What is Ankylosing Spondylitis?

Ankylosing spondylitis (AS) is a type of chronic arthritis that affects the joints in the spine and the sacroiliac joints. The sacroiliac joints are formed where the sacrum (the bone directly above the tailbone) meets the iliac bones (bones on either side of the upper buttocks). It is located in the lower back. The name AS is derived from Greek words ankylos meaning stiffening of a joint and spondylo, meaning vertebra. Apart from the spine and the sacroiliac joints, other joints that can be affected by AS include shoulders, ribs, hips, knees and feet. Tendons and ligaments in other parts of the body apart from those that are attached to the vertebrae of the lower spine can become inflamed. Some people may have involvement of other organs such as the eyes, bowel and very rarely, the heart and lungs.

AS inflammation of spinal joints (vertebrae) cause redness, heat, swelling and pain in the spine or vertebrae. Chronic inflammation can lead to pain and stiffness in and around the spine. With progression of the disease, inflammation of the spine (spondylitis) can lead to a complete cementing together (fusion) of the vertebrae thereby, causing the spine to fuse in a fixed and immobile position. This process is known as ankylosis. In some people, it can lead to a forward-stooped posture. This forward curvature of the spine is called kyphosis.

The common age group in which AS starts is teen or young adult years. Most cases develop symptoms before the age of 30. In rare cases, (less than five percent) symptoms develop after the age of 45. The disease is twice more common in men as compared with women.

Severity of symptoms can vary from mild to severe. Some people may have mild back pain that comes and goes whereas others have severe and ongoing pain. Back pain is the most common and significant symptom of AS. In most cases, the pain is mild initially and may gradually become worse over several months. Involvement of other joints such as hips, knees, ankles and shoulders can cause the affected joint to become painful, stiff and swollen. General symptoms that may be experienced by a person with AS include feeling generally unwell, tiredness, weight loss or anaemia. Chronic spondylitis and ankylosis (fusion of spine) can limit breathing capacity and lead to scarring of the lungs. This can cause coughing and shortness of breath, especially when the person does exercise or has an infection.

The exact cause of disease is not known and hence, there is no known way to prevent the disease. Currently, there is no medication, which can cure AS. In most cases, however, treatments and medications can reduce symptoms and manage the pain. Newer therapies such as biologic medications can potentially slow or halt the disease’s progression in some people.

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