The cause of ankylosing spondylitis is currently unknown.
The disorder does tend to run in families, so genetics probably play a role. If your parents or siblings have ankylosing spondylitis, research estimates you’re 10 to 20 times more likely to have it than someone with no family history.
A family history of ankylosing spondylitis is a risk factor, along with the presence of the HLA-B27 protein. According to a 2002 study, more than 90 percent of people who receive a diagnosis of this condition have the gene that expresses this protein.
Unlike other arthritic and rheumatic disorders, initial symptoms of ankylosing spondylitis often appear in younger adults. Symptoms often appear between ages 20 and 40.
Ankylosing spondylitis is around three times more common in males but is seen in females as well.
This condition is more common in people of Caucasian descent than those of African descent or other ethnicities.
The symptoms of ankylosing spondylitis vary. It’s often characterized by mild to moderate flare-ups of inflammation that alternate with periods of almost no symptoms.
The most common symptom is back pain in the morning and at night. You may also experience pain in the large joints, such as the hips and shoulders. Other symptoms may include:
Because ankylosing spondylitis involves inflammation, other parts of your body can be affected as well. People with ankylosing spondylitis may also experience:
While ankylosing spondylitis is primarily a condition of the spine, it can impact other parts of the body, too.
A rheumatologist is often consulted to help diagnose ankylosing spondylitis. This is a doctor who specializes in arthritis.
The first step will be a thorough physical exam. Your doctor will ask you for details about your pain and your history of symptoms.
Your doctor will then use an X-ray to check for erosion on your spine and any painful joints. Erosion may not be detected if the disease is in its early stages. An MRI study may also be done. However, MRI results are often difficult to interpret.
A blood test called an erythrocyte sedimentation rate may be done to gauge the presence of any inflammation. A blood test for the protein HLA-B27 may be done. However, the HLA-B27 test doesn’t mean that you have ankylosing spondylitis. It only that you have the gene that produces this protein.
Diagnosing this type of arthritis can take some time.
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, are often used to help manage pain and inflammation. They’re long-acting drugs and are generally safe with few complications.
When NSAIDs no longer provide enough relief, your doctor may prescribe stronger medications. Corticosteroids are commonly prescribed for the short term. This medication is a powerful inflammation fighter, so it can ease symptoms and slow damage to and around the spine.
Tumor necrosis factor (TNF) inhibitors are drugs that can block inflammation triggers in your body. These drugs act to prevent inflammation, and they may ease joint pain and stiffness. TNF inhibitors are typically used after the condition has progressed and NSAIDs are no longer effective.
Lastly, in severe cases, your doctor may prescribe disease-modifying antirheumatic drugs (DMARDs). These drugs work to slow the process of the disease in the body in order to prevent worsening symptoms.
If you have severe damage or deformity to your knee or hip joints, a joint replacement surgery may be necessary. Likewise, an osteotomy may be performed on people with poor posture caused by fused bones. During this procedure, a surgeon will cut and realign the bones in the spine.
Treatment relies largely on how severe the condition is and how troublesome the symptoms are.
In addition to more traditional medical treatments, some natural remedies may help ease symptoms of ankylosing spondylitis. These treatments may be used alone. They may also be combined with other treatments. Talk with your doctor about which ones are safe to use together and best for you.
Range-of-motion exercises, as well as strength training exercises, may help ease the symptoms of ankylosing spondylitis. Both these exercises can strengthen joints and help them be more flexible. Your doctor may refer you to a physical therapist so you can learn how to do these exercises correctly and safely.
Stretching can make your joints more flexible and improve strength. This can lead to less pain and better range of motion in your joints.
Stiffness in the spine may encourage bad posture. Over time, bones in the spine can fuse together in slouching or slumping positions. You can reduce the risk for this by practicing good posture.
Because this may not come naturally after years of poor posture positions, you may need to encourage better posture with reminders to correct your posture regularly. You can also use support devices, such as chairs or seat cushions.
Heat and cold therapy
Heating pads or a warm shower can help ease pain and stiffness in the spine and other affected joints. Ice packs can reduce inflammation in painful or swollen joints.
This alternative treatment may reduce pain and other symptoms of ankylosing spondylitis. It does so by activating natural pain-relieving hormones.
In addition to being relaxing and invigorating, massage can help you maintain flexibility and improve range of motion. Be sure to tell your massage therapist that you have ankylosing spondylitis. They can be aware for tender points around your spine.
There’s no one-size-fits-all diet for ankylosing spondylitis. A healthy diet that provides plenty of vitamins and minerals through a wide variety of foods is a great place to start. Be sure to include:
Cut down or eliminate foods that are rich in fat, sugar, and sodium. This includes highly processed foods. Boxed, bagged, or canned foods often contain ingredients like preservatives and trans fats. These can make inflammation worse.
Likewise, limit how much alcohol you drink, or avoid it altogether. Alcohol can interfere with medications and may make symptoms worse.
Other foods and supplements may make symptoms of ankylosing spondylitis better or worse.
Daily exercise and posture practice is encouraged to help you maintain flexibility and range of motion. Each of these exercises may help reduce symptoms of ankylosing spondylitis:
It’s not known how you can prevent ankylosing spondylitis, because no one knows what causes it in the first place. However, if you have the disease, you can focus on preventing disability by:
These healthy lifestyle approaches, as well as traditional treatments, may help delay or slow the progression of the disease.