Ankylosing Spondylitis

Ankylosing Spondylitis Risk Factors

AS affects less than 1% of the U.S. population. One of the main risk factors for AS is having the HLA-B27 gene. But most people who have the gene don't end up with AS, which means that other things play a role. People who don't have the HLA-B27 gene can also get AS.

You are more likely to have AS if you:

• Are assigned male at birth
• Are under 40 (about 80% of cases begin around age 30) 
• Have a close family member with AS 

Having another autoimmune disease could also raise your chances of having AS. These conditions include:

• Crohn's disease
• Psoriasis
• Ulcerative colitis

Ankylosing Spondylitis Diagnosis

AS can be tough to spot because so many people have back pain, its main symptom. 

Tests for ankylosing spondylitis

There’s no single test to confirm AS. Your doctor may rely on your symptoms as well as:

• A physical exam
• Blood tests to see if you have the HLA-B27
• An imaging test, such as an X-ray or MRI scan

Your doctor may also send you to a rheumatologist, a specialist who treats arthritis.

Progression of Ankylosing Spondylitis

Everyone's AS progresses in different ways. Some people never have more than mild back pain and stiffness. Others have more serious symptoms that get worse over time. Treatment can help at any stage. 

Early ankylosing spondylitis

In the first stages of AS, you might feel:

• Back pain and stiffness that usually starts in the morning and gets better as the day goes on, or when you exercise
• Pain in your neck
• Fatigue

Worsening ankylosing spondylitis

If AS progresses, it starts to affect your vertebrae and slowly moves up your spine, leading to more discomfort and stiffness in your back. It can begin to cause the bones in your spine to fuse, or join together. It may also affect where your ligaments and tendons join to your bones, and cause pain in your feet, legs, hips, ribs, and shoulders. You might feel extra tired as your body works to try to fight the inflammation.

Advanced ankylosing spondylitis

As the condition advances, more of the joints in your spine fuse together. This limits your movement. It may also flatten out the curve in your lower back and lead to a bent-over posture, called kyphosis. You might find it harder to breathe because your chest can't expand as much as it should.

Ankylosing Spondylitis Treatment

There are many options for treating AS, both medically and through lifestyle changes.

Exercise. Staying active is one of the things you can do to lessen your symptoms. The less you sit or lie down, the better you’ll feel. Exercise helps you stand straighter and keeps your spine limber. Staying active can also ease pain.

Physical therapy. You'll need to practice good posture, learn how to stretch tight muscles and keep your spine stable, and use other techniques that can ease your pain. You can do them at home, but most people benefit more from working with a professional physical therapist or with a group.

Lifestyle changes and home remedies for ankylosing spondylitis

Here are some things that can help you feel better:

Make time to exercise every day, even a few minutes at a time. Working out in water helps many people who have AS.

Keep a healthy weight: This ensures that your joints aren’t under as much stress. A diet high in omega-3 fatty acids might help. Watch for patterns if you think certain foods might trigger changes in how you feel.

Don’t smoke. People who smoke tobacco often have symptoms that get worse as they get older.

Manage stress with things such as massage, yoga, meditation, and counseling.

Apply heat to stiff joints and tight muscles, and use cold on inflamed areas.

Ankylosing Spondylitis Health Disparities

While it can be tricky to diagnose AS in anyone, the process often takes longer for women. That may be because the disease is less likely to show up on X-rays in women. Also, health care providers tend to think of AS as a men's disease. By the time many women are diagnosed, AS is in a later stage and harder to treat.

Black people are less likely to get AS than some other racial and ethnic groups. But when they do have it, it's likely to be more serious and more disabling. Doctors may also overlook some cases of AS in Black people because it's less common for them to get the condition.

Studies show that people with lower social and economic statuses also tend to have more serious AS. And the condition is likely to have more of an effect on their daily lives. 

Ankylosing Spondylitis Complications

AS can cause pain and inflammation throughout your body, including in your:

Spine. In rare cases, your vertebrae may become weak, making them more likely to fracture or break. Damaged vertebrae can press on or irritate a group of nerves in the bottom of your spinal cord called the cauda equina. You might have sexual problems, a loss of reflexes, or trouble controlling your bowels or bladder.

