Condition: Spinal Deformity Associated with Ankylosing Spondylitis

Also called: Spinal deformity

What is ankylosing spondylitis?

Ankylosing spondylitis (AS) is a type of arthritis of the spine. It causes inflammation (swelling) between your vertebrae (the bones that make up your spine) and the joints between your spine and pelvis. AS inflammation can cause stiffness and make it difficult to move and bend.

Symptoms of AS can range from mild to severe back pain. Over time, AS can fuse (grow together) your vertebrae, limiting movement and causing a hunched posture. In some people, AS can affect other joints or body parts.

There is no cure for AS, but early treatment can help manage symptoms, slow down the disease, and help you lead a more productive life.

Who is more likely to get ankylosing spondylitis?

Ankylosing spondylitis usually starts before age 45. Early symptoms may begin between the ages of 15 and 30. Your chance of developing AS can also increase if:

• You're a man. AS is more common and severe in men.
• You have a family history. If a member of your family has AS, you're more likely to get the disease.
• You have other medical conditions that may increase your risk of getting AS. These include Crohn's disease, ulcerative colitis, or psoriasis.

What causes ankylosing spondylitis?

No one knows what causes ankylosing spondylitis, but the environment and genes likely play a role. Your genes are parts of DNA in your cells that are passed down from your parents. Certain genes may increase your risk of getting the disease, but not everyone with these genes gets AS.

What are the symptoms of ankylosing spondylitis?

AS affects people differently. The most common symptom is pain and stiffness in the lower back and/or hips. The pain is usually worse during the night or after sitting for a long time.

Over time, AS may progress to other areas of your spine or body. Symptoms may depend on which areas of your body the disease affects. Some people have symptoms that come and go. Others may have severe, ongoing pain.

Other symptoms of ankylosing spondylitis may include:

• Pain, stiffness, and inflammation of the joints.
• Difficulty taking a deep breath. This could occur if the joints connecting the ribs are affected.
• Changes in vision.
• Fatigue.
• Loss of appetite.
• Weight loss.
• Skin rashes, such as psoriasis.
• Abdominal (belly) pain and loose stools (poop).

How is ankylosing spondylitis diagnosed?

There is no single test for ankylosing spondylitis. To find out if you have AS your health care provider may:

• Ask about your medical history, including your symptoms.
• Ask about your family health history, including relatives who have had AS.
• Do a physical exam.
• Order blood tests or imaging studies.

What are the treatments for ankylosing spondylitis?

AS has no cure, but treatment may help relieve symptoms, maintain posture, and slow down the disease. Since other parts of your body can be affected by AS, you will likely work with a team of health care professionals for tests, diagnosis, and care.

Treatment usually includes medicine to help relieve symptoms and keep the disease from getting worse, as well as physical therapy to improve mobility. If AS is severe, surgery may be needed.

You can help manage your AS symptoms if you:

• Exercise
• Monitor your symptoms
• Manage your stress
• Use assistive devices as needed
• Follow a healthy diet
• Stop smoking, or don't start

NIH: National Institute of Arthritis and Musculoskeletal and Skin Disease

Ankylosing spondylitis

Ankylosing spondylitis is a form of painful, ongoing joint inflammation (chronic inflammatory arthritis) that primarily affects the spine.  Early symptoms of ankylosing spondylitis typically begin between the ages of 15 and 30. Most commonly, affected individuals first experience chronic back pain and stiffness. This pain worsens with rest or inactivity, and tends to be relieved with physical activity or exercise.

Pain in ankylosing spondylitis results from inflammation of the joints between the pelvic bones (the ilia) and the base of the spine (the sacrum). These joints are called sacroiliac joints, and inflammation of these joints is known as sacroiliitis. The inflammation gradually spreads to the joints between the vertebrae, eventually involving the whole spine, causing a condition called spondylitis. Over time, back movement gradually becomes limited as the bones of the spine (vertebrae) fuse together. This progressive bony fusion is called ankylosis. These fused bones are prone to fracture.

Ankylosing spondylitis can involve other joints as well, including the shoulders, hips, and, less often, the knees. As the disease progresses, it can affect the joints between the spine and ribs, restricting movement of the chest and making it difficult to breathe deeply. 

Ankylosing spondylitis affects the eyes in more than 30 percent of cases, leading to episodes of eye inflammation called acute iritis. Acute iritis typically affects one eye at a time and causes eye pain and increased sensitivity to light (photophobia). Rarely, ankylosing spondylitis can also cause serious complications involving the heart, lungs, and nervous system. Six to 10 percent of people with ankylosing spondylitis have additional inflammatory disorders such as psoriasis, which affects the skin, or ulcerative colitis or Crohn's disease, which both affect the digestive tract.