Ankylosing Spondylitis: Definition, Causes, Symptoms and Treatments

ankylosing spondylitis icd 10

Ankylosing spondylitis is inflammatory arthritis, a disease affecting mostly young males.

Ankylosing spondylitis is another form of arthritis. But this kind of arthritis affects the spine causing pain and stiffness from the neck down to the lower back.

The condition can be mild or severe and can lead to stooped-over posture.

It is crucial to get early treatment for this condition to prevent the stooped-over posture from happening. This condition is common in boys in their late teens and men in their early 20’s.

Ankylosing spondylitis (AS) is a chronic form of arthritis. It most commonly affects bones and joints at the base of the spine, where it connects to the pelvis.

These joints become inflamed and swollen. Over time, the affected vertebrae may join.

Symptoms of ankylosing spondylitis

There are three symptoms of ankylosing spondylitis. When you are having more than one of these symptoms, then you should seek immediate treatment from a doctor or specialist.

The usual symptoms of ankylosing spondylitis are:

  • Pain and stiffness in the spine. You might have pain and stiffness in your lower back, buttocks, and hips for more than three months.
  • Bony fusion. This condition can cause the bones to overgrown that can lead to the abnormal joining of the bones in your spine, hips or neck. This is called bony fusion.
  • Any pain in the ligaments and tendons in your back. The ankylosing spondylitis can cause pain and tenderness in the ligaments and tendons that are attached to the bones. You can even have some sensitivity in the back of the ankle and the heel.

The AS begins with a low back pain that appears and disappears. Such low back pain is present most of the time as the disease progresses.

Pain and stiffness are worse at night, in the morning, or when it is not active. The discomfort can wake you up.

Sometimes, regular exercise or constant activity can lessen the pain and discomfort

Back pain can begin in the middle of the pelvis and the spine (sacroiliac joints). Over time, it may compromise all or part of the spine.

The lower part of the spine becomes less flexible. Over time, you can stand in a humped forward position.

Other parts of the body that may present stiffness and pain include swelling and pain in the joints of the shoulders, knees, and ankles.

The intercostal bones and the sternum can become stiff too so you cannot fully expand the chest. Swelling and redness of the eye may also happen.

Less common symptoms include slight fever. Also, Ankylosing spondylitis can occur along with other conditions such as:

  • Psoriasis
  • Ulcerative colitis or Crohn’s disease
  • Chronic ocular inflammation (iritis) or recurrent


Ankylosing spondylitis is the leading member of a family of similar forms of arthritis called spondyloarthritis.

Other related conditions include psoriatic arthritis, inflammatory bowel disease arthritis, and reactive arthritis.

The diseases related to arthritis are quite common in the world population, affecting 1 out of every 100 people.

The cause of AS is unknown. Genes seem to have a role. Most people with AS have an HLA-B27 positive.

The disease usually begins in the 20’s and 40’s but can start before age 10. It affects men more than women.

Tests and exams.

Tests may include:

  • CSC
  • Erythrocyte sedimentation rate (a measure of inflammation)
  • HLA-B27 antigen (which detects the gene linked to ankylosing spondylitis)
  • Rheumatoid factor (which should be negative)
  • X-rays of the spine and pelvis
  • Magnetic resonance imaging of the spine and pelvis

Treatment of ankylosing spondylitis

Unfortunately, there isn’t any cure for ankylosing spondylitis. But, there are a few treatment options available to treat the disease and to reduce the discomfort and to improve function.

The goal of all the treatment plans is to reduce pain and stiffness and to ensure a good posture. These are some of the treatments that you can do for ankylosing spondylitis.

  • You can go for physical and occupational therapy to prevent deformity and to maintain functions.
  • You can do a daily exercise program to strengthen the muscles around the joints to minimize the risk of disability. One of the exercises that are good for this condition is swimming.
  • Different medication options also can mitigate the effects of this condition. You need to speak to your doctor for prescribing the best possible medication for you.

There might not be any cure for ankylosing spondylitis, but with a good exercise routine and some medication, you can maintain good health without a lot of pain and stiffness in your spine. And, with the treatment plans, you can minimize the risk of disability.

Your healthcare provider may prescribe medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation and pain.

People can buy some NSAIDs without a prescription. These include acetylsalicylic acid (aspirin), ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn).

Your provider can prescribe other NSAIDs, according to your needs. Talk to your provider or pharmacist before using any over-the-counter NSAIDs.

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

  • Therapy with corticosteroids (such as prednisone) used for a short time
  • Sulfasalazine
  • TNF inhibitors (such as etanercept, adalimumab, infliximab, certolizumab or golimumab)

If pain or joint damage is too severe, the patient might need to get surgery.

Exercises can help improve posture and breathing. Lying on your back at night can help maintain a healthy posture.

Expectations (prognosis).

The course of the disease is difficult to predict. Over time, the signs and symptoms of AS reappear suddenly (relapse) or become calm (remission).

Most people can function well unless they have a lot of hip damage. Joining a support group of people with the same problem can usually help.

NSAID treatment often reduces pain and inflammation. Treatment with TNF inhibitors seems to slow the progression of arthritis of the spine.

Rarely, people with ankylosing spondylitis may have problems with:

  • Psoriasis, a chronic skin disorder
  • Eye inflammation (iritis)
  • Inflammation of the large intestine (colitis)
  • Abnormal heart rhythm
  • Scarring or thickening of lung tissue
  • Scarring or thickening of the aortic valve of the heart

When to Contact a Medical Professional.

Call your health care provider if: You have symptoms of ankylosing spondylitis, or already has ankylosing spondylitis and presents new symptoms during treatment