Ankylosing Spondylitis (AS)/Inflammatory Back Pain for AS

AS is a type of arthritis that affects mainly the joints of the spine (back-bone) and the buttocks. As these joints become damaged, the spine stiffens and back becomes less flexible. AS usually affects teenagers and young adults, less than 40 years old.

The cause of AS is unknown, but genetic factors are implicated, particularly, the gene HLA B-27, which is present in 90% of patients with AS.

• Back pain and stiffness, which usually starts from the lower back or neck, and persists over several months. The pain is usually worse in the morning and may wake you up at night. Rest does not make it better but exercise eases the pain.
• Other joints, tendons and ligaments may also be affected. Sometimes the eye may become painful, red and inflamed.

If you experience these symptoms, seek a doctor’s advice. You may be referred to a specialist Rheumatologist who will confirm the diagnosis and start you on appropriate treatment.

Diagnosis is made based on a combination of a patient’s symptoms, blood tests and imaging studies such as X-rays or MRI.

The symptoms of AS can be alleviated, and joint damage can be prevented by prompt and appropriate treatment:

• Exercise is the cornerstone of treatment for AS. A physiotherapist will teach you specific exercise routines for AS. In addition, non-spinal loading exercises such as swimming are very useful.
• Non-steroidal anti-inflammatory drugs (NSAIDs) are useful for pain control and reduction of inflammation.
• Biologics are targeted medications and are reserved for patients with severe disease in whom other treatments including NSAIDs have failed.