Ankylosing spondylitis is a long-term disease that causes inflammation of the joints between the spinal bones, and the joints between the spine and pelvis. It eventually causes the affected spinal bones to join together.
See also: Arthritis
The cause of ankylosing spondylitis is unknown, but genes seem to play a role.
The disease most often begins between ages 20 and 40, but may begin before age 10. It affects more males than females. Risk factors include:
The disease starts with low back pain that comes and goes.
You may lose motion or mobility in the lower spine. You may not be able to fully expand your chest because the joints between the ribs are involved.
Fatigue is also a common symptom.
Other, less common symptoms include:
Tests may include:
Your doctor may prescribe nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation and pain.
Corticosteroid therapy or medications to suppress the immune system may also be prescribed. Drugs called TNF-inhibitors (etanercept, adalimumab, infliximab), which block an inflammatory protein, have been shown to improve the symptoms of ankylosing spondylitis.
Some health care professionals use drugs that block cell growth (cytotoxic drugs) in people who do not respond well to corticosteroids or who are dependent on high doses of corticosteroids.
Surgery may be done if pain or joint damage is severe.
Exercises can help improve posture and breathing. Lying flat on the back at night can help maintain normal posture.
The course of the disease is unpredictable. Symptoms may come and go at any time. Most people are able to function unless the hips are severely involved.
Rarely, people may have problems with the aortic heart valve (aortic insufficiency) and heart rhythm problems.
Call your health care provider if:
Prevention is unknown. Awareness of risk factors may allow early detection and treatment.
Rheumatoid spondylitis; Spondylitis; Spondylarthropathy
Goldman L, Ausiello DA. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007.
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.
Dagfinrud H, Kvien TK, Hagen KB. Physiotherapy interventions for ankylosing spondylitis. Cochrane Database, Syst Rev. 2008. (1):CD002822.
Reviewed by: Neil J. Gonter, MD, Assistant Professor of Medicine, Columbia University, NY and private practice specializing in Rheumatology at Rheumatology Associates of North Jersey, Teaneck, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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