About your disease

Ankylosing spondylitis (AS) is a disease where the body's immune system mistakenly attacks the joints of the spine. This results in pain and stiffness (inflammation) in the back.

AS IN OTHER JOINTS

AS can also cause:

• Pain and stiffness in peripheral joints, such as the hips and shoulders
• Inflammation of the tendons surrounding the joints. Some of the common spots for this are the back of the heels (Achilles tendonitis), underneath the bottoms of the feet, on the outside of the hips, and along the breast bone.

AS IN OTHER PARTS OF THE BODY

AS may also cause inflammation in the eye, a condition called uveitis or iritis. In rare cases, the lungs and heart can also be affected.

Symptoms of AS

INFLAMMATION

Pain and stiffness in your lower back and hips, especially in the morning and after periods of inactivity.

The most common areas of pain and stiffness are:

• The joint between the base of the spine and pelvis
• The vertebrae in the lower back
• Between your breastbone and ribs
• Hip and shoulder joints

POSTURE CHANGE AND BONE PROBLEMS

In AS, some of the vertebrae in your spine may fuse together. This makes the spine less flexible and can lead to a hunched-forward posture.

EXTREME TIREDNESS (FATIGUE)

The body burns energy to deal with the inflammation of AS, thus causing fatigue. Also, mild to moderate anemia (low levels of red blood cells) can occur which makes you feel tired.

Diagnosis

There is no specific test that will diagnose AS. Some people live with mild AS for many years without knowing they have it.

If, following a discussion of current symptoms, AS is suspected, your doctor will do the following:

• Physical examination
• Perform blood tests (to detect inflammation)
  • Erythrocyte sedimentation rate (ESR)
  • C-reactive protein (CRP)
• X-rays may be taken to determine if there are changes in the joints at the bottom of the spine.
  • Further imaging may be done with a CT scan or an MRI

Other health problems that may occur with AS

Compression fractures: 

• A thinning of the bones may occur during the early stages of AS. Weakened vertebrae may crumble and vertebral fractures can damage the spinal cord and the nerves that pass through the spine.

Difficulty breathing: 

• If AS affects the ribs, the fused bones can't move when you breathe; therefore, it becomes difficult to fully inflate your lungs.

Heart problems: 

• AS can affect the aorta, the largest artery in your body. The inflamed aorta can enlarge to the point that it distorts the shape of the aortic valve in the heart, which has a negative effect on its function.

Extra articular manifestations