Overview
Ankylosing spondylitis (AS) is a form of inflammatory arthritis that mainly affects the spine and the sacroiliac (SI) joints. It is part of a larger group called axial spondyloarthritis. Over time, some people develop stiffness and new bone formation that can fuse parts of the spine.
Inflammatory back pain often starts before age 45, improves with movement and worsens with rest, which helps tell it apart from mechanical back pain.
Watch and learn
Video: “Ankylosing Spondylitis : Disease Overview (1 of 5)” from Johns Hopkins Rheumatology on YouTube. It loads from youtube-nocookie.com only when you press play. Shown for general education; GSMC did not produce it. Watch on YouTube
Video: “Ankylosing Spondylitis - Treatment (4 of 5)” from Johns Hopkins Rheumatology on YouTube. It loads from youtube-nocookie.com only when you press play. Shown for general education; GSMC did not produce it. Watch on YouTube
Captions: press the CC button in the video player to turn on captions. Some captions are generated automatically by YouTube and may contain errors.
Symptoms
- Low back or buttock pain that lasts more than 3 months
- Morning stiffness that improves with exercise
- Pain that wakes you in the second half of the night
- Heel pain or tendon pain (enthesitis)
- Eye inflammation (uveitis): red, painful eye; seek prompt care
- Reduced spinal flexibility
Causes and risk factors
- Genetic risk, including the HLA-B27 gene
- Immune-driven inflammation
- Links with psoriasis and inflammatory bowel disease
How it is diagnosed
- Blood tests: HLA-B27; CRP and ESR for inflammation
- Imaging: X-rays of the SI joints; MRI can show early inflammation before X-ray changes
- Exam: spinal mobility and chest expansion measurements
Treatment, step by step
Treatment is tailored to you. Medicines are described here in general terms; your rheumatologist will explain the specific options, benefits, risks and monitoring for your situation.
Lifestyle and self-care
Daily exercise and stretching are central to care. Posture work and not smoking may help.
Disease-modifying medicines (DMARDs and biologics)
NSAIDs are often the first medicine. If inflammation continues, biologics such as TNF or IL-17 inhibitors may be used.
Joint injections and infusions
Injections may help a single inflamed joint, such as the SI joint, in selected cases.
Referral and team care
Care may involve ophthalmology for uveitis and gastroenterology for bowel symptoms.
What to expect at GSMC
- Your first visit: a rheumatologist reviews your symptoms, history and medicines and examines your joints, skin and other areas.
- Tests: blood tests and imaging, as needed, to confirm the diagnosis and check how active the disease is.
- Your plan: we explain your options, including lifestyle steps and medicines, and how each is monitored.
- Follow-up: regular visits and lab checks to adjust treatment over time.
Shahzad Hussain, MD sees rheumatology patients in Brick, Toms River and Whiting. Call 732-202-3000 to schedule.
Frequently asked questions
How is AS different from regular back pain?
Inflammatory back pain improves with activity, worsens with rest and often comes with morning stiffness.
Does everyone with HLA-B27 get AS?
No. Most people with HLA-B27 never develop it.
Is exercise safe?
Yes. Regular exercise and stretching are a core part of treatment.
This page is general patient education and does not replace advice from your own clinician. Individual results vary.