Ankylosing Spondylitis

What is Ankylosing Spondylitis (AS)?

Ankylosing spondylitis (AS) is a chronic inflammatory disease that primarily affects the spine, causing pain, stiffness, and loss of mobility. 

It belongs to a group of conditions known as spondyloarthritis, which are characterised by inflammation of the joints and entheses (the sites where tendons and ligaments attach to bones).

Early symptoms often include back and neck pain, which is usually worse early in the morning or after rest. The pain may improve with exercise. AS can also affect other joints or include symptoms such as bowel irritation and sore eyes.

Common early symptoms include aching across the buttocks and pain across the chest or between the shoulder blades. Symptoms may flare and go into remission or slowly worsen over time. Without early treatment AS may lead to permanent stiffening of the spine and damage to other joints.

While AS can be challenging to live with, understanding the condition and its management can greatly improve quality of life.

Symptoms of Ankylosing Spondylitis (AS):

The most common symptoms of AS include:

  1. Back Pain: Persistent pain and stiffness in the lower back, buttocks, and hips are common symptoms of AS. This pain is often worse in the morning or after periods of inactivity.
  2. Stiffness: People with AS may experience stiffness and limited mobility, particularly in the morning or after prolonged periods of sitting or lying down.
  3. Fatigue: Chronic inflammation and pain associated with AS can lead to fatigue and reduced energy levels.
  4. Joint Pain: In addition to the spine, AS can affect other joints such as the shoulders, knees, and ankles, causing pain and swelling.
  5. Eye Inflammation: Some people with AS may develop inflammation of the eyes (uveitis), leading to redness, pain, and sensitivity to light

Who gets it?

AS usually runs in the family and can be associated with people who carry the HLA-B27 gene. Generally symptoms will appear between the ages of 15-40.

How is it diagnosed?

Diagnosing AS can be challenging, as its symptoms can mimic those of other conditions.

A rheumatologist can diagnose AS by analysing tests and examining your symptoms.

The rheumatologist will usually discuss your family history; examine your spine and other joints, your eyes; test a blood sample for the HLA-B27 gene; and may order an x-ray or scan of your spine and pelvis.

What is the treatment?

There is currently no cure for AS but there has been great progress in managing the disease. Treatment options may include:

#1. Medications:

Medications can help slow down the damage, relieve pain and stiffness and reduce long term disability. The aim of treatment is remission - to be symptom free and return to normal function. Each person responds differently to medications, so you will need to work with your rheumatologist or GP to find the best medications for you.

#2. Eating well:

Eating a balanced diet that is low in saturated fat, sugar and salt, but high in fresh fruit, vegetables and healthy fats (omega-3 fatty acids) is good for most people. Managing your weight can help you reduce strain on your lower back, hips, legs and feet.

#3. Keeping active:

Regular physical activity helps reduce pain, strengthen muscles, maintain good posture and improves overall health. Consider working on a prescribed set of exercises with your physiotherapist. Suggested activities include swimming, walking, jogging, low-impact aerobics and tennis. 

#4. Psychological:

By taking control of your condition you can approach it with a positive attitude. Early diagnosis, a good relationship with your doctor and assistance from a psychologist can help you to deal with pain and the psychological impact of AS.

What Are Some Ways to Help Manage AS?

Living with ankylosing spondylitis requires proactive management and self-care. Here are some tips for managing AS effectively:

#1. Maintain Good Posture: Practice good posture habits to minimise strain on the spine and prevent worsening of symptoms.

#2. Use Heat Therapy: Applying heat packs or taking warm baths can help reduce pain and stiffness in the joints.

#3. Seek Support: Joining one of our Online Support Groups or connecting with others living with AS in our Peer-Mentor Telephone Service 'Arthritis Assist' can provide valuable emotional support and practical advice. 

#4. Stay Informed: Stay informed about the latest research and treatment options for AS, and work closely with your healthcare team to develop a personalised management plan.


Learn about Associate Professor Tony Kenna's research on the treatment of AS -  Personalised Medicine in the treatment of Ankylosing Spondylitis

By understanding ankylosing spondylitis and actively managing its symptoms, people with AS can lead fulfilling and productive lives despite the challenges posed by the condition.

With the right combination of treatment, lifestyle modifications, and support, it is possible to minimise the impact of AS and maintain a good quality of life.

How can we help? 

More information and support 

Order your free booklet Taking control of your Ankylosing Spondylitis. 

Join one of our online support groups to connect with other Australians living with arthritis. 

Register for Arthritis Assist to speak one-on-one with someone else living with arthritis. 

Register for our online exercise program, Arthritis Moves!