach to bone — common at the Achilles tendon and plantar fascia.
Joint inflammation beyond the spine, commonly affecting hips, shoulders, and knees.
Anterior uveitis (eye inflammation) in 25-40%, inflammatory bowel disease, and psoriasis.
Certain factors may increase your likelihood of developing Ankylosing Spondylitis.
Common approaches to managing ankylosing spondylitis. Always consult a healthcare provider for personalized treatment.
First-line treatment. Continuous NSAIDs reduce inflammation and may slow radiographic progression.
Anti-TNF (adalimumab, infliximab) and IL-17 inhibitors (secukinumab) for NSAID-refractory disease.
Regular exercise is essential — it is as important as medication for maintaining mobility and posture.
Tofacitinib and upadacitinib for patients who fail biologics.
MRI of sacroiliac joints showing inflammation (active sacroiliitis) is the key imaging finding. X-rays show changes only in established disease. HLA-B27, CRP/ESR support diagnosis.
See a doctor if you have back pain lasting more than 3 months that is worse in the morning, improves with activity, and does not improve with rest.
Steps that may help reduce the risk of developing or worsening ankylosing spondylitis.
No prevention for the disease itself
Regular exercise maintains mobility
Early treatment prevents spinal fusion
Smoking cessation (smoking worsens outcomes)
If left untreated or poorly managed, ankylosing spondylitis may lead to:
HLA-B27 is inherited, but not everyone with the gene develops AS. Family history increases risk.
Absolutely. Regular exercise is one of the most important parts of treatment, maintaining flexibility and posture.
Not currently. But modern biologic treatments can achieve remission and prevent progression in many patients.
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.