What is ankylosing spondylitis?

Ankylosing spondylitis is a form of arthritis that targets the spine. You determine if you have ankylosing spondylitis by undergoing a medical exam, imaging tests, and blood tests.
Ankylosing spondylitis is a form of arthritis that targets the spine. You determine if you have ankylosing spondylitis by undergoing a medical exam, imaging tests, and blood tests.

Ankylosing spondylitis is a form of arthritis that targets the spine, including ligaments and joints. This disease is easy for healthcare providers to identify, and many treatments are available to help improve your quality of life as you learn to live with ankylosing spondylitis.

Your spine can move and bend thanks to the ligaments and joints in your spine. When you have ankylosing spondylitis, you could experience anything from mild back pain and increased stiffness to fused vertebrae, decreased flexibility in your spine, and the spread of arthritis to other parts of your body.

Also known as Bechtrew’s disease, this kind of arthritis most often results in inflamed spinal joints, but it can also cause stiffness in your shoulders, ribs, heels, hips, hands, and feet. Ankylosing spondylitis can give you extreme pain and discomfort that is difficult to get rid of. On rare occasions, your lungs and heart can be impacted by ankylosing spondylitis.

There is no cure for ankylosing spondylitis, but there are ways to mitigate the symptoms and keep the disease from progressing.

Symptoms of ankylosing spondylitis

Pain and stiffness in your lower back and hip areas are the most common signs of ankylosing spondylitis. This discomfort usually gets worse when you are inactive or rest for long periods, like after sitting or laying for a long time.

Everyone with ankylosing spondylitis can experience different symptoms. You might have manageable pain every once in a while, or you might have continual, extreme pain. You can also have flare-ups or periods where your pain and stiffness get noticeably worse.

Other symptoms of ankylosing spondylitis include:

How is ankylosing spondylitis diagnosed?

After experiencing symptoms of ankylosing spondylitis, you should make an appointment with your healthcare provider. They may recommend that you see a rheumatologist — a doctor trained to treat inflammatory diseases like arthritis.

You can prepare for your doctor’s appointment by taking note of:

  • Symptoms, even if you don’t think they’re related to ankylosing spondylitis
  • Personal details, like significant life changes, family medical history, and major causes of stress
  • Medicines, vitamins, any supplements you might take, and dosage amounts
  • Questions you’d like to ask

Your healthcare provider may begin by checking your spine’s range of motion by having you bend  in different directions, pushing on the parts of your body where you experience pain, and asking you to hold your breath to check mobility in your chest.

Common diagnosis tests include imaging and labs. Imaging tests consist of X-rays or MRIs. An x-ray will show changes to your bones and joints. These visible signs of Bechtrew’s disease might not be apparent if you’ve only recently started to have symptoms. An MRI gives a better, more detailed view of your bones and soft tissues. Due to its high quality, an MRI can catch ankylosing spondylitis earlier than an X-ray.

Although there aren’t specific lab tests used to check for ankylosing spondylitis, there are blood tests that look for inflammation and for a gene associated with the condition. Positive results don’t necessarily mean that you have this form of arthritis, but it helps narrow down the causes of your symptoms.

Causes of ankylosing spondylitis

The precise cause of ankylosing spondylitis is unclear, but your genes are likely involved. Many people who get Bechtrew’s disease have a genetic marker indicated by the presence of a particular protein, HLA-B27. If you have this marker, this doesn’t necessarily mean that you’ll get this form of arthritis. HLA-B27 is the most common, but there are many other genes associated with ankylosing spondylitis and similar diseases.

Who is affected by ankylosing spondylitis?

If any of the following apply to you, it’s possible that you are predisposed to get ankylosing spondylitis:

  • You tested positive for the HLA-B27 gene.
  • Ankylosing spondylitis is part of your family’s health history.
  • You often get gastrointestinal infections.

Women are less likely than men to get this disease. People with Crohn’s disease, psoriasis, or ulcerative colitis are more likely to get ankylosing spondylitis.

Ankylosing spondylitis is unique from other forms of arthritis because it initially affects younger people between ages 17 and 45. It’s estimated that more than 1.5 million people in the United States have ankylosing spondylitis.

Treatment for ankylosing spondylitis

The main goal of treatment in people with this form of arthritis is to ease pain, relieve stiffness, and put off serious complications. There is no cure for ankylosing spondylitis. Medicine, therapy, and surgery are common treatment options.

Medicine. Because ankylosing spondylitis results in a lot of inflammation, you can take nonsteroidal anti-inflammatory medications to relieve symptoms like pain and stiffness. Your healthcare provider might recommend some form of naproxen or ibuprofen. If these don’t work, or if they cause gastrointestinal bleeding, ask your doctor for other medication options.

Physical Therapy. If you have Bechtrew’s disease, physical therapy can relieve pain, improve strength, increase flexibility, and more. Depending on what parts of your body are affected by the arthritis, your physical therapist will create an exercise plan that could include:

  • Exercises focusing on stretching and range of motion
  • Exercises designed to strengthen abdominal and back muscles
  • Positions that encourage non-painful sleeping and walking

Surgery. Typically, ankylosing spondylitis doesn’t require surgery. However, if your pain is extreme or a joint is damaged and must be replaced, your healthcare provider may recommend surgery.

You could work with a number of providers on your journey in living with ankylosing spondylitis:

  • Rheumatologists specialize in treating bone, joint, and muscle diseases.
  • Gastroenterologists specialize in treating digestive system conditions.
  • Mental health specialists help people handle disease-related challenges at home, in the workplace, or elsewhere.
  • Occupational therapists educate people on how to care for their joints, decrease pain, carry out daily tasks, and more.
  • Ophthalmologists work specifically with eye conditions.

There are plenty of resources to take advantage of as you learn to thrive with ankylosing spondylitis.

Living with ankylosing spondylitis

With time, you will become accustomed to your condition and different ways to cope with it. Don’t be afraid to try new things. Once you find something that works for you, try to be as consistent as possible. Keep in close contact with your healthcare provider.


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Medically Reviewed on 3/24/2022

Mayo Clinic: "Ankylosing spondylitis."

National Institute of Arthritis and Musculoskeletal and Skin Diseases: "??Ankylosing Spondylitis."

Spondylitis Association of America: "Overview of Ankylosing Spondylitis."