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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Ankylosing spondylitis

Spondylitis; Spondyloarthropathy

Last reviewed: April 20, 2013.

Ankylosing spondylitis is a long-term type of arthritis. It most commonly affects the bones and joints at the base of the spine where it connects with the pelvis.

These joints become swollen and inflamed. Over time, the affected spinal bones join together.

Causes, incidence, and risk factors

The cause of ankylosing spondylitis is unknown. Genes seem to play a role.

The disease most often begins between ages 20 and 40, but it may begin before age 10. It affects more males than females.

 

Symptoms

The disease starts with low back pain that comes and goes. Low back pain is present most of the time as the condition progresses.

  • Pain and stiffness are worse at night, in the morning, or when you are less active. The discomfort may wake you from sleep.
  • The pain often gets better with activity or exercise.
  • Back pain may begin in the sacroiliac joints (between the pelvis and spine). Over time, it may involve all or part of the spine.
  • Your lower spine becomes less flexible. Over time, you may stand in a hunched forward position.

Other parts of your body that may be stiff and painful include:

Fatigue is also a common symptom.

Skeletal spine

Less common symptoms include:

  • Loss of appetite
  • Slight fever
  • Weight loss

Signs and tests

Tests may include:

Treatment

Your doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce swelling and pain.

  • Some NSAIDs can be bought over-the-counter (OTC), such as aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn).
  • Other NSAIDs are prescribed by your health care provider.
  • Talk to your health care provider or pharmacist before using any over-the-counter NSAID.

You may also need stronger medicines to control pain and swelling, such as:

Surgery may be done if pain or joint damage is severe.

Exercises can help improve posture and breathing. Lying flat on your back at night can help you keep a normal posture.

Expectations (prognosis)

The course of the disease is hard to predict. Symptoms may come and go at any time. Most people are able to function unless they have a lot of damage to the hips.

Rarely, people may have problems with:

Calling your health care provider

Call your health care provider if:

  • You have symptoms of ankylosing spondylitis
  • You have ankylosing spondylitis and develop new symptoms during treatment

References

  1. Yu D, Lories R, Inman RD. Pathogenesis of ankylosing spondylitis and reactive arthritis. In: Firestein GS, Budd RC, Gabriel SE, et al, eds. Kelley's Textbook of Rheumatology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 74.
  2. Inman RD. The spondyloarthropathies. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011: chap 273.
  3. Sidiropoulos PI, Hatemi G, Song IH, et al. Evidence-based recommendations for the management of ankylosing spondylitis: systematic literature search of the 3E Initiative in Rheumatology involving a broad panel of experts and practising rheumatologists. Rheumatology (Oxford). 2008. 47(3):355-61. [PubMed: 18276738]

Review Date: 4/20/2013.

Reviewed by: Gordon A. Starkebaum, MD, Professor of Medicine, Division of Rheumatology, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.

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Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • Physiotherapy for ankylosing spondylitisPhysiotherapy for ankylosing spondylitis
    To answer this question, scientists working with the Cochrane Musculoskeletal Group found and analyzed 11 studies testing over 700 people who had ankylosing spondylitis (AS). Studies compared people who did exercises at home, went to group exercise programs, went to spa or balneotherapy, performed different exercise programs or had no therapy at all. These studies provide the best evidence we have today.
See all (9) ...

Figures

  • Skeletal spine.
    Cervical spondylosis.

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