What are the symptoms of ankylosing spondylitis?

Ankylosing spondylitis symptoms usually develop very slowly over time, often in the form of a dull pain or vague stiffness that comes and goes in the lower back. Because these symptoms are caused by spinal joint inflammation, many patients experience heightened discomfort upon waking up in the morning and after other periods of prolonged inactivity. The pain and stiffness typically improve with physical activity or a warm shower.

In response to spinal joint inflammation, the body sometimes produces excess bone, or bone spurs, to protect the affected joints. As the condition progresses, these bony deposits can sometimes cause the spinal bones to fuse together. This can affect the flexibility and mobility of the spine, making it difficult for a patient to perform daily activities. In advances stages, ankylosing spondylitis can lead to kyphosis, an excessive curvature of the upper spine that creates a “hunchbacked” appearance.

What is spondylitis?

Spondylitis is a relatively rare type of inflammatory arthritis that mostly affects the spinal joints. While the condition can be classified into several different subcategories — ankylosing spondylitis, psoriatic arthritis, enteropathic arthritis, reactive arthritis, juvenile spondyloarthritis (SpA) and undifferentiated SpA — the symptoms among these subcategories are usually consistent.

The exact causes of ankylosing spondylitis are not yet fully understood. Some researchers believe that genetics may play a role in its development. For instance, many people who are diagnosed with the condition test positive for the human leukocyte antigen HLA-B27, which is a protein found on the surface of white blood cells. Even so, approximately 10 percent of people who have this antigen do not develop spondylitis.

Treatment options

A treatment plan for any type of spondylitis will usually include one or more of the following options:

  • Medications — Many patients benefit from nonsteroidal anti-inflammatory drugs (NSAIDs), which can help improve spinal joint pain and stiffness. If the improvement is insufficient, a physician may prescribe a second-line medication, such as a disease-modifying anti-rheumatic drug (DMARD).
  • Exercise — A physician or physical therapist can recommend an exercise program that is specifically designed to improve posture, enhance flexibility, reduce pain and help prevent some of the complications of ankylosing spondylitis, such as kyphosis.
  • Hot and cold therapy — The application of heat to stiff joints and tight muscles can promote relaxation and alleviate pain; the application of cold to inflamed areas can help reduce swelling.

Some patients also benefit from complementary and alternative treatments, such as therapeutic massage and transcutaneous electrical nerve stimulation (usually by wearing a battery-operated TENS unit). Additionally, lifestyle changes like maintaining a healthy body weight and eating a balanced diet can improve a patient’s ankylosing spondylitis symptoms as well as his or her overall health and wellness.

Surgery

In severe cases, surgery may be necessary to correct deformities, such as severe spine curvatures, and there is always a chance of recurring ankylosis (joint stiffening and immobility due to bone fusion). Laser Spine Institute does not offer minimally invasive spine surgery to treat ankylosing spondylitis. However, our care team can help you find alternative treatments to help relieve your chronic back pain and other symptoms.