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Ankylosing Spondylitis
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Immune System

Ankylosing Spondylitis

Ankylosing spondylitis is a chronic inflammatory arthritis that primarily affects the spine, causing pain, stiffness, and potential fusion of vertebrae. Early diagnosis and treatment can manage symptoms and slow disease progression.

What is ankylosing spondylitis?

Ankylosing spondylitis (AS) is a type of arthritis of the spine. It causes inflammation (swelling) between your vertebrae (the bones that make up your spine) and the joints between your spine and pelvis. AS inflammation can cause stiffness and make it difficult to move and bend.

Symptoms of AS can range from mild to severe back pain. Over time, AS can fuse (grow together) your vertebrae, limiting movement and causing a hunched posture. In some people, AS can affect other joints or body parts.

There is no cure for AS, but early treatment can help manage symptoms, slow down the disease, and help you lead a more productive life.

Who is more likely to get ankylosing spondylitis?

Ankylosing spondylitis usually starts before age 45. Early symptoms may begin between the ages of 15 and 30. Your chance of developing AS can also increase if:

  • You're a man. AS is more common and severe in men.
  • You have a family history. If a member of your family has AS, you're more likely to get the disease.
  • You have other medical conditions that may increase your risk of getting AS. These include Crohn's disease, ulcerative colitis, or psoriasis.

What causes ankylosing spondylitis?

No one knows what causes ankylosing spondylitis, but the environment and genes likely play a role. Your genes are parts of DNA in your cells that are passed down from your parents. Certain genes may increase your risk of getting the disease, but not everyone with these genes gets AS.

What are the symptoms of ankylosing spondylitis?

AS affects people differently. The most common symptom is pain and stiffness in the lower back and/or hips. The pain is usually worse during the night or after sitting for a long time.

Over time, AS may progress to other areas of your spine or body. Symptoms may depend on which areas of your body the disease affects. Some people have symptoms that come and go. Others may have severe, ongoing pain.

Other symptoms of ankylosing spondylitis may include:

  • Pain, stiffness, and inflammation of the joints.
  • Difficulty taking a deep breath. This could occur if the joints connecting the ribs are affected.
  • Changes in vision.
  • Fatigue.
  • Loss of appetite.
  • Weight loss.
  • Skin rashes, such as psoriasis.
  • Abdominal (belly) pain and loose stools (poop).

How is ankylosing spondylitis diagnosed?

There is no single test for ankylosing spondylitis. To find out if you have AS your health care provider may:

  • Ask about your medical history, including your symptoms.
  • Ask about your family health history, including relatives who have had AS.
  • Do a physical exam.
  • Order blood tests or imaging studies.

What are the treatments for ankylosing spondylitis?

AS has no cure, but treatment may help relieve symptoms, maintain posture, and slow down the disease. Since other parts of your body can be affected by AS, you will likely work with a team of health care professionals for tests, diagnosis, and care.

Treatment usually includes medicine to help relieve symptoms and keep the disease from getting worse, as well as physical therapy to improve mobility. If AS is severe, surgery may be needed.

You can help manage your AS symptoms if you:

  • Exercise
  • Monitor your symptoms
  • Manage your stress
  • Use assistive devices as needed
  • Follow a healthy diet
  • Stop smoking, or don't start

Frequently Asked Questions

Unlike mechanical back pain, which typically improves with rest and worsens with activity, ankylosing spondylitis pain is inflammatory. It is often worse in the morning or after periods of inactivity and improves with gentle movement or exercise. Additionally, AS pain usually lasts for more than three months and may be accompanied by morning stiffness that lasts longer than 30 minutes. If your back pain is persistent, improves with exercise, and is associated with fatigue or other symptoms like eye inflammation, you should consult a rheumatologist for evaluation.
The HLA-B27 gene is present in approximately 90% of people with ankylosing spondylitis, but it is also found in about 8% of the general population. Therefore, a positive HLA-B27 test alone is not diagnostic for AS. It is used as a supportive tool in conjunction with clinical symptoms and imaging. A diagnosis is typically confirmed when a patient has chronic inflammatory back pain, a positive family history or HLA-B27 status, and radiographic evidence of sacroiliitis (inflammation of the sacroiliac joints) or MRI findings of active inflammation.
Regular, low-impact aerobic exercise is critical for maintaining spinal mobility and posture. Swimming and water aerobics are often recommended because the buoyancy reduces stress on the joints while allowing for full range of motion. Stretching exercises, particularly those targeting the chest, hips, and hamstrings, help counteract the forward hunching posture that can develop over time. It is also important to maintain good posture during daily activities and use a firm mattress with a thin pillow to prevent spinal curvature while sleeping.
Yes, AS is a systemic inflammatory disease that can affect other parts of the body. Common extra-articular manifestations include uveitis (inflammation of the eye), which presents as eye pain, redness, and sensitivity to light, and requires immediate ophthalmologic care to prevent vision loss. AS is also strongly associated with inflammatory bowel disease, such as Crohn's disease or ulcerative colitis, so persistent gastrointestinal symptoms should be reported. Additionally, it can cause aortic regurgitation or heart block in rare cases, so regular cardiovascular monitoring is advised for long-term patients.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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