Ankylosing Spondylitis: Symptoms and Treatment

As a rare type of arthritis, ankylosing spondylitis (AS) causes stiffness and pain in the spine. Some people also use the term Bechterew disease to describe AS. The condition typically starts in the lower back and can spread upward toward the neck. It can also cause joint damage in other parts of the body. AS primarily strikes males in their late teens or early 20s, although it can affect females and people outside of that age range as well. AS tends to be milder in women, which can make it more challenging to receive an accurate diagnosis.

Understanding Ankylosing Spondylitis

In addition to stiffness and pain, AS can cause loss of mobility as the condition progresses. When you have this condition, the bones in your spine slowly deteriorate and increased bone formation can occur. That can cause some of the bones within the spine to fuse together. People with advanced cases of AS can suffer from spinal deformity. AS primarily affects the area of the lower spine that connects to the hips. These are called the sacroiliac joints.

Other AS Symptoms

The stiffness, pain, and inflammation associated with AS is often worse when waking in the morning or after sitting in one position for a long time. Other symptoms you might notice include:

  • Fatigue
  • Inability to take deep breaths
  • Joint Swelling
  • Spine curves forward in a rigid manner

Besides your spine, lower back, and hips, you could also feel discomfort in these areas:

  • Buttocks
  • Feet
  • Hands
  • Heels
  • Neck
  • Rib cage
  • Shin bone in lower leg
  • Shoulders
  • Thighs

AS affects each person differently. Your symptoms may come on slowly or quickly and you may not experience each one listed here. The severity of symptoms can also vary from day to day.

Causes and Complications of AS

Age and gender appear to be the largest factors that influence whether a person develops AS, although medical researchers do not understand the reason why. One theory is that people with AS may have a gene called HLA-B27 that could contribute to development of this disease by offsetting our immune system.

AS affects men at a disproportionate rate, striking them earlier in life and causing more severe symptoms. Women who develop the health condition often have a milder form of it called non-radiographic axial spondyloarthritis. More than 80 percent of people with AS receive a diagnosis by age 30 and 95 percent by age 45.

Diagnosing AS

We urge you to schedule an appointment with UHC Rheumatology right away if you recognize any of the symptoms above. Your doctor will conduct a thorough exam and ask detailed questions about your medical history. The biggest thing rheumatologists look for is inflammation present with certain features. These include:

  • Gradually worsening back pain that starts before age 40 and is not attributable to another cause like an injury.
  • Pain does not improve with rest.
  • Pain interrupts sleep and makes it difficult to consistently get good quality of sleep.
  • Stiff spine upon waking up in the morning that improves with motion and exercise.
  • Symptoms last three months or longer with little relief.

UHC Rheumatologists may also order an imaging test such as a CT scan, MRI, or X-ray. Blood tests are not useful for diagnosing AS, but they can help your provider rule out other causes of your present symptoms.

Treating AS

Although it may be difficult when you are struggling with pain from AS, staying physically active is one of the most important things you can do. Standing and moving frequently helps your spine remain straighter and keeps it as limber as possible. Your rheumatologist may recommend that you start physical therapy to learn how to keep your spine stable and stretch your muscles. You will learn additional techniques to decrease your pain as well.

Medication such as prescription non-steroidal anti-inflammatory drugs (NSAID) or biologics for severe cases of AS can help. However, you and your rheumatologist need to weigh the benefits carefully against the potential side effects as they can be serious. Heart problems and bleeding in the stomach have been reported with prescription NSAIDs while people taking biologics have reported serious infections.

Home remedies and lifestyle changes can also improve your AS symptoms. Smoking, for example, has been proven to make AS symptoms worse. If you smoke, the best thing you can do is quit now. Other things you can do include:

  • Commit to exercising every day, even if you can only tolerate a few minutes at a time. If you are physically able, swimming and water aerobics can be especially beneficial in reducing your pain and inflammation.
  • Maintain a healthy weight to avoid putting excess pressure on your joints. A diet that regularly includes omega-3 fatty acids can help your symptoms and make it easier to lose weight if you are currently overweight or obese.
  • Manage the stress in your life the best you can since chronic stress can worsen your symptoms. Counseling, yoga, meditation, or massage are some things you can consider if you are struggling.
  • Use a heating pad for stiff muscles and joints.

Request an Appointment with UHC Rheumatology Today

Untreated AS can make your daily life challenging at best or immobilize you at worst. The experienced and dedicated rheumatologists at UHC are here to help. We invite you to contact us at 681-342-3490 to schedule an initial diagnostic appointment.

Please note, the information provided throughout this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and video, on or available through this website is for general information purposes only. If you are experiencing related symptoms, please visit your doctor or call 9-1-1 in an emergency.