Is Ankylosing Spondylitis Easy to Diagnose?

Pain and stiffness in the lower back and buttocks are characteristic symptoms of ankylosing spondylitis, which usually starts in late adolescence or early adulthood. 

In addition to pain and stiffness, early-stage ankylosing spondylitis symptoms may include: 

• General discomfort 
• Loss of appetite 
• Mild fever 

Other symptoms of ankylosing spondylitis may include: 

• Irritation of soft tissues (muscles, ligaments, tendons) where they enter the bones (enthesitis), most often in extremities
• Arthritis
• Fatigue
• Bowel inflammation
• Anemia 
• Eye inflammation (uveitis or iritis)
  • Blurred vision
  • Painful, watery, and red eyes
  • Sensitivity to bright light
• Stooped posture (advanced stage)

The cause of ankylosing spondylitis is unknown. A combination of genetic and environmental factors is believed to play a role.

Risk factors for ankylosing spondylitis include: 

• Family history of the condition
• Smoking 

In people who may have a genetic predisposition, triggers for ankylosing spondylitis may include: 

• Infections
• Heavy physical activity
• Work stress
• Emotional stress
• Pregnancy 

Treatment for ankylosing spondylitis usually involves a combination of exercise and physical therapy, healthy lifestyle changes, and medication. Surgery may be needed in severe cases. 

Physical therapy and exercise used to treat ankylosing spondylitis includes:

• Exercise
• Posture training to help prevent the spine from becoming “frozen” 

Lifestyle modifications to help manage ankylosing spondylitis include: 

• Safety measures to minimize accidents caused by limited mobility 
  • Modify the home to decrease the risk of falls
  • Wear seat belts in motor vehicles
  • Sleep on a thin pillow to help avoid developing deformities of the neck
  • Avoid contact sports and high-impact activities if the spine is inflexible
  • Limit alcohol
  • Avoid or limit the use of narcotics and sleeping pills 
• Eat a healthy diet with anti-inflammatory foods
• Don’t smoke
• Pace yourself and take breaks when needed
• Support groups 

Medications used to treat ankylosing spondylitis include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain and stiffness
• Biologics may be used if NSAIDs don’t work well
• Sulfasalazine (a DMARD) and methotrexate for arthritis symptom relief
• Corticosteroid injections for swollen, painful joints 
• Opioids (narcotics) to treat pain

Surgery is rarely used to treat ankylosing spondylitis and most patients will not require surgical intervention. When surgery is needed, it may include:

• Joint replacement to help with severe pain or joint damage 
• Fracture stabilization 
• Spinal surgery