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Diagnosis Definition: Ankylosing Spondylitis

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Back Pain ManVivek Mohan MD, MS

Almost everyone has experienced back pain at some point in their life. However, some patients may have suffered from chronic back pain since childhood. Of those long-time sufferers, a small percentage are diagnosed with the autoimmune inflammatory disorder known as ankylosing spondylitis, or AS.

Ankylosing spondylitis has no known cause but has been linked to the HLA-B27 gene. Patients who possess the HLA-B27 gene have significantly increased risk of developing the disease, but may not develop AS. Other factors and genes involved are not yet defined and many people carry the gene but do not have AS.

Initial symptoms of AS include chronic low back pain that radiates into the buttocks. This is typically dull and diffuse. Many patients also have abdominal symptoms and can be associated with Crohn’s Disease or Ulcerative Colitis. Symptoms can begin at any age, but usually appear in adolescence or early adulthood.

Ankylosing spondylitis primarily affects the spine but other joints can also be involved. The spinal joints and discs become inflamed and lead to bone formation. The vertebrae, once fused, become stiff and can lead to a forward leaning posture known as kyphosis.

Currently, there is no known cure for AS. Treatments are directed towards maximizing function and minimizing pain. Regular exercises and anti-inflammatory medications are recommended. Stronger medications can be prescribed for progressive symptoms. Surgery is considered when the disease is advanced, resulting in a deformity or decreased mobility.



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