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Ankylosing Spondylitis

What is Ankylosing Spondylitis?

Ankylosing spondylitis (AS) is a progressive autoimmune disease that causes the spine to slowly fuse (ankylose) and has an inflammatory component (spondylitis). It is more common in men than women (3:1) and most people with ankylosing spondylitis (90%) have a gene called HLA-B27. Having this gene however does not mean that the individual will always develop AS.

Ankylosing spondylitis is a special type of arthritis known as ‘spondyloarthritis’ which has similarities to autoimmune diseases but does not have an immunological component and is often referred to as an autoinflammatory disease.

Ankylosing spondylitis primarily affects the spine. Inflammation develops in the spine including the joints, ligaments, tendons, disc and synovial tissue. As it develops the inflammation can lead to chronic back pain and stiffness.

Ankylosing Spondylitis Progresses

Grandfather and son on a hike. It is important to determine if a person has AS as soon as possible because there is a predictable pattern of progression that can result in complete fusion of the spine. Usually clients find that pain begins in the sacroiliac joints (SIJ) and after period of time in the lower lumbar spine. Soon after this AS develops at the thoracolumbar junction (TLJ) which is the junction of thoracic spine, to which ribs attach, and the lumbar spine.

Once AS has developed in the TLJ it will slowly progress from the lower lumbar spine upwards to the TLJ. Following this it is common to develop in the neck at the cervicothoracic junction (CTJ). From here AS can further develop throughout the thoracic spine, including the rib joints, and into the neck (the cervical spine).

Ankylosing spondylitis can advance to the point that the inflamed spinal bones begin to fuse together making the spine rigid and inflexible.

This rigidity will then be permanent and the spine will then be inflexible. This means that posture will not change. If this posture is unnaturally hunched-forward posture the client will have greater difficulty walking or standing which can be painful.

Ankylosing Spondylitis Symptoms

Ankylosing spondylitis most frequently develops in individuals who are between the ages of 17 and 35 years but can affect people of any age. Some early symptoms include:

  • Persistent progressive discomfort in the lower back, hips and buttocks
  • Pain and stiffness that seem worse after periods of rest and inactivity
  • Movement reduces stiffness and pain
  • Pain and stiffness can occur in other joints, e.g. the shoulders, wrists, fingers, knees, ankles or toes
  • Heel pain making it difficult to walk or stand especially on hard surfaces
  • Eye symptoms such as pain, inflammation, redness or light sensitivity
  • Loss of appetite
  • General fatigue

It is important to know that the symptoms above can be a result of many things other than AS and a diagnosis is determined on a wide range of different factors. No one symptom indicates the presence of AS.

Treatment and Chiropractic Care

Ankylosing Spondylitis needs to be managed with an attempt to slow progression, maintain flexibility and preserve good posture. Chiropractic care forms an important part of maintaining range of motion, enhancing posture and correcting walking and spinal gait. By ensuring that the spine functions as well as possible inflammation could be reduced and weight bearing forces will be more evenly spread through the spine reducing the stress load of joints affected by AS.

Chiropractic care can provide a huge advantage in the care and maintenance of clients with AS. At Inspired Chiropractic we use a large range of different techniques that can improve the motion of spinal joints, rib joints and the sacroiliac joints. With the care of clients with ankylosing spondylitis it is important to limit force being applied to the spine as inflammation can be corrosive to the supporting ligaments of the spine and force can aggravate inflammation. To combat this we use highly effective, low force techniques and typically avoid spinal manipulation.

It is important to know that every individual with AS will find that their condition develops differently and as such the approach to their chiropractic care will be tailored to suit each individual.

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What to Do Now

If you or someone you know have concerns, call our office today on 01603 764777 or email to make an appointment now.


Ankylosing Spondylitis Norwich, Norfolk NFK | 01603 764777

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