Introduction

Ankylosing Spondylitis (AS) is a chronic inflammatory disease that primarily affects the spine and sacroiliac joints. Over time, it can cause pain, stiffness, and reduced flexibility of the spine. If left untreated, the inflammation may lead to fusion of the spinal bones, resulting in permanent loss of mobility.

Although Ankylosing Spondylitis commonly begins in young adults between the ages of 15 and 40, early diagnosis and treatment can significantly improve quality of life and help prevent long-term complications.

What Is Ankylosing Spondylitis?

Ankylosing Spondylitis is a type of inflammatory arthritis that mainly affects the joints between the spine and pelvis, known as the sacroiliac joints.

The condition causes chronic inflammation that can lead to:

• Persistent lower back pain
• Morning stiffness
• Reduced spinal flexibility
• Postural changes
• Joint pain

In advanced cases, the vertebrae may gradually fuse together, making the spine less flexible.

Causes of Ankylosing Spondylitis

The exact cause of Ankylosing Spondylitis is not fully understood. However, genetics play a major role.

HLA-B27 Gene

Many patients with Ankylosing Spondylitis carry a genetic marker known as HLA-B27. While not everyone with this gene develops the disease, it significantly increases the risk.

Other factors may include:

• Family history
• Immune system abnormalities
• Environmental triggers

Who Is at Risk?

Ankylosing Spondylitis is more common in:

• Young adults
• Men (though women can also be affected)
• Individuals with a family history of AS
• People who test positive for HLA-B27

Early Symptoms of Ankylosing Spondylitis

Recognizing symptoms early is important for preventing progression.

Chronic Lower Back Pain

Pain usually develops gradually and persists for more than three months.

Morning Stiffness

Patients often experience stiffness after waking up that improves with movement.

Pain in the Buttocks

Inflammation of the sacroiliac joints may cause pain in one or both buttocks.

Reduced Flexibility

Difficulty bending forward or twisting may develop over time.

Fatigue

Chronic inflammation can cause persistent tiredness.

Neck Pain

Some patients experience pain and stiffness in the neck.

Symptoms Beyond the Spine

Ankylosing Spondylitis can affect other parts of the body.

Hip and Shoulder Pain

Large joints may become inflamed.

Heel Pain

Inflammation where tendons attach to bone can cause pain, particularly at the Achilles tendon.

Eye Inflammation (Uveitis)

Symptoms include:

• Eye redness
• Eye pain
• Blurred vision
• Sensitivity to light

Chest Tightness

Inflammation of joints between the ribs and spine may reduce chest expansion.

How Is Ankylosing Spondylitis Diagnosed?

Clinical Evaluation

An orthopedic or rheumatology specialist evaluates:

• Symptoms
• Family history
• Physical examination findings

Imaging Studies

X-rays

Can identify sacroiliac joint damage and spinal changes.

MRI Scan

MRI helps detect inflammation in the early stages before changes appear on X-rays.

Blood Tests

Tests may include:

• HLA-B27
• ESR (Erythrocyte Sedimentation Rate)
• CRP (C-Reactive Protein)

These tests help assess inflammation and support diagnosis.

Complications of Untreated Ankylosing Spondylitis

Without treatment, AS may lead to:

Spinal Fusion

Bones of the spine may fuse together, causing severe stiffness.

Postural Deformity

Patients may develop a forward-stooped posture.

Reduced Mobility

Daily activities become increasingly difficult.

Osteoporosis

Weakened bones increase fracture risk.

Eye Problems

Repeated episodes of uveitis can affect vision.

Breathing Difficulties

Reduced chest expansion may affect lung function.

Treatment of Ankylosing Spondylitis

While there is no permanent cure, treatment can effectively control symptoms and slow progression.