Eyes. About 40% of people with AS have an eye problem called uveitis. It’s a kind of eye inflammation that's painful and can blur your vision and make you sensitive to bright light. If you have uveitis, your doctor might check for AS even if you don’t have any other symptoms.

Lungs. Stiffness in your spine and ribs may keep you from breathing deeply. Sometimes, AS also leads to scarring in your lungs that can affect your breathing.

Heart. Rarely, AS can enlarge your aorta, the largest artery in your body. This can change the shape of your aortic valve, allowing blood to leak back into your heart. Your heart won’t pump as well, leaving you tired and short of breath.

People with AS are also more likely to get certain types of cancers. They include bone and prostate cancers in men and colon cancer in women, as well as blood-related cancers in both sexes.

Living With Ankylosing Spondylitis 

It's not always easy to live with a chronic condition such as AS. Taking good care of your physical and mental health can improve your daily life.

Ankylosing spondylitis diet

No particular diet has been shown to help with AS symptoms. But a balanced eating plan that helps you maintain a healthy weight is important. Extra weight adds stress on your joints, which can increase the pain of AS.

Your diet should include:

• Plenty of brightly colored fruits and vegetables, which are rich in anti-inflammatory nutrients called antioxidants
• Lean sources of protein
• Calcium and vitamin D for bone health
• Omega-3 fatty acids, found in fatty fish and some vegetable oils, which may benefit people with inflammatory types of arthritis

Limit highly processed and sugary foods as well as alcohol, all of which can contribute to inflammation.

Watch for patterns if you think certain foods might trigger changes in how you feel.

Costs of ankylosing spondylitis

If you have AS, you can expect to have extra health care expenses for things such as doctor visits, hospitalizations, and medication. One study found that people with AS spent 3.3 to 24.9 times more for health care each year than people without the condition. 

Depending on how serious your AS is, you may also have costs related to:

• Lost work time and productivity
• Mobility aids such as canes and reachers
• Accessibility upgrades to your home, such as handrails and grab bars 
• Hiring caregivers

Managing ankylosing spondylitis

Here are some things you can do to deal with some of the everyday effects of AS:

Move daily. Make time to exercise every day, even a few minutes at a time. Working out in water helps a lot of people with AS. Make sure your exercise routine includes moves that help you stay flexible. Stretching keeps your muscles from shortening and helps you avoid becoming bent over.

Use good posture. Work to keep your spine in good alignment, whether you're sitting, standing, lying down, driving, or walking. If you work at a desk, make sure it and your chair are properly positioned. Your physical therapist can teach you exercises to help with posture. 

Pace yourself. Listen to your body. To help preserve your energy when you're having a flare, break difficult tasks into small segments and do one at a time. Take rest breaks every 30 or 40 minutes. Delegate tasks to others when possible.

Ankylosing Spondylitis Prognosis

Most people who have AS never become seriously disabled. But some have spinal fusion and joint damage that limit their movement. They may need help with daily activities such as bathing, dressing, and household chores. 

AS itself doesn't usually shorten your life. But some of its complications, such as heart disease or spinal fractures, can affect life expectancy. 

Can ankylosing spondylitis be cured?

AS is a lifelong disease that doesn't have a cure. You also can't reverse its damage to your spine and joints once you have it.

Takeaways

Early diagnosis and treatment can prevent disability in people with AS. Talk to your doctor if you think you might have AS. If you've already been diagnosed, exercise, physical therapy, and medications can ease symptoms and keep you active.

Ankylosing Spondylitis FAQs

Is ankylosing spondylitis a serious disease?

If diagnosed early, ankylosing spondylitis can be managed well with medications, physical therapy, and lifestyle changes. When it's not caught early and worsens without treatment, it can become a more serious condition.

Who is most likely to get ankylosing spondylitis?

White men below the age of 40 and people who have the HLA-B27 gene.

What is the life expectancy of ankylosing spondylitis?

With proper treatment, AS has a minor effect on life expectancy. But without proper treatment, the risk of complications and death increases.