Back Pain and the Effects of Ankylosing Spondylitis

Close-up of an anatomical model of spinal vertebraeAnkylosing Spondylitis, also referred to as AS, is a type of arthritis largely affecting the spine. The joints within the spine become chronically inflamed and eventually fused, causing bouts of pain for those afflicted.

The name explains it all. Ankylosing means “to become joined,” and Spondylitis means “inflammation of the vertebrae.” AS currently affects roughly 2.7 million Americans.

Ankylosing Spondylitis Symptoms

While Ankylosing Spondylitis targets the spine, Ankylosing Spondylitis symptoms include more than just back pain. Most people complain about feeling tight and stiff, especially in the mornings. The onset is gradual, but both sides of the body will be involved.

While the effects of ankylosing spondylitis can vary greatly from person to person, there are some common traits of the disease, such as…

  • Neck Pain
  • Mild Fever
  • Fatigue
  • Weight Loss/Lack of Appetite
  • Mild to Moderate Anemia

As the disease progresses, symptoms can begin to vary quite a bit. Other organs can also begin to become involved, even some that might not seem related.

Other Complications

 Aside from joint and back pain, many AS sufferers will experience other problems, including:

  • Digestive and Intestinal Dysfunction
  • Cardiac complications such as pericarditis, cardiomegaly, and aortitis
  • Ophthalmological Issues such as Uveitis, which affects as many as 33 percent of AS patients

These problems can often be as dangerous or even worse than AS itself. In fact, coronary involvement has been shown to significantly impact mortality rates. It is important to stay vigilant and seek out more than just a Rheumatologist if these complications occur.

Close-up of a man holding his lower back in pain

Risk Factors

While anyone can develop AS, it does tend to target some people more than others. Risk factors include:

  • Age – Most people develop AS during late adolescence and early adulthood, although the average age at diagnosis is 33.
  • Gender – Males develop AS at a higher rate than females.
  • Genetics – People with the HLA-B27 gene have a higher chance of developing AS. While researchers have not identified why there is an increased risk, this gene is known to help the immune system differentiate between healthy and unhealthy molecules in the body.
  • Family History – While not always the case, studies have shown that AS is hereditary.

Disease Progression

Severe cases of AS can lead to ankylosis.  Also referred to as bamboo spine, this occurs as your spine breaks down and tries to heal itself over time. The repeated cycle eventually begins to fuse the spine together, leaving a brittle result that severely decreases mobility.

There are several medications that aim to prevent this from happening. There are also surgical options available if ankylosis does become a problem.


If your symptoms begin to indicate that you might be suffering from Ankylosing Spondylitis, there are several things your Rheumatologist might check in order to diagnose you. Typically, more than one of the following will be conducted:

  • Physical Exam to check for movement and mobility
  • X-rays of the spine and sacroiliac (SI) joints
  • MRI of the SI joints and surrounding areas
  • Genetic Testing to check for the HLA-B27 gene

Ankylosing Spondylitis Treatment Options

To date, there is no cure for Ankylosing Spondylitis. However, there are Ankylosing Spondylitis treatment options available to ease symptoms and slow the progression of the disease.


  • Nonsteroidal Anti-Inflammatories (NSAIDs) – Celecoxib, Naproxen
  • Steroids – Prednisone, Dexamethasone
  • Disease-Modifying Antirheumatic Drugs – Methotrexate, Sulfasalazine
  • Biologics – Cosentyx, Humira

Physical Therapy

  • Stretching
  • Core and Lower Back Strengthening
  • Posture Training
  • Aquatic Therapy
  • Deep Breathing Exercises

There are pros and cons to many treatment options. Many medications bring an increased risk of infection and cancer. Even if you are on a medication regimen, physical therapy is a good option to seek. It can help improve range of motion and mobility, as well as offer some pain management techniques.

Get Treatment for Ankylosing Spondylitis at Cawley Physical Therapy

If you or a loved one are suffering from Ankylosing Spondylitis, give Cawley Physical Therapy a call at 570-208-2787 or email us at Our neck and back physical therapy experts can help you live a more functional and mobile life.