Ankylosing spondylitis (AS) is a long-term condition in which the spine and other areas of the body become inflamed. AS tends to first develop in teenagers and young adults. It's also around 2 times more common in men than in women. The symptoms of AS can vary, but usually
involve: These symptoms tend to develop gradually, usually over several months or
years, and may come and go over time. In some people the condition gets better with time, but for others it can get slowly worse. Read about symptoms of ankylosing spondylitis. You should see your GP if you have persistent symptoms of AS. If your GP thinks you may have the condition, they should refer you to a specialist in conditions affecting muscles and joints (rheumatologist) for further tests and any necessary treatment. Further tests may include blood tests and imaging tests. Read about diagnosing ankylosing spondylitis. It's not known what causes the condition, but there's thought to be a link with a particular gene known as HLA-B27. Read about the causes of ankylosing spondylitis. Treating ankylosing spondylitisThere's no cure for AS and it's not possible to reverse the damage caused by the condition. However, treatment is available to relieve the symptoms and help prevent or delay its progression. In most cases treatment involves a combination of:
Surgery is sometimes needed to repair significantly damaged joints or correct severe bends in the spine, but this is uncommon. Read about treating ankylosing spondylitis. Complications of ankylosing spondylitisThe outlook for AS is highly variable. For some people the condition improves after an initial period of inflammation, whereas for others it can get progressively worse over time. Some people with AS are able to remain fully independent or minimally disabled in the long-term. However, some people eventually become severely disabled as a result of the bones in their spine fusing in a fixed position and damage to other joints, such as the hips or knees. With modern treatments, AS does not normally affect life expectancy significantly, although the condition is associated with an increased risk of other potentially life-threatening problems. For example, AS can lead to:
Read about the complications of ankylosing spondylitis. Living with ASThe National Axial Spondyloarthritis Society (NASS) has information on living with ankylosing spondylitis, including advice on working, travelling and driving. Video: back stretchesIn this video, a physiotherapist shows some simple back stretches to help prevent aches and pains. Media last reviewed: 16 November 2020 The exercises in this video are suitable for most people. They are general exercises only and are not aimed at treating any specific cause of pain or condition. Get advice from a GP or health professional before trying it, especially if:
Stop the exercise immediately and get medical help if you feel any pain or feel unwell. Page last reviewed: 11 July 2019 Like most aspects of ankylosing spondylitis, an inflammatory type of arthritis that affects nearly half a million people in the United States, according to the Arthritis Foundation, the prognosis is complicated and can be hard to predict. Some people won’t have trouble with mobility and may even see their disease come to a standstill. But for others, this form of arthritis can progress to disability. The course of the disease is highly variable, says Eric Matteson, MD, professor emeritus of rheumatology at the Mayo Clinic in Rochester, Minnesota. “Some patients have inflammation limited to the sacroiliac joints, which doesn’t significantly impair their mobility,” he says. “Others have very extensive involvement of the spine.” Ankylosing spondylitis causes inflammation in the sacroiliac joints, where the spine joins with the pelvis, but in severe cases, the bones in the spine can fuse together and become very stiff, Dr. Matteson explains. One thing is true for all ankylosing spondylitis cases: Getting treated early is key. The right treatment can help slow the progression of the disease, Matteson says. Here’s how ankylosing spondylitis could play out and what you can do about it. Symptoms of Ankylosing SpondylitisAnkylosing spondylitis typically comes on at a young age, often between the ages of 17 and 45, according to the Spondylitis Association of America (SAA). Symptoms usually begin with dull back pain and stiffness that develop gradually over weeks or months, according to the SAA. A key sign of ankylosing spondylitis is pain and stiffness that’s worse in the morning or after resting but improves with exercise. And almost everyone with ankylosing spondylitis experiences flares, periods of time when pain gets worse, followed by remission, which is when symptoms subside. Fatigue can also be a symptom because the body uses energy to deal with inflammation, according to the SAA. And early on, ankylosing spondylitis may cause a fever and loss of appetite. Other than these factors, ankylosing spondylitis can vary widely from person to person. Some experience mild and sporadic pain, while others experience more severe pain that’s chronic. In some people, ankylosing spondylitis also affects other joints where ligaments or tendons attach