Ankylosing spondylitis (AS) is a form of arthritis that typically affects the back and can lead to chronic pain.

What you need to know about ankylosing spondylitis

• It is an autoimmune disease that causes inflammation, stiffness and often pain.
• It is progressive, that is, it gets worse over time.
• There is no cure, but the condition can be managed.
• The disease is more common in men than women.
• It affects 2.4 million people, making it more common that multiple sclerosis and cystic fibrosis combined.

Understanding ankylosing spondylitis

Ankylosing spondylitis has been described as arthritis of the spine. The body’s immune system fights against itself. It runs in families, and new research has identified a gene associated with this condition.

Ankylosing spondylitis causes swelling between the vertebrae of the spinal column. This can put pressure on nerves and cause pain. Over time, ankylosing spondylitis may limit movement. Often ankylosing spondylitis affects the sacroiliac joints at the base of the spine, where the spine attaches to the pelvis.

Symptoms of ankylosing spondylitis

The first symptoms are often back pain and stiffness that start in adolescence or early adult years. Many people experience pain and stiffness that comes and goes in “flares.” For some, the condition can be disabling.

Treatment of ankylosing spondylitis

Although there is no cure for this condition, it can be managed using the state-of-the-art approach of:

• Medications
• Physical therapy and exercise

Medications help reduce inflammation. This permits physical therapy and exercise, which can improve mobility and may help to reduce pain and stiffness.

In some instances, surgery may be recommended.

What kind of medications are used?

Your physician will discuss medications with you, but in general, three main types of drugs are used for ankylosing spondylitis patients:

• Pain relievers.
• So-called disease-modifying drugs (DMARDs) that work to suppress the immune system.
• Drugs that block tumor necrosis factor alpha, a substance in the body associated with immune-related diseases. These drugs are called TNF-alpha-blockers.

Living with ankylosing spondylitis

With good medical management, many people with ankylosing spondylitis live relatively normal lives. For some, symptoms are mild; for others, symptoms are intense but come and go; and for others, the disease may be debilitating. Over time, the condition tends to worsen.

Once you have a diagnosis, discuss your treatment options with your physician. While there is no cure for ankylosing spondylitis, there are many effective strategies to manage it.

While you are under treatment, you must be mindful of events that may require medical intervention. If any of the following occurs, be sure to consult with your doctor:

• Sudden change in the condition, in particular worsening pain or stiffness
• Side effects from the medications
• Exposure to an infection, the flu or some other virus
• Progressive stiffening of the back or other joint
• Trouble walking or sitting for prolonged periods of time
• Problems with balance