Ankylosing Spondylitis: What is it? What are the Signs and Symptoms?

Feb 14, 2023
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Do you or a loved one feel that you may have ankylosing spondylitis? Keep reading to learn more about the disease, its signs, and symptoms.

What is ankylosing spondylitis?

Ankylosing spondylitis is a rare chronic inflammatory disease that mainly affects the spine. It is a type of arthritis. The disease can cause some of the bones in the spine to fuse, which makes the spine less flexible. In some cases, ankylosing spondylitis may affect the ribs, making breathing difficult. It may spread to your neck or damage joints in other body parts. The disease is more common in men than in women.

What are the early signs of ankylosing spondylitis?

Early symptoms of ankylosing spondylitis usually begin before age 40. Some early signs and symptoms of ankylosing spondylitis are:

  • Chronic low back pain that gets better with exercise
  • Stiffness in lower back lasting at least 45 minutes in the morning
  • Pain and stiffness in hips 
  • Increased inflammation markers in bloodwork

What are the symptoms of ankylosing spondylitis?

Pain in the lower back or hips is the most common symptom of ankylosing spondylitis. Some people have persistent pain while others have milder symptoms. Symptoms tend to flare up and wane over time. Some symptoms which suggest you may have ankylosing spondylitis are:

  • Pain and stiffness in the lower back
  • Hip pain
  • Joint pain
  • Loss of appetite
  • Skin rash
  • Neck pain
  • Fatigue
  • Abdominal pain
  • Unexplained weight loss
  • Breathing difficulty 
  • Painful red eyes that’s sensitive to light

Is ankylosing spondylitis hereditary or dependent on lifestyle?

Both genetics and environmental factors play a role in causing ankylosing spondylitis. About 95% of people with ankylosing spondylitis have variations in a gene called HLA-B. Specifically, a mutated gene HLA-B27 increases the risk of disease in some people.  It is not clear how the HLA-B27 gene causes ankylosing spondylitis. Many people with HLA-B27 mutation do not develop the condition.

How is ankylosing spondylitis diagnosed by doctors?

There is no single test that can confirm ankylosing spondylitis. However, doctors rely on symptoms, physical examination, imaging tests, and blood tests to diagnose whether or not you have ankylosing spondylitis.

Your doctor may recommend X-ray, CT scan, or an MRI scan to examine your joints and bones for ankylosing spondylitis. MRI provides more detailed images of bones and soft tissues around the joints that help identify ankylosing spondylitis.

There are no specific blood tests that help to confirm ankylosing spondylitis. However, some inflammatory markers can be used to identify the disease. A blood test for the HLA-B27 gene can also be done, but it is not a confirmatory test for ankylosing spondylitis.

How is ankylosing spondylitis treated with medications?

There is no cure for ankylosing spondylitis. The main goal of treatment is to reduce symptoms and delay the progression of the disease. The following medications can be used in treating ankylosing spondylitis:

  • Non-steroidal anti-inflammatory drugs (NSAIDs) – These medications help reduce inflammation, pain, and stiffness. Some examples of NSAIDs include ibuprofen and naproxen.
  • Tumor necrosis factor (TNF) blockers – If NSAIDs are not helpful, your doctor may prescribe TNF blockers. These medications are injected under your skin or intravenously. Some examples of TNF blockers include infliximab, adalimumab, etanercept, and certolizumab.

Sometimes your doctor may prescribe you an interleukin-17 inhibitor to treat ankylosing spondylitis. Some examples include secukinumab and ixekizumab.

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