Ankylosing Spondylitis

Ankylosing spondylitis is a type of arthritis that causes the spine to become stiff, resulting in spinal pain. Ankylosing spondylitis is an inflammatory disease that causes fusion in the smaller bones of your spine, called vertebrae.

Signs and symptoms

Ankylosing spondylitis commonly affects the lower back, hips, shoulder joint, neck and cartilage between the breastbone and ribs. Early symptoms include pain or stiffness in the lower back and hips, as well as neck pain or fatigue. It may be worse in the morning, after sitting for an extended time or after inactivity. Other signs can include tiredness, difficulty breathing and swelling in the joints. In some cases, this results in the spine bending forward and becoming immovable. 

Potential Causes

We aren’t sure what causes this condition. Researchers have identified a protein called HLA-B27, which is produced by a gene in most people with ankylosing spondylitis. The theory is that this protein may have influence on the immune system and result in these symptoms. 


Diagnosis of ankylosing spondylitis starts with a physical exam and medical history. Other procedures and tests may be needed to diagnose this condition, including x-rays and magnetic resonance imaging (MRI).

Treatment options

Treatment options depend on the severity of your symptoms and can include:

  • Medication to reduce pain, stiffness and swelling
  • Physical therapy to improve range of motion and reduce stiffness
  • Steroid injections.  This procedure injects a steroid and a local anesthetic into the space around your spine to help decrease inflammation and swelling, typically leading to improvement in pain in your neck, arms, back and legs. 
  • Surgery to repair joint damage or reduce severe pain.
    • Lumbar decompression and fusion surgery.  This procedure is performed to take pressure off of the nerves in the lower back and to treat or prevent instability of the lower spine. Your surgeon will remove a window of bone—a procedure called a laminectomy—as well as ligament and parts of the joints of the spine to take the pressure off of the nerves. The fusion portion of the procedure involves using screws and rods to connect bones of the spine together, along with placing bone grafts that will grow over time, typically 6 – 12 months, and fuse the bones of the spine together.

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