Ankylosing spondylitis: clear steps to spot it and live better
Does your lower back hurt most after waking up and loosen after you move? That pattern is classic for ankylosing spondylitis (AS). It often starts in your late teens to 30s and can slowly stiffen the spine if ignored. The good news: early diagnosis and the right care make a big difference.
AS is an inflammatory disease that mainly affects the sacroiliac joints and the spine. Expect morning stiffness, back pain that improves with exercise, and sometimes pain where tendons attach to bone (like the heel). Other clues include reduced chest expansion, eye inflammation (sudden red, painful eye), fatigue, and occasional swelling in hips or shoulders.
Worried you have it? Here’s how doctors confirm the diagnosis: they’ll ask about symptoms and family history, do a physical exam (simple tests measure spinal flexibility), and often order blood tests like HLA-B27. A positive HLA-B27 raises the chance of AS but isn’t a diagnosis by itself. Imaging matters: X-rays can show sacroiliitis in later stages, while MRI catches early inflammation before X-rays change.
Treatment basics that actually help
First-line treatment for pain and stiffness is regular NSAIDs—these reduce inflammation and often help patients get moving. If you have peripheral joint problems, drugs like sulfasalazine can help; it’s used for joint inflammation outside the spine. For persistent axial disease that doesn’t respond to NSAIDs, biologic drugs (TNF inhibitors or IL-17 blockers) are very effective at controlling inflammation and protecting function.
Medicine is only one part of the plan. Daily exercise and physiotherapy are essential. Stretching that focuses on spinal extension, chest-opening exercises, and low-impact cardio (swimming, walking, cycling) keeps you flexible and reduces pain. A physiotherapist can show you posture drills and a tailored routine.
Practical tips for everyday life
Keep moving: set an alarm to stand and stretch every 30–60 minutes. Sleep on a medium-firm mattress and use a pillow that supports neck alignment. If you sit for work, try a standing desk or add short walking breaks. Stop smoking—smokers with AS have worse outcomes.
Watch for extra symptoms: sudden eye pain or vision changes need quick medical attention. If you’re starting biologics, plan vaccinations and discuss infection risks with your doctor. Bone health matters—ask about bone density checks, since long-term inflammation can increase fracture risk.
Track your symptoms and meds in a simple diary or app—this helps your rheumatologist tune treatment. Join a local or online support group to swap tips on exercise, work adjustments, and pain flares. With the right team—rheumatologist, physiotherapist, and primary care—you can control inflammation, protect your spine, and stay active.
If you’re unsure what to do next, book an appointment with a rheumatologist. Early action pays off: fewer flares, better posture, and more freedom to do the things you enjoy.
