What is ankylosing spondylitis?

Ankylosing spondylitis (AS) is a kind of arthritis that mainly affects the joints and ligaments of your spine (back bone). ‘Ankylosing’ means stiff and ‘spondylo’ means vertebra.

It can also affect other large joints, like your hips and shoulders. Ankylosing spondylitis can also cause problems in your:

• eyes
• skin
• bowel
• lungs

Ankylosing spondylitis symptoms usually begin before the age of 40 years.

What are the symptoms of ankylosing spondylitis?

The symptoms of ankylosing spondylitis tend to come and go. The symptoms can also vary in severity between people.

The more common symptoms involve pain and stiffness in your spine. The inflammation usually starts in the sacroiliac joints (where your pelvis meets your spine).

Symptoms may include:

• stiffness in your back, neck or buttocks, which may be worse in bed at night
• other joint pain
• pain in tendons and ligaments, such as in your chest wall, soles of your feet, or heels

Typically, ankylosing spondylitis symptoms:

• last for longer than 3 months
• include morning stiffness and night pain
• improve with physical activity — and don’t improve with rest

What causes ankylosing spondylitis?

The cause of ankylosing spondylitis is not yet fully understood.

But doctors believe that genetics may play a role, because ankylosing spondylitis tends to run in families. Also, 9 out of 10 people with ankylosing spondylitis have the same gene, called human leucocyte antigen B27 (HLA-B27).

When should I see my doctor?

If you have lower back pain or other signs that could be ankylosing spondylitis, you should see a doctor. They can help you get a diagnosis and start treatment.

How is ankylosing spondylitis diagnosed?

Your doctor will talk to you and examine you. They may arrange for you to:

• have an x-ray
• have blood tests to look for inflammation markers
• see a rheumatologist (doctor who specialises in bone, joint and muscle problems)

How is ankylosing spondylitis treated?

At the moment, there’s no cure for ankylosing spondylitis, so treatment aims to improve your quality of life. This includes:

• controlling the inflammation
• managing your symptoms — such as pain and stiffness
• improving your physical functioning — so you can take part in social and work activities
• stopping progressive damage to your bones
• lowering your chance of complications

Your doctor will recommend you:

• stop smoking (if you smoke)
• exercise
• use non-steroidal anti-inflammatory drugs (NSAIDs) to help with pain

If you have ankylosing spondylitis, your doctor may suggest that you see a physiotherapist. They will suggest different types of exercise to:

• strengthen your back
• encourage movement in the spine
• reduce pain

Your specialist doctor may also give you other types of medicines to manage the inflammation, pain and stiffness. These can include:

• corticosteroid injections
• so-called ‘biological disease-modifying anti-rheumatic drugs’ (bDMARDs)

Can ankylosing spondylitis be prevented?

As we don’t know exactly what causes ankylosing spondylitis, you can’t stop it occurring.

There are many treatments that can help you manage your ankylosing spondylitis symptoms.

Complications of ankylosing spondylitis

Up to 3 in 10 people with ankylosing spondylitis get acute uveitis (inflammation of the eye). If this happens, your doctor will refer you to an ophthalmologist (specialist eye doctor).

If you develop a painful watery eye, you should see a doctor immediately.

Other complications are:

• poor balance
• reduced mobility
• osteoporosis
• heart complications

Over time, you may also develop an abnormal posture.

Resources and support

Arthritis Australia has more information on ankylosing spondylitis or you can call their Arthritis Information Line on 1800 011 041.

Arthritis Australia also have a practical guide to living with ankylosing spondylitis — Taking Control of Your Ankylosing Spondylitis.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.