Ankylosing spondylitis (AS) is a long-term condition that causes inflammation of the spine. It is also known as ‘axial Spondyloarthritis’ (axSpA). Over time, this inflammation can cause the spinal bones to fuse, leading to stiffness and, in some cases, a…

📋 Overview

What is ankylosing spondylitis?

Ankylosing spondylitis (AS) is a long-term condition that causes inflammation of the spine. It is also known as ‘axial Spondyloarthritis’ (axSpA). Over time, this inflammation can cause the spinal bones to fuse, leading to stiffness and, in some cases, a hunched posture.

Why is it important?

Without treatment, AS can lead to:

• Progressive spinal stiffness and loss of flexibility
• Fusion of spinal bones and poor posture
• Difficulty expanding the chest while breathing
• Inflammation affecting the eyes and other joints

Early diagnosis and treatment can reduce pain, maintain flexibility and prevent long-term complications.

Who is commonly affected?

• Usually starts before age 40, often in the 20s–30s
• More common in men
• Affects about 0.2%–0.5% of people
• Often runs in families due to genetic factors

⚡Causes—Why It Happens

Underlying causes and risk factors

The exact cause of AS is not fully understood. Both genes and environmental factors may play a role. Key risk factors include:

• Presence of the human leukocyte antigen B27 (HLA-B27) gene (though not everyone with this gene develops AS)
• Family history of AS
• Younger age
• Conditions such as psoriasis or inflammatory bowel disease

Lifestyle contributors

Lifestyle habits may worsen AS symptoms and affect mobility.

🔍 Signs & Symptoms

Common symptoms

🚩 Warning Signs

Seek medical review if:

• Back pain starts before 45 years of age
• Symptoms persist for more than 3 months
• Morning stiffness lasts more than 30 minutes
• Pain or stiffness improves with movement but returns after rest

🏥 Diagnosis & Investigations

Clinical evaluation

The diagnosis is based on the combination of medical history, physical examination, imaging and blood tests. A healthcare professional will assess:

• The pattern and duration of back pain
• Morning stiffness and whether it improves with movement
• Family history of AS or related inflammatory conditions
• Associated symptoms such as eye problems or heel pain

🧪 Tests

Investigations may include:

• Blood tests such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) to check for inflammation
• HLA-B27 genetic test
• X-rays of the spine and sacroiliac joints
• Magnetic resonance imaging (MRI) scans to detect early inflammation

What patients should expect Patients may require repeated examinations and imaging because early AS changes may not appear immediately on X-rays. MRI scans can help detect inflammation earlier.

💊 Treatment Options

Medications

Common treatments include:

• Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen
• Biologic medicines for moderate-to-severe conditions
• Other medicines recommended by the doctor
• Steroid injections for painful joints in some patients

Lifestyle changes

Non‑surgical management

Physiotherapy and daily stretching exercises help maintain flexibility and reduce stiffness. Low-impact activities such as swimming and hydrotherapy may improve mobility while reducing joint strain.

When is a procedure or surgery needed?

Surgery is rarely required in AS. It may be considered for:

• Severe hip joint damage requiring hip replacement surgery
• Severe spinal deformity or spinal complications affecting posture and movement

💡Myths & Facts

❓Frequently Asked Questions