Ankylosing Spondylitis 101

Dr. A. Tieng: Ankylosing spondylitis is a disease that can cause pain and stiffness in the back. It's a type of spinal arthritis, meaning that it's an inflammatory arthritis of the spine. Dr. B. Johnson: You have an immune system in a normal person that fights cold and infections. In the person with ankylosing spondylitis, your own immune system is attacking your spine and your hips, and causing inflammation and pain. Dr. A. Tieng: Some people believe that the cause for ankylosing spondylitis starts in the gut. In the gut, you can have immune cells that are activated and then they migrate to the joints where they lead to an inflammatory process. Dr. B. Johnson: Ankylosing spondylitis has a genetic component, but not in the sense of, there's one gene that if you have it you will have ankylosing spondylitis. But patients who have this genotype, called HLA-B27, are more likely to develop ankylosing spondylitis. Dr. A. Tieng: The gene for HLA-B27 can be detected in the blood. Dr. B. Johnson: The symptoms of ankylosing spondylitis are pain and stiffness in the low back. Dr. A. Tieng: Including arthritis in the shoulders, hips, knees, ankles, and also can cause pain in the heels. Dr. B. Johnson: It typically occurs in younger individuals, aged 45 and under, and it tends to affect men more than women, although women can also get it. Dr. A. Tieng: Because it affects patients who have symptoms in their teenage or young 20s, they may brush off the back pain as from another cause and not really seek medical attention right away. Dr. B. Johnson: The difference with ankylosing spondylitis is that it's usually low back pain that goes on for three months or longer. The other clue is that the pain is worse in the morning and it gets worse with rest and better with activity. Dr. A. Tieng: There is no one test to diagnosis ankylosing spondylitis. Dr. B. Johnson: There are different diagnostic criteria that your doctor would use. X-rays, the types of symptoms, as well as blood work. Dr. A. Tieng: If someone is untreated for ankylosing spondylitis, that patient can develop kyphosis, which can look like a hunchback posture. Dr. B. Johnson: Their spine will kind of hunch forward and they'll be stuck in a position where they're basically looking at the ground. So I think it's very important for patients with AS to maintain a positive outlook. Dr. A. Tieng: They can lead a comfortable life if they seek treatment.