Ankylosing spondylitis
Ankylosing spondylitis is an inflammatory arthritis that mainly affects the spine and sacroiliac joints. Symptoms often begin with persistent lower-back or hip pain and stiffness that improve with movement rather than rest.
At a glance
Quick facts
- Category
- Inflammatory arthritis · axial spondyloarthritis
- Main pattern
- Inflammatory back pain and stiffness
- Key sites
- Sacroiliac joints · spine · entheses
- Diagnosis
- Clinical assessment + imaging
- Specialist
- Rheumatology
- Transmission
- Not contagious
Dr. Fitsum Admasu Tinsae
General Medicine · Public Health · Digital Health
Reviewed for clinical accuracy, clarity and practical public-health context.
Names & terminology
How this entity may be named or searched
- Canonical name
- Ankylosing spondylitis
- Abbreviation
- AS
- Classification context
- Radiographic axial spondyloarthritis is closely related terminology used in modern classification; it is not treated here as a simple one-word synonym.
- Historical / eponym
- Bechterew disease may appear in older material or some languages.
Structured entity profile
Clinical profile
What is ankylosing spondylitis?
Ankylosing spondylitis is a chronic inflammatory arthritis that can cause pain and stiffness in the spine. In more severe disease, inflammation can contribute to new bone formation and fusion of vertebrae. Peripheral joints, eyes, skin and the gastrointestinal tract can also be involved. [1]
Symptoms
Lower-back or hip pain and stiffness are common. A typical inflammatory pattern is worse after rest or prolonged sitting and improves with movement or exercise. Other features can include fatigue, peripheral joint pain, heel pain, uveitis, psoriasis or bowel symptoms. [1]
SYMPTOM MATRIX
How ankylosing spondylitis may present
Symptoms vary; no single symptom confirms the diagnosis.
- Lower-back or buttock pain
- Morning or night-time stiffness
- Pain that improves with movement
- Reduced spinal mobility
- Fatigue
- Heel or tendon-insertion pain
- Peripheral joint pain or swelling
- Chest-wall stiffness
- Eye inflammation (uveitis)
- Psoriasis or bowel inflammation
- Painful red light-sensitive eye
- Sudden vision change
- New marked weakness or numbness
- Severe systemic illness while immunosuppressed
Acute eye pain or visual symptoms can indicate uveitis and warrant prompt clinical assessment.
Diagnosis
Diagnosis combines history and physical examination with imaging and, where useful, laboratory tests. X-rays can show structural joint changes but may be normal earlier in disease; MRI can detect inflammatory changes sooner. HLA-B27 can support the clinical picture but cannot diagnose the condition by itself. [2]
Diagnostic pathway
How ankylosing spondylitis is assessed
A rheumatology diagnosis combines symptoms, examination, imaging and selected laboratory information.
Diagnostic assessment summarized from NIAMS patient information and standard rheumatology practice.
Treatment
There is no cure, but treatment can reduce symptoms and preserve function. Management commonly includes regular exercise and physical therapy, anti-inflammatory medicines, and for some people biologic medicines or JAK inhibitors. Surgery is reserved for selected cases with severe joint damage. [2]
Self-management is an important part of care because exercise, posture, symptom coping and psychological support can help patients maintain function and quality of life.
Treatment & care hub
Treatment combines movement, symptom control and disease-modifying therapy
Management is individualized according to symptoms, inflammation, function, associated conditions and treatment response.
Exercise & physiotherapy
Regular exercise, posture work and physiotherapy help maintain mobility and function.
NSAIDs
Anti-inflammatory medicines are commonly used for pain and stiffness when appropriate.
Biologic therapy
TNF or IL-17 pathway biologics may be considered when disease remains active.
Targeted / selected care
JAK inhibitors and, in selected cases, surgery may be considered under specialist care.
Treatment categories are a reference overview, not an individual prescription.
Associated problems and complications
Possible extra-articular problems include uveitis, psoriasis and inflammatory bowel disease. Long-standing spinal stiffness can limit flexibility and posture. Treatment and monitoring are individualized according to symptoms, imaging and involvement outside the spine. [1]
Geo data · systematic review
Ankylosing spondylitis prevalence by region
Regional prevalence estimates are shown together because they use the same systematic-review comparison layer. Country-specific African studies with different designs are listed separately below.
Population-based AS prevalence
Older rural population-based study; not a current national estimate.
PLOS systematic review ↗nr-axSpA in inflammatory-back-pain cohort
7 of 38 South African patients selected for inflammatory back pain; different entity/denominator from population AS prevalence.
Rheumatology and Therapy ↗Common questions
Frequently asked questions
No. It is an inflammatory arthritis. Its back pain often improves with movement and worsens with rest, although symptoms alone are not enough for diagnosis.
No. HLA-B27 increases risk and can support diagnosis, but many people with the gene never develop ankylosing spondylitis.
Yes. Uveitis can cause eye pain, redness and visual symptoms and requires prompt assessment.
Yes. Exercise and physical therapy are core parts of management for mobility, posture and function.
There is no cure at present, but treatment can control inflammation, symptoms and functional impact.
Sources
Clinical statements in this reference are linked to named public-health, regulatory or guideline sources.
- 1. NIAMS. Ankylosing Spondylitis — overview, symptoms and risk factors. Source ↗
- 2. NIAMS. Ankylosing Spondylitis: Diagnosis, Treatment, and Steps to Take. Source ↗
- 3. Dean LE et al. / PubMed. Global prevalence of ankylosing spondylitis — systematic review, 2014. Source ↗
- 4. PLOS ONE. Prevalence of Arthritis in Africa: systematic review and meta-analysis; includes population-based ankylosing-spondylitis evidence from rural South Africa. Source ↗
- 5. Rheumatology and Therapy. Non-radiographic axial spondyloarthritis among inflammatory-back-pain patients in Northwest and South Africa, 2018. Source ↗
This article is based on trusted medical sources and has undergone clinician review. It is not a substitute for personalized medical advice.
I pay particular attention to family history and to spinal movement on examination. Ankylosing spondylitis often begins in younger people, so it should not be thought of as a disease only of older adults.