Ankylosing spondylitis (AS) is a chronic, inflammatory disease of the axial spine that can manifest with various clinical signs and symptoms. Chronic back pain and progressive spinal stiffness are the most common features of the disease.
Whether it's through physical therapy or on your own, dedicating time to stretching is key. “We recommend making sure that you maintain your flexibility,” says Dr. Elghawy. “And so doing with physical therapy or flexibility exercises on your own for your low back can provide a lot of relief.”
Early symptoms of ankylosing spondylitis might include back pain and stiffness in the lower back and hips, especially in the morning and after periods of inactivity. Neck pain and fatigue also are common. Over time, symptoms might worsen, improve or stop at irregular intervals.
"Fatigue from inflammation in ankylosing spondylitis can feel like you have the flu. You can ache all over," says Rochelle Rosian, MD, the director of regional rheumatology at the Cleveland Clinic in Ohio. “That's because inflammation affects your whole body, not just your joints.”
Some foods can trigger ankylosing spondylitis, so it's important to avoid certain foods to prevent inflammation. These include foods that are high in fat, salt, and sugar; processed foods, dairy products, alcohol, caffeine, artificial sweeteners, and others.
Ankylosing spondylitis may affect more than the spine. The disease may inflame joints in the pelvis, shoulders, hips and knees, and between the spine and ribs.
The hallmark feature of ankylosing spondylitis is the involvement of the sacroiliac (SI) joints during the progression of the disease. The SI joints are located at the base of the spine, where the spine joins the pelvis. More information on ankylosis and iritis can be found in the Complications section.
At this time, no single test diagnoses ankylosing spondylitis. Your doctor may order a blood test to check for the HLA-B27 gene, which is present in most people with the disease. You may have the HLA-B27 gene and never develop ankylosing spondylitis, but it can give doctors more information when making a diagnosis.
The inflammation usually is felt at the sites where ligaments and tendons attach to the bone. These sites are tender to touch and sometimes called “hot spots.” The heel and the back of the foot are common sites for tender spots, which can cause difficulty in standing and walking.
Many people with ankylosing spondylitis have mild episodes of back pain and stiffness that come and go. But others have severe, ongoing pain with loss of flexibility in the spine. In addition, other symptoms may develop depending on which other areas of the body are affected by the disease.
Sleep on your back to ease ankylosing spondylitis symptoms
Many people find relief from their ankylosing spondylitis symptoms by sleeping on their back. I tell my patients that the key to sleeping in this position is to maintain the natural curvature of their spine.
Don't do movements that cause pain
Carefully consider high-impact exercises, such as running, or jarring and twisting sports, such as tennis, squash, and racquetball. These could increase pain in the spine, hips, and knees.
Nonsteroidal anti-inflammatory drugs (NSAIDs) — such as naproxen sodium (Aleve) and ibuprofen (Advil, Motrin IB, others) — are the medicines health care providers most commonly use to treat axial spondyloarthritis and nonradiographic axial spondyloarthritis.
Ankylosing spondylitis is associated with changes in the gut microbiome and inflammation in the digestive system. People with ankylosing spondylitis are more likely to have digestive symptoms and even inflammation in their gut. They have higher rates of functional bowel disorders and inflammatory bowel diseases.
Causes of AS Flares
In a study on AS flares, patients reported “the main perceived triggers of flare were stress and 'overdoing it,'” Dr. Appleyard says. “Keep in mind 'stress' may mean both physical stress, such as an illness, or emotional stress. Excess fatigue may also trigger a flare.”
If you're still looking for answers to your AS symptoms, your doctor may talk with you about the latest treatment for ankylosing spondylitis, Janus kinase (JAK) inhibitors. JAK inhibitors earned the Food and Drug Administration's green light for ankylosing spondylitis in 2021.
"B27 disease" is a new autoimmune disease that afflicts millions of people throughout the world. "B27 disease" occurs in individuals who have ankylosing spondylitis (AS) or preankylosing spondylitis and/or uveitis and are also positive for HLA-B27.
Cervical spondylosis is a general term for age-related wear and tear affecting the spinal disks in your neck. As the disks dehydrate and shrink, signs of osteoarthritis develop, including bony projections along the edges of bones (bone spurs). Cervical spondylosis is very common and worsens with age.
Ankylosing spondylitis is a chronic inflammatory disease that often causes pain in your back, hips, and other joints. It can also affect your brain and your ability to perform normal functions. These changes can cause brain fog, memory loss, or brain lesions.
Ankylosing spondylitis (AS) is an inflammatory condition that primarily causes back pain from damage to the spinal joints. AS can spread to other joints too—most commonly, the hips. 1 However, it can also affect the knees and ankles, leading to leg pain.