Ankylosing spondylitis (AS), also called radiographic axial spondyloarthritis, is a chronic inflammatory condition that primarily affects the spine and sacroiliac joints. It can cause persistent back pain, stiffness, reduced mobility, and inflammation in other parts of the body. Although there is no cure, treatment can reduce inflammation, relieve symptoms, preserve mobility, and help prevent or limit structural damage. Early diagnosis, regular monitoring, and an individualized treatment plan can help control inflammation, preserve mobility, and reduce the impact of the disease on daily life.
Ankylosing spondylitis is an inflammatory form of arthritis that primarily affects the joints between the spine and pelvis.
Over time, inflammation can lead to new bone formation around the spine in some people, potentially causing sections of the spine to become less flexible.
The condition may also affect:
Symptoms often begin before age 45 and may include:
Symptoms may fluctuate between periods of increased activity and improvement.
Diagnosis typically involves a combination of medical history, physical examination, laboratory testing, and imaging.
Healthcare providers may use:
No single test can diagnose ankylosing spondylitis on its own.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used as an initial medication treatment.
They can help reduce:
Different NSAIDs may work differently for different individuals, and long-term use requires consideration of potential gastrointestinal, kidney, blood pressure, and cardiovascular risks.
When symptoms remain active despite conventional treatment, biologic medicines may be considered.
Common biologic classes include:
These medicines target specific inflammatory pathways involved in ankylosing spondylitis and can reduce disease activity for many patients.
Targeted synthetic medications that affect specific immune signaling pathways may also be considered for certain people with active disease.
Treatment selection depends on disease activity, previous medication response, other health conditions, and individual treatment considerations.
Regular movement is an important part of ankylosing spondylitis management.
A physical therapist may recommend exercises focused on:
Low-impact activities such as swimming, walking, and cycling may also help maintain physical function when appropriate.
Healthy habits can complement medical treatment.
Recommendations may include:
Lifestyle measures cannot eliminate inflammation but can support mobility and overall health.
Regular rheumatology appointments help determine whether treatment is controlling inflammation.
Monitoring may include:
Treatment can be adjusted if disease activity remains high.
Ankylosing spondylitis can occur alongside other inflammatory conditions.
These may include:
New eye pain or redness, persistent digestive symptoms, or significant skin changes should be discussed with a healthcare professional.
Prompt medical evaluation is important for symptoms such as:
Some symptoms may indicate complications requiring urgent assessment.
Ankylosing spondylitis is a chronic inflammatory disease that can affect the spine, joints, and other organs. Treatment commonly combines exercise and physical therapy with medications such as NSAIDs, biologic therapies, and targeted treatments when appropriate.