Understanding Ankylosing Spondylitis
Ankylosing spondylitis (AS) is a type of arthritis that causes inflammation affecting the joints and ligaments in the spine and can cause the bones of the spine (vertebrae) to fuse. This makes the spine less flexible and causes stiffness. In severe cases, the spine becomes rigid and inflexible. The cause of AS is unknown. Research shows some people with HLA-B27 (a protein in the blood) are at increased risk of developing the disease. Other risk factors include family history, age (most people develop AS before age 45), and other conditions such as Crohn’s disease, ulcerative colitis, or psoriasis.
Symptoms of Ankylosing Spondylitis
The most common symptoms of ankylosing spondylitis (AS) are pain and stiffness in the lower back and/or hips. Pain may worsen during periods of inactivity which may be relieved by moving or exercise. Pain may be worse in the middle of the night or after prolonged sitting. Symptoms vary person to person and may be mild and intermittent or may be chronic resulting in severe pain. When AS affects other areas of the body additional symptoms may develop including pain and stiffness in affected areas (ribs, shoulders, knees, feet), difficulty taking deep breaths (if rib joints are affected), vision changes and eye pain, fatigue, loss of appetite, weight loss, skin rashes, abdominal pain and loose bowel movements.
Diagnosing Ankylosing Spondylitis
Diagnosing ankylosing spondylitis (AS) includes a physical exam, medical history, family history, x-rays, and blood tests.
Treating Ankylosing Spondylitis
There is no cure for AS but there are treatments to help manage it. The goals of treatment include symptom relief, maintaining good posture, flexibility, and strength, and stopping or slowing worsening of AS. Treatment medications may include over the counter anti-inflammatory medications, injections of steroids into the affected joints, and biologic medications including FDA-approved drugs commonly prescribed to reduce signs and symptoms of AS such as infliximab (e.g., Inflectra®, Remicade®) and golimumab (Simponi Aria®), administered into the blood stream intravenously. An FDA-approved formulation of golimumab (Simponi®) is administered under the skin subcutaneously. Other biologics including Janus kinase (JAK) inhibitors may also be prescribed if the disease is not responsive to other treatments.
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Last reviewed 12/16/2025
