Ankylosing spondylitis (AS) is a rare type of arthritis that causes pain and stiffness in your spine. This lifelong condition, also known as Bechterew disease, usually starts in your lower back. It can spread up to your neck or damage joints in other parts of your body.
“Ankylosis” means fused bones or other hard tissue. “Spondylitis” means inflammation in your spinal bones, or vertebrae. Severe cases can leave your spine hunched.
Symptoms may include:
AS often starts in your sacroiliac joints, where your spine connects to your pelvis. It can affect places where your tendons and ligaments attach to bones. It can even cause your vertebrae to fuse together.
You might have pain or stiffness in your:
You might also notice:
Pain that’s worse in the morning or after sitting for a long time
A rigid spine that curves forward
Swelling in your joints
Trouble taking deep breaths
Symptoms can differ from person to person. Your condition also may change quicker or slower than someone else’s.
Complications may include:
AS can cause pain and inflammation throughout your body, including:
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 trouble controlling your bowels or bladder, sexual problems, or a loss of reflexes.
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.
Heart valve: 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, which can leave 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.
Causes may include:
Researchers aren’t sure what triggers AS, but they think it’s tied to your genes. Most people with AS have a gene that makes a protein called HLA-B27. Doctors think it tells your immune system to attack some common bacteria in your body and sets off AS symptoms.
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Certain things that you can’t control might raise your risk of AS:
Sex: Men are more likely than women to have AS, and it strikes them earlier and harder. Women tend to have a milder form of AS called non-radiographic axial spondyloarthritis.
Age: AS often starts in your teens and young adulthood. About 80% of cases begin before the person turns 30, and 95% by age 45.
Ankylosing Spondylitis Diagnosis
Can be tough to spot because so many people have back pain, has main symptom. A diagnosis may be even trickier for women because the condition is much more common in men.
There’s also no single test to confirm AS. Your doctor may rely on your symptoms, a physical exam, and blood tests.
You also might have an X-ray or an MRI. But this doesn’t always help, because joint damage may not show up right away on imaging tests.