Ankylosing spondylitis
Also called: Axial spondyloarthritis
Inflammatory arthritis of the spine and pelvis causing back pain and stiffness that is worse in the morning and better with exercise. Over years parts of the spine may fuse.
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Causes
- Immune-mediated; strongly associated with HLA-B27
Risk factors
- HLA-B27
- Family history
- Male sex
- Onset before 45
Symptoms
- Chronic low back pain starting before 45
- Morning stiffness over 30 minutes
- Pain improving with activity and worse with rest
- Night pain
- Heel pain, eye inflammation (uveitis)
Diagnosis — tests and examinations
- MRI of sacroiliac joints
- HLA-B27
- CRP
Treatment
Medicines and medical treatment
- NSAIDs
- Biologics: anti-TNF or anti-IL-17 (secukinumab)
- JAK inhibitors
Operations and procedures
- Hip replacement or spinal surgery in advanced disease
Self-care, home remedies and lifestyle
- Daily stretching and exercise
- Stop smoking
- Posture awareness
Possible complications
- Spinal fusion and fracture
- Uveitis
- Heart and lung involvement
Prevention
- Early diagnosis and treatment
Outlook
Modern biologics control symptoms and may slow progression.
When to see a doctor
See a doctor for back pain over 3 months that is worse in the morning and better with exercise.
Sources and further reading
These sources cover this condition. They have not been checked against every statement on this page.
Related conditions
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