Spondylitis; Spondyloarthritis; HLA - B27
Ankylosing spondylitis (AS) is a chronic form of arthritis. It mostly affects the bones and joints at the base of the spine where it connects with the pelvis. These joints can become swollen and inflamed. Over time, the affected spinal bones may join together.
AS is the main member of a family of similar forms of arthritis called spondyloarthritis. Other members include psoriatic arthritis, arthritis of inflammatory bowel disease and reactive arthritis. This family of arthritis affects up to 1 in 100 people.
The cause of AS is unknown, however genes seem to play a role. The majority of people with AS are positive for the HLA-B27 gene, but not everyone who has this gene has AS.
The disease often begins between ages 20 and 40, but it may begin before age 10. It affects more males than females.
AS starts with lower back pain that comes and goes but usually becomes present most of the time as the condition progresses.
Other parts of your body that may be affected include:
Fatigue is also a common symptom.
Less common symptoms include:
AS may occur with other conditions, such as:
Tests may include:
Your health care provider may prescribe medicines such as non-steroidal anti-inflammatory drugs (NSAIDs) to reduce swelling and pain.
You may also need stronger medicines to control pain and swelling, such as:
Surgery, such as hip replacement, may be done if pain or joint damage is severe.
Exercises can help improve posture and breathing. Lying flat on your back at night can help you keep a normal posture.
The course of the disease is hard to predict. Over time, signs and symptoms of AS flareup (relapse) and quiet down (remission). Most people are able to function well unless they have a lot of damage to the hips or the spine. Joining a support group of others with the same problem may often help.
Treatment with NSAIDs often reduces the pain and swelling. Treatments given by IV or injection such as TNF inhibitors early in the disease appears to slow progression of the spine arthritis. Other newer drugs such as Interleukin-17 inhibitors and oral medicines, Janus kinase (JAK) inhibitors have been approved as well.
Rarely, people with ankylosing spondylitis may have problems with:
Contact your provider if:
Gardocki RJ, Park AL. Degenerative disorders of the thoracic and lumbar spine. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 39.
Inman RD. The spondyloarthropathies. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 249.
van der Linden S, Brown M, Gensler LS, Kenna T, Maksymowych WP, Taylor WJ. Ankylosing spondylitis and other forms of axial spondyloarthritis. In: Firestein GS, Budd RC, Gabriel SE, Koretzky GA, McInnes IB, O'Dell JR, eds. Firestein & Kelley's Textbook of Rheumatology. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 80.
Ward MM, Deodhar A, Gensler LS, et al. 2019 Update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network Recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis. Arthritis Care Res (Hoboken). 2019;71(10):1285-1299. PMID: 31436026 pubmed.ncbi.nlm.nih.gov/31436026/.
Werner BC, Feuchtbaum E, Shen FH, Samartzis D. Ankylosing spondylitis of the cervical spine. In: Shen FH, Samartzis D, Fessler RG, eds. Textbook of the Cervical Spine. Philadelphia, PA: Elsevier Saunders; 2015:chap 28.
BACK TO TOPReview Date: 4/30/2023
Reviewed By: Neil J. Gonter, MD, Assistant Professor of Medicine, Columbia University, New York, NY, and private practice specializing in Rheumatology at Rheumatology Associates of North Jersey, Teaneck, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Health Content Provider
06/01/2025
|
A.D.A.M., Inc. is accredited by URAC, for Health Content Provider (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics. This site complied with the HONcode standard for trustworthy health information from 1995 to 2022, after which HON (Health On the Net, a not-for-profit organization that promoted transparent and reliable health information online) was discontinued. |
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2024 A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.