to the bone, such as the hips, knees, feet, and shoulders. Ankylosing Spondylitis PrognosisThe long-term outlook for people with ankylosing spondylitis can also vary greatly. For some, pain may be intermittent while for others it’s chronic. In some cases, ankylosing spondylitis can be debilitating and lead to disability, according to the SAA. Over time, the inflammation associated with ankylosing spondylitis can cause the vertebrae of the spine to fuse together. In severe cases, when this happens, the spine can curve and cause a stooped position. This may also affect the ribs and make it difficult for the lungs to function properly. As ankylosing spondylitis progresses, inflammation may affect other joints, such as the hips and shoulders, and organs, such as the bowels and eyes. Some people with ankylosing spondylitis may have Crohn’s disease or ulcerative colitis, and up to 40 percent of those with ankylosing spondylitis will develop eye inflammation, in which the eye becomes red and painful, according to the SAA. Although ankylosing spondylitis is a progressive disease, meaning it tends to worsen as you age, it can also stop progressing in some people. Why? Doctors aren’t sure, Matteson says. However, a study published in March 2016 in Arthritis & Rheumatology found that men with ankylosing spondylitis tend to experience greater radiographic progression, erosive damage, and joint fusion compared with women with the condition. The long-term goal for all people with ankylosing spondylitis is to maintain as much physical activity as possible without altering their daily lives. Can Treatment Stop Ankylosing Spondylitis Progression?Getting the right treatment early can affect how the disease plays out — treatment can improve symptoms and even slow the progression of the disease, says Matteson. Drugs used to treat ankylosing spondylitis include non-steroidal anti-inflammatory medications, methotrexate, sulfasalazine, and biologic medications, including tumor necrosis factor (TNF) inhibitors or interleukin 17 (IL-17) inhibitors. Sometimes corticosteroids are used for a limited time to treat ankylosing spondylitis. Biologics may help slow progression of ankylosing by targeting specific proteins that promote inflammation in the body. According to research published in November 2014 in the European Journal of Clinical Investigation, people with ankylosing spondylitis that were treated with TNF inhibitors for at least four years showed evidence on MRIs that the progression of the disease had slowed. TNF inhibitors are also effective at treating the inflammation in the digestive system and eyes that’s often associated with ankylosing spondylitis, according to the SAA. But medication isn’t the only form of relief for people with ankylosing spondylitis. Physical therapy is often also part of the treatment plan, as physical activity has been shown to significantly help with symptoms. A study published in February 2018 in The Archives of Physical Medicine and Rehabilitation found that exercise drastically improved symptoms and function in people with ankylosing spondylitis. Whether you smoke may also affect how the disease progresses. According to a study in the April 2017 issue of Seminars in Arthritis and Rheumatism, which looked at data from 17 studies involving approximately 5,000 adults with ankylosing spondylitis, the more people smoked, the more likely they were to report experiencing pain and problems with mobility. Plus, study participants who smoked more than 10 cigarettes a day had significantly worse health-related quality of life than people who didn’t smoke. Some things may be out of your control when it comes to the course of ankylosing spondylitis, but there are steps you can take to protect your joints. Talk with your doctor about the right treatment plan to improve your prognosis and avoid severe joint damage. Additional reporting by Blake Miller Can ankylosing spondylitis lead to death?Ankylosing spondylitis can cause stiffness and discomfort, but more serious complications can also develop over time if your disease becomes severe. Heart and lung problems caused by inflammation from the condition can increase your risk of death.
Does ankylosing spondylitis get worse with age?Ankylosing spondylitis symptoms may gradually worsen as you age. The condition is rarely disabling or life-threatening. Still, symptoms like joint pain may interfere with your ability to do the things you love. Early interventions can ease inflammation and pain.
What is the last stage of ankylosing spondylitis?Advanced Ankylosing Spondylitis
It happens slowly, but it sometimes leads to complete spinal fusion over time. Fusion in your spine can put you at a high risk for fractures. It can also make your spine curve forward, leading to a hunched-over posture. Physical therapy can help.
Is ankylosing spondylitis a terminal illness?Ankylosing spondylitis is not a fatal condition. It may be progressive, and rapid progression of the disease may limit normal movement and breathing ability.
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What is the life expectancy of someone with ankylosing spondylitis
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