Ankylosing spondylitis | Better Health Channel
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Summary

Ankylosing spondylitis (AS) is a type of inflammatory arthritis that targets the joints of the spine, particularly the sacroiliac (SI) joint where the spine attaches to the pelvis. Symptoms include back pain, stiffness and reduced mobility.

Ankylosing spondylitis (AS) is a type of inflammatory arthritis that targets the joints of the spine. It particularly affects the sacroiliac (SI) joint where the spine attaches to the pelvis. Other joints, such as the hip and shoulders, can also be affected. The eyes, skin, bowel and lungs may also be involved. Symptoms include back pain, stiffness and reduced mobility in the spine.

Ankylosing spondylitis affects men more often than women. The condition usually appears between the ages of 15 and 45 years. There is no cure for AS, however there are strategies to help control the symptoms of the condition.

The effects of ankylosing spondylitis


Inflammation occurs as part of the disease. New bone may grow around the joints in the spine in response to the inflammation. This leads to permanent stiffness in the back and neck of some people with AS. In severe cases, this extra bone can fuse the bones of the spine together. This used to be common, but now can usually be presented by starting proper treatment as early as possible.

Most cases of AS can be well controlled, and people with AS can lead full and active lives. There are times when symptoms may become worse (known as a flare) and times when the symptoms become better. It is important that you learn about your condition and play an active role in the management of your AS.

Causes of ankylosing spondylitis


The exact cause of ankylosing spondylitis is unknown, but genes are thought to play a part. You are more likely to get AS if you have a history of it in your family. Studies show that almost nine out of ten people with AS have the gene called HLA-B27. However, this gene is present in eight per cent of the general population, including people without AS.

Since the presence of this gene does not automatically lead to the development of AS, other factors are thought to be involved. It is currently thought that exposure to certain environmental triggers can lead to the development of AS in people with a genetic susceptibility. These triggers, however, are unknown.

Symptoms of ankylosing spondylitis


The symptoms of AS vary from one person to the next, but they are usually worse after rest and relieved with exercise. The most common symptoms are:
  • Pain and stiffness in the back, buttocks or neck
  • Pain in tendons (which connect muscles to bones) and ligaments (which connect bones to each other), often felt as pain at the front of the chest, back of the heel or underneath the foot.

Diagnosis of ankylosing spondylitis


Early diagnosis is important so that treatment can be commenced to prevent damage to the spine.

Tests used to diagnose AS may include:
  • Medical history
  • Physical examination
  • X-ray
  • Scanning procedures such as CT or MRI
  • Blood test
  • Genetic testing.
These tests are generally organised by a rheumatologist or doctor who can explain the results.

Treatment for ankylosing spondylitis


There is no cure for ankylosing spondylitis. Medical treatment aims to manage pain, reduce the risk of complications and improve quality of life. Treatment will be tailored to your specific symptoms and the severity of your condition.

Medications


Medication options include:
  • Non-steroidal anti-inflammatory medications (NSAIDs)
  • Disease-modifying anti-rheumatic drugs (DMARDs)
  • Biologic DMARDs – new drugs that work by targeting certain proteins that are overproduced, causing inflammation and damage to bones, cartilage and tissue
  • Corticosteroid medications
  • Analgesics (pain relief medication).

Exercise


Although exercise is important for general wellbeing, it is especially important in managing AS. Exercise can be used to relieve pain, but is also important in maintaining mobility in the spine.

Specific strengthening exercises should be performed to maintain strength through the spine. Exercises performed in warm water (hydrotherapy) can also be beneficial.

For overall wellbeing, general strengthening and aerobic exercises should also be performed. If you have AS, you may benefit from seeing a health professional to get an exercise program prescribed for your specific needs. Consider seeing a physiotherapist or exercise physiologist who specialises in the treatment of AS.

Peer support groups


Dealing with a chronic condition like ankylosing spondylitis can be isolating. Being able to speak with others who understand your condition can be a great relief. Contact Arthritis Victoria for details of the Ankylosing Spondylitis Group of Victoria.

Where to get help

Things to remember

  • Ankylosing spondylitis (AS) is a type of inflammatory arthritis that targets the joints of the spine, particularly the sacroiliac (SI) joint where the spine attaches to the pelvis.
  • There is no cure for AS – medical treatment aims to manage pain, reduce the risk of complications and improve quality of life.
  • The most important management tool is regular exercise (including stretching), which helps to keep the spine mobile and flexible.
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This page has been produced in consultation with and approved by:

Arthritis Victoria

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Arthritis Victoria

Last reviewed: August 2011

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Ankylosing spondylitis (AS) is a type of inflammatory arthritis that targets the joints of the spine, particularly the sacroiliac (SI) joint where the spine attaches to the pelvis. Symptoms include back pain, stiffness and reduced mobility.

Content on this website is provided for education and information purposes only. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your qualified health professional. Content has been prepared for Victorian residence and wider Australian audiences, and was accurate at the time of publication. Readers should note that over time currency and completeness of the information may change. All users are urged to always seek advice from a qualified health care professional for diagnosis and answers to their medical questions.

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