Ankylosing Spondylitis (AS)

Ankylosing spondylitis (AS) is a type of arthritis that affects the spine. It is also systemic and can affect other parts of the body such as the shoulders, ribs, hips, knees, and feet. In certain cases, AS can also affect the tendons and ligaments attach to bone; it can even affect the eyes, bowel, heart, and lungs. Symptoms involve redness, heat, swelling, stiffness, and pain in the spine or where pelvic bone joins at the bottom of the spine.

Like most arthritic conditions, it is unclear what is the exact cause of AS. However, it is more prevalent in men, as they are twice more likely than women to develop AS. Genetic and environmental factors may contribute to developing AS.

In order to diagnose AS properly, physicians will need to assess a patient’s medical history, conduct a physical exam, study images of the patient’s bones and joints, and also have blood work done. A rheumatologist usually gives the final diagnosis for ankylosing spondylitis, since this is a physician who is trained to treat arthritic conditions. However, since AS can affect different parts of your body, it is not unusual to see more than one doctor. Other physicians, such as an ophthalmologist (eye disease), gastroenterologist (bowel disease), physiatrist (physical medicine and rehabilitation), and physical therapist (stretching and exercise programs.

There is no cure for ankylosing spondylitis, but treatment is available to help manage symptoms and prevent the disease from progressing. There are safe and effective medicines to treat AS, such as:

  1. Nonsteroidal anti-inflammatory drugs (NSAIDs) which help relieve pain and swelling
  2. Corticosteroids also help relieve pain and swelling. This strong medicine is similar to the cortisone found in your body. 
  3. Disease-modifying antirheumatic drugs (DMARDs) work to reduce pain and swelling, and to slow down disease progression
  4. Biologic agents are newer types of genetically engineered proteins medicine that mimic normal biological functions

Exercise can help strengthen and stretch joints, but it is important to consult with a physician on what is the most beneficial exercise program for each patient. Often, patients with AS find that exercises in water are helpful to relieve joint pain. Furthermore, a healthy diet can help with weight loss, which in turn reduces stress on painful joints. Surgery should only be considered as a last resort. When AS causes significant joint damage and daily activities are too difficult, joint replacement is an option, with knee and hip replacements as the most common.