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Ankylosing Spondylitis

(Marie-Strumpell Disease)

Definition

Ankylosing spondylitis is an inflammation in the joints and tissues of the spine. The bones in the spine may also grow together. This leads to stiffness and problems moving the spine.

Ankylosing Spondylitis
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Causes

The exact cause is not known. Genes and the environment may play a role.

Risk Factors

This problem is more common in men. It often starts in people who are 20 to 30 years of age.

Other things that may raise the risk are:

  • Having other family members with ankylosing spondylitis
  • Having a marker on HLA-B27 gene

Symptoms

Problems may be mild to severe. The main problem is pain and stiffness in the lower back and where the back and hip meet. The pain may also spread down the legs.

Other problems may be:

  • Pain that is often worse at night
  • Stiffness that is worse in the morning
  • Pain that gets better with activity
  • Pain and stiffness in other joints
  • Chest pain
  • Eye pain, eyesight changes, or increased tearing

Less common symptoms may be:

  • Lack of energy
  • Lack of hunger
  • Weight loss
  • Fever
  • Numbness
  • Blood in the urine

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. It will focus on the spine.

Blood tests may be done to check for the HLA-B27 gene marker.

Images of the joints may be taken. This can be done with:

Treatment

There is no cure. The goal of treatment is to manage symptoms and prevent them from worsening. Choices are:

  • Medicines to ease pain and inflammation, such as:
    • Over the counter or prescription nonsteroidal pain relievers
    • Corticosteroids
    • Disease-modifying antirheumatic drugs (DMARDs)
  • Regular exercise and physical therapy to promote strength, flexibility, and range of motion

People who are not helped by these methods may need surgery. A hip or joint replacement may be done to ease pain and promote movement. Spinal surgery may also be needed to improve posture.

Prevention

There are no known guidelines to prevent this health problem.

RESOURCES:

Arthritis Foundation
http://www.arthritis.org

Spondylitis Association of America
http://www.spondylitis.org

CANADIAN RESOURCES:

The Arthritis Society
http://www.arthritis.ca

Canadian Spondyloarthritis Association
http://www.spondylitis.ca

REFERENCES:

Ankylosing spondylitis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/ankylosing-spondylitis. Accessed February 16, 2021.

Ankylosing spondylitis. Spondylitis Association of America website. Available at: http://www.spondylitis.org/About-Spondylitis/Ankylosing-Spondylitis. Accessed February 16, 2021.

Ankylosing spondylitis. University of Washington Orthopedics and Sports Medicine Department website. Available at: http://www.orthop.washington.edu/?q=patient-care/articles/arthritis/ankylosing-spondylitis.html. Accessed February 16, 2021.

Sieper J, Poddubnyy D. Axial spondyloarthritis. Lancet. 2017 Jul 1;390(10089):73-84.

Last reviewed December 2020 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM  Last Updated: 2/16/2021