Ankylosing spondylitis is a variation of arthritis affecting the spine and pelvis. The underlying cause is unknown but 90% of those affected in the UK are HLA-B27 antigen positive. It is therefore thought to have a combination of genetic and environmental factors and be underpinned by an autoimmune response.
Diagnosis is with a combination of clinical examination, blood tests and imaging.
Signs and symptoms appear gradually over time and result in chronic lower back pain combined with stiffness, particularly bad in the early morning. Progression leads to loss of spinal flexibility and limitation of range of movement, particularly in flexion and extension of the lumbar region. Eventually it can lead to fusion of the vertebrae and a rigid kyphotic posture.
Treatment involves medications to relieve pain and stiffness and slow the progression of the disease. This often involves anti-inflammatory drugs and disease-modifying anti-rheumatic drugs. TNF-alpha blockers can often be useful as can other specialist drugs under the supervision of a rheumatologist. Physiotherapy is often helpful in reducing pain and stiffness. Very occasionally surgery to correct spinal deformity or replace joints is required in severe cases.
If you would like to speak to a rheumatologist about potential management of ankylosing spondylitis or to one of our spinal surgeons about potential surgical management, please contact the office on 01483 938750 or email firstname.lastname@example.org.