Ankylosing Spondylitis (AS)

Ankylosing spondylitis (AS) is a long-term condition in which the spine and other areas of the body become inflamed.

The symptoms of AS can vary but usually involve:

  • back pain and stiffness that improves with exercise and isn’t relieved by rest
  • pain and swelling in other parts of the body, such as the hips, knees and ribs
  • fatigue (extreme tiredness)

These symptoms tend to develop gradually, usually over several months or years, and may come and go over time.

In some people, the condition gets better with time, but for others it can get slowly worse.

It is not known what causes the condition, but there is thought to be a link with a particular gene known as HLA-B27. Having this gene does not necessarily mean you will develop AS. It is estimated that 8 in every 100 people in the general population have the HLA-B27 gene, but most do not have AS. It is thought that having this gene may make you more vulnerable to developing AS, and the condition is triggered by one or more environmental factors – although it is not known what these are.

AS tends to first develop in teenagers and young adults. Most cases first start in people aged 20-30, with only a minority of cases first affecting adults over 45.

AS is around three times more common in men than in women.

There are around 200,000 people in the UK who have been diagnosed with the condition.

Keeping active can improve your posture and range of spinal movement, along with preventing your spine from becoming stiff and painful.

As well as keeping active, manual therapy is a key part of treating AS. A chiropractor, osteopath or physiotherapist (a healthcare professional trained in using physical methods of treatment) can advise about the most effective exercises and draw up an exercise programme that suits you.

Some people prefer to swim or play sport to keep flexible. This is usually fine, although some daily stretching and exercise is also important.

You will also be prescribed medication. Some medication is taken to slow down or halt the progression of AS, others are to help with pain or inflammatroy “flare ups”

top 5 tips for managing AS
  1. a tailored exercise programme – to relieve stiffness and discomfort and improve strength and flexibility
  2. massage – your muscles and other soft tissues are manipulated to relieve pain and improve movement
  3. hydrotherapy – exercise in water (usually a warm, shallow swimming pool or a special hydrotherapy bath); the buoyancy of the water helps make movement easier by supporting you, and the warmth can relax your muscles
  4. quit smoking – not only will the inflammatory chemicals in tobacco make your symptoms worse, but AS also puts you at a higher risk or heart disease, and smoking will contribute to this too
  5. improve your diet – introduce foods which will reduce inflammation, such as fresh vegetables, oily fish and spices like turmeric. You should also increase your calcium and Vitamin D intake to support the health of your bones, as AS puts you at a higher risk of osteoporosis (thinning bones)

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