Ankylosing Spondylitis

Ankylosing spondylitis is an inflammatory disease that, over time, can cause some of the small bones in your spine (vertebrae) to fuse. This fusing makes the spine less flexible and can result in a hunched-forward posture. If ribs are affected, it can be difficult to breathe deeply. This disease often affects Men more than Women


 The most common early symptoms of AS are frequent pain and stiffness in the lower back and buttocks. At first, discomfort may only be felt on one side, or alternate sides.

 The pain and stiffness is usually worse in the mornings and also during the night. Also, in the early stages of AS, there may be a mild fever or loss of appetite, and just a general discomfort. It is important to note that back pain from AS is inflammatory and not mechanical.

This pain may become persistent and is felt on both sides, usually lasting for at least three months. Over the course of months or years, the stiffness and pain can spread up the spine and into the neck. Pain and tenderness spreading to the ribs, shoulder blades, hips, thighs, and heels is also possible.

You might notice:

  • Pain that’s worse in the morning or after sitting for a long time
  • A rigid spine that curves forward
  • Tiredness
  • Swelling in your joints
  • Trouble taking deep breaths

Symptoms can differ from person to person. Your condition also may change quicker or slower than someone else’s.


There are no known causes for ankylosing spondylitis. Flare-ups also cannot always be controlled. Some people with AS may feel that their flare-ups have certain triggers. Knowing your triggers, if you have any, may help prevent future flare-ups.

A known medical study showed that patients with AS felt that stress caused flare ups. As many as 80% of patients believe this is true according to the study.


Healthy lifestyle choices may also help manage flare ups of AS. For example, regular exercise and physical therapy are often prescribed by Rheumatologists and may help reduce your pain and stiffness.

Quitting smoking and also avoiding secondhand smoke can make a difference for some patients. People with ankylosing spondylitis who smoke are proven to be at higher risk of spine damage. This condition also affects your heart. You may have a higher risk of heart disease and stroke if you’re a smoker.

Take all your medications exactly as prescribed to help prevent and soothe flare-ups. Your doctor may prescribe one or more of the medications below that help to control inflammation. This may help prevent or ease flare-ups. Drugs used to treat ankylosing spondylitis include:

  • adalimumab (Humira)
  • etanercept (Enbrel)
  • golimumab (Simponi)
  • infliximab (Remicade)
  • anti-TNF drugs
  • chemotherapy drugs
  • IL-17 inhibitor, such as secukinumab (Cosentyx)