What is ankylosing spondylitis?
Ankylosing spondylitis, or AS, is a type of inflammatory arthritis that affects the spine and the sacroiliac joints which attach the pelvis to the base of the spine. Ankylosing
means fusing and spondylitis
means inflammation of the spine. As well as being a form of inflammatory arthritis, AS is also an autoimmune disease meaning the body’s own immune system attacks healthy tissue. With AS inflammation, the immune attack targets the ligaments and tendons attached to bone in the joints of the spine. The bone erodes at these sites and the body tries to repair itself by forming new bone. The bones of the spine begin to fuse, or grow together, causing the spine to become stiff, inflexible and painful. Even though new bone forms, the original bone in the spine can become thin, increasing the risk of spinal fractures.
Ankylosing spondylitis is the most common form of spondyloarthritis. Spondyloarthritis describes a group of inflammatory arthritis diseases that are clinically and genetically related, but have distinct features from one another. They are categorized into axial spondyloarthritis which describes conditions affecting the spine, such as ankylosing spondylitis, and peripheral spondylarthritis, such as psoriatic arthritis, which affects other parts of the body such as the fingers, arm and leg joints, the skin and the gastrointestinal tract, and the eyes.
While spondyloarthritis is a form of inflammatory arthritis, it differs from rheumatoid arthritis, because people with spondyloarthrits do not have rheumatoid factor antibodies in their blood. They are known as seronegative whereas those with rheumatoid arthritis are seropositive.
Once your diagnosis is confirmed, there are many treatments that can help decrease your pain and increase your movement. Physiotherapy, occupational therapy, regular exercise and relaxation techniques are very important parts of the overall treatment of AS. Although many of these can be undertaken on your own, it is important to build out a health-care team who can help oversee and direct your treatment. Learning as much as you can about AS is also an important part of making sure you do all you can to best manage your condition.
The general approach to treating AS is to reduce joint inflammation to improve your function and mobility, with the hope of preventing long-term damage to the spine and joints. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are the most commonly used medication to treat the pain and inflammation of AS. Disease-Modifying Anti-Rheumatic Drugs (DMARDs) can be used in combination with NSAIDs, although they generally don’t work as well for inflammation in the spine. DMARDs can sometimes be used when inflammation occurs in joints away from the spine. Corticosteroids (steroids) are sometimes used to try and control symptoms during flares of AS.
A newer class of medications called biologics has revolutionized the treatment of AS. These medications suppress inflammation and may help prevent damage to the joints of the spine. Biologics block a molecule called TNF (tumour necrosis factor) that appears to be important in causing inflammation in AS. It is critical to discuss the use of any arthritis medications with your doctor.
For more information about medications, refer to our online Arthritis Medications: A Reference Guide.
Explore the Arthritis Medications A Reference Guide
The optimal treatment is what is best in each individual case – so speak with your doctor and/or pharmacist about what kind of medications are most appropriate for you.
Those with severe, advanced AS may require surgery for badly damaged joints. Surgery usually involves replacing a joint with an artificial joint. This is most commonly used for the end stage of damage to the hip joints, called a total hip joint replacement. Benefits include less pain, better movement and restored function. Spinal surgery is complex and is only used in those with severe deformity.
For more information on hip & knee replacement or ankle replacement surgery, please visit our comprehensive section on surgery.
Joint Replacement Surgery
The Arthritis Society provides a range of in-person workshops and online programs, all with a specific focus in mind. They include chronic pain management, overcoming fatigue, understanding your health-care team, symptom checkers, and more. Participants learn new information and skills, and for in-person workshops, can share ideas and experiences with others.
Explore arthritis workshops and courses
Online Arthritis Self Management Courses
The Arthritis Society has developed evidence-based, online education programs that are informative, convenient and FREE. There is much you can do to actively manage your arthritis, and each course is devoted to a specific issue or symptom linked to the disease. Click the button below to access courses that are jam-packed with helpful tips and information.
Online Arthritis Self Management Courses
Discover information you can trust, because it’s based on evidence and vetted by experts, in The Society’s resource area. Learn about each disease, possible treatments, self-management, lifestyle issues, and so much more.