Ankylosing Spondylitis

Ankylosing spondylitis is a type of arthritis that primarily affects the spine. It causes inflammation in the sacroiliac joints, vertebrae and the small joints between them, resulting in pain and discomfort. In advanced cases, it can lead to severely restricted mobility due to the formation of new bone and bony fusion of adjacent vertebrae. Ankylosing spondylitis typically affects young adults (ages 17 to 35), tends to be hereditary, and affects men two to three times more often than women. The disease course is highly variable.

What Are the Symptoms of Ankylosing Spondylitis?

Ankylosing spondylitis symptoms tend to originate in the lower back and buttocks and develop gradually over a period of months to years. It is not uncommon for these symptoms to disappear and reappear at irregular intervals. Many patients have had symptoms for several years before seeking medical help.

Typical symptoms of ankylosing spondylitis include:

Lower back pain and stiffness, particularly on waking up in the morning (caused by inflammation in the spine).
Buttock pain (due to inflammation in the sacroiliac joints), which may alternate between left and right
Reduced mobility and chest tightness due to stiffening of the spine. Tying shoes or turning the head when driving may be difficult.

Additional symptoms may include:

Fatigue.
Pain, swelling and limited range of motion in the hips and other joints.
Pain at sites where tendons attach to bones (enthesitis).
Eye inflammation.

Ankylosing Spondylitis Diagnosis and Treatment at Brigham and Women's Hospital

Physicians at the Brigham and Women’s Hospital (BWH) Center for Arthritis and Joint Diseases collaborate with BWH specialists in orthopaedics, bone and joint radiology, occupational and physical therapy, pain management, physiatry, and other services to evaluate and treat ankylosing spondylitis.

Diagnosis

Following a complete medical history and a thorough physical examination, your physician may also order one or more of the following diagnostic tests to evaluate your condition:

C-reactive protein (CRP). This blood test measures inflammation.
X-ray or MRI. These imaging studies detect bony abnormalities and inflammation in the spine.
Genetic testing for HLA-B27. Most patients with the disease carry a copy of this gene, and this test may help in establishing a diagnosis.

Treatment

Treatment for ankylosing spondylitis is focused on reducing pain and stiffness and preventing deformities. Spondylitis treatments may include:

Non-steroidal anti-inflammatory drugs (NSAIDs) to reduce pain and stiffness.
Tumor necrosis factor (TNF) blockers to reduce pain and stiffness.
Physical therapy and exercise to strengthen the back muscles, maintain flexibility, and promote good posture.
Disease-modifying anti-rheumatic drugs (DMARDs) to treat the arthritis in peripheral joints.
Surgery may be required to replace a severely damaged hip joint or, rarely, to correct deformities of the spine.

Bone and Joint Care at Brigham and Women's Hospital

The Orthopaedic & Arthritis Center at BWH is one of the most highly regarded orthopaedic and joint disease research and treatment programs in the world. Comprehensive and innovative bone and joint care is the foundation of the Center, beginning nearly a century ago when one of our founding hospitals, the Robert Breck Brigham Hospital, became the first teaching hospital in the country wholly devoted to arthritis and related diseases.

Today, the Center – a collaboration of the Department of Orthopaedic Surgery and the Division of Rheumatology, Inflammation, and Immunity – is known for its pioneering team of physicians and researchers dedicated to doing everything possible for our patients while helping to develop and apply the most advanced treatments for bone and joint diseases and conditions.

Patient- and Family-centered Care

BWH has long been committed to not only the care of our patients but also the many other needs that they and their families have. This philosophy of patient- and family-centered care involves systems and services that emphasize healing in a comfortable, relaxed environment.

Quality of Patient Care

BWH is committed to providing all of our patients with the safest, highest-quality, most-satisfying care possible and follow established protocols that have been shown to improve patient outcomes. Our Inpatient Satisfaction Survey, sent to patients to assess their total care experience, helps us to monitor what we are doing well and areas for improvement. We pride ourselves in the Quality of Patient Care we provide and how we are measured compared with other hospitals.

Brigham and Women's Hospital Ankylosing Spondylitis Care Team

Year after year, our Rheumatology and Orthopaedic Services are ranked among the top programs in the country by U.S. News & World Report.

The Orthopaedic & Arthritis Center is able to maintain this level of care through a combination of medical expertise, with one of the largest and most experienced staffs in the country; a commitment to quality care, demonstrated by our numerous quality and safety awards; state-of-the-art facilities; and advanced technologies.

Our Orthopaedic & Arthritis Center team of physicians, nurses, physician’s assistants, and staff work closely with colleagues in specialties throughout BWH and nursing to deliver safe, effective, and compassionate care to every patient.

Our Rheumatology and Orthopaedics Team:

Contact Us

If you believe you should have an evaluation and would like to schedule an appointment with one of our ankylosing spondylitis experts, call 1-800-294-9999 to speak to one of our knowledgeable coordinators who can help to connect you to the doctor that best meets your needs, or fill out an online appointment request form.