What Is Ankylosing Spondylitis?

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*This booklet is produced by the Ankylosing Spondylitis Association of Ireland

Ankylosing Spondylitis (AS) is a form of arthritis which can make your  neck, lower back and buttocks feel painful and stiff. In some people, it can also affect the shape of the spine.“Ankylosing” means “fusing together”. “Spondylitis” means “inflammation of the spine”, which causes stiffness, tenderness and discomfort.

What are the symptoms of Ankylosing Spondylitis?

Ankylosing Spondylitis can lead to new bone formation in your spine. Although it mainly affects the spine, Ankylosing Spondylitis can also cause pain and/or swelling in the shoulders, hips, knees, heels, chest/ribs and small joints of the hands and feet. 

Sometimes, the eyes are also affected. In rare cases, the heart and lungs canbe affected, too. The severity of Ankylosing Spondylitis symptoms varies greatly. Some people will have mild neck/back pain and discomfort for short periods; others will have severe pain and stiffness in several parts of the body for a long time. In severe cases, Ankylosing Spondylitis can seriously impact on everyday life and lead to disability.

Over time, Ankylosing Spondylitis can cause the spine to become rigid and curved, giving the person a “bent forward” posture. This is known as kyphosis. It’s important to note that not everyone with Ankylosing Spondylitis will develop kyphosis. Significant medical advances in recent years mean that new treatments can reduce the pain associated with and symptoms of the condition and help improve the quality of life for people living with Ankylosing Spondylitis. 

How is Ankylosing Spondylitis diagnosed?

When you visit your doctor/consultant a detailed history of your symptoms will be taken. This will include some questions about the type and pattern of your pain and stiffness.

Some questions that may be asked include:

  • How long have your symptoms lasted for?
  • How does the pain and stiffness feel when you wake up in the morning and how long does it take to subside?
  • What happens when you engage in physical activity or exercise?
  • How does the pain and stiffness respond to non-steroidal anti-inflammatory drugs (NSAIDs)?
  • Questions about your medical and family history will also be required. 

Are there any special tests that are used to diagnose Ankylosing Spondylitis? 

Your doctor will give you a thorough examination which will include assessing the areas where you are experiencing pain or inflammation, determining how much spinal mobility you have and checking to see how far your chest can expand.

  • Your doctor may order some routine blood tests that tell us about your general well being and about inflammation in the body.
  • She/he may order a specific blood test which is called a HLA–B27. This is a genetic marker, the presence of which is often associated with AS.
  • X-rays of the spine are taken to determine whether the joints show signs of damage. If the x-rays don’t show changes caused by AS, in some cases the doctor may order an MRI (Magnetic Resonance Imaging) scan.
  • The MRI scan can illustrate changes called sacroilitis. You may be diagnosed with non-radiographic axial spondyloarthritis – this means that the changes are not seen on an x-ray but the MRI has detected changes showing active inflammation.

What causes Ankylosing Spondylitis? 

At the moment, it is not known exactly what causes Ankylosing Spondylitis. However, a combination of environmental and genetic factors may make you more likely to have Ankylosing Spondylitis. Environmental factors such as infections may also be involved.

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