Ankylosing spondylitis: symptoms, treatments and pain therapies

Ankylosing spondylitis and pain in the spine

Ankylosing spondylitis, also called spondylitis, spondyloarthropathy, a disease of pott is a chronic inflammatory disease, which affects the spine in a selective manner, at the dorsal, lumbar and sometimes even in the cervical. Spondylitis in practice is inflammation that affects the vertebrae, from which the vertebral column is composed, it causes pain and limits the functions of the back. Ankylosing spondylitis usually worsens when resting and improves during exercise, in fact it is very different from the classic backache. If this disease is not adequately treated, it is possible to form, in the future, even if very slowly, bone bridges which irreversibly limit the movement of the joint, which is why spondylitis is defined as an ankylosing. Ankylosing spondylitis tends to almost always affect young people between 20 and 30 years, in most cases the subjects who suffer from it are males. But ankylosing spondylitis does not immediately affect the patient but has a very gradual evolution.


It is not a very frequent disease, in fact it manages to affect less than 1% of the population. The causes are not easy to identify and can be varied, as for all rheumatological diseases, although it is conceivable that only the contribution of genetic or environmental factors such as common infections, can promote their birth. Therefore, ankylosing spondylitis is not a pathology that is inherited and to date it is not possible to establish exactly what combination of factors, if bacteria or viruses, or those internal to our body, trigger the origin of the disease.

Symptoms of ankylosing spondylitis and differences with back pain

In ankylosing spondylitis, as described above, the disks of the spine are affected by inflammation, resulting in painful symptoms that make the patient disabling , especially when he is at rest. Despite back pain, or low back pain, if you prefer, is a very frequent pathology and that has affected most people at least once in life, the patient's symptoms taken from ankylosing spondylitis, are different from a common backache . For example, during ankylosing spondylitis, back pain will have different effects compared to normal low back pain, in fact:

Back pain begins to increase over time, however it is difficult to establish how much it starts out precisely;
The duration of painful symptoms is more than 3 months;
Low back pain increases pain during sleep, especially during the night, causing nocturnal awakenings due to inflammation;
Low back pain improves with movement and physical activity;
Once awakened, the patient will have a stiff and blocked back, after at least 1 hour, the patient will be able to move better;


Instead the common backache, tends to hit very quickly with very sharp twists, the symptoms are resolved after a few days or weeks, while at rest the pain decreases and on the contrary, increases with physical activity. During the night and upon awakening with a common low back pain, the back will not give particular problems as it causes ankylosing spondylitis. 

Low back pain is therefore almost always the first symptom of the person suffering from ankylosing spondylitis. During the more advanced stages, the inflammation can extend and go back up the spine and get to also affect the back and neck areas, bringing in case of progress of the pathology also to have vertebral ankylosis. In this case the patient will have a curvature of the vertebral column that will make the back to have a "hump" in a completely compromising manner.

It is obvious that in these conditions, the person will have difficulty in carrying out many activities of daily life, such as driving a car or even sitting for a long time. In addition to back pain, the patient suffering from ankylosing spondylitis usually has symptoms similar to sciaticaor inflammation, tingling and sometimes a burning sensation in the area of ​​the hips and in the areas where the biceps are located. 

But unlike a common sciatica, in cases of ankylosing spondylitis, the pain reaches up to the knee, without extending throughout the leg and tends to strike alternately, both legs. These symptoms are completely characteristic of ankylosing spondylitis and for this reason it is possible to differentiate from other pathologies similar to this one. 

Even the joints, after years of disease, if the latter has not been treated properly, will almost certainly undergo an ankylosis, or bone bridges will form that will weld the two articular heads. In cases like this there will not be any particular alteration of the conformation, as it happens in the vertebral column. 


Almost 50% of people with ankylosing spondylitis also have symptoms of the joints underneath the lower back. In particular, bones in the lower limbs, such as hips, knees and ankles, can be affected, but the involvement of the bones of the upper limbs such as the elbows and wrists is much rarer. If the joints of the lower limbs are struck by ankylosing spondylitis, these joints will be called painful or swollen, with consequent decay of the functions of the latter. 

knees and ankles, on the other hand, the involvement of the bones of the upper limbs such as elbows and wrists is much rarer. If the joints of the lower limbs are struck by ankylosing spondylitis, these joints will be called painful or swollen, with consequent decay of the functions of the latter. knees and ankles, on the other hand, the involvement of the bones of the upper limbs such as elbows and wrists is much rarer. 

If the joints of the lower limbs are struck by ankylosing spondylitis, these joints will be called painful or swollen, with consequent decay of the functions of the latter.

Unlike what happens in other diseases such as rheumatoid arthritis, in ankylosing spondylitis the joints are not spared and only the hands and feet are not endangered. However, the feet can be affected by the pain in the heel or in the plantar area, in this case the joints are not involved but the tendons. 

Ankylosing spondylitis is therefore a pathology that predominantly affects the joints and tendons. However, there are cases in which the organs may also be affected. In 25% of patients taken from ankylosing spondylitis, there were pains in the ocular zone. Well, in cases like this the inflammation affects the most anterior part of the eye, causing pain, redness of the eye and increasing sensitivity to light.

If we intervene in an appropriate and timely manner, the treatment will allow the possible healing without particular consequences. In very rare cases, the inflammation caused by ankylosing spondylitis can lead to damage to the heart valve, leading to a defect during the respiratory closure. 

Only in very rare cases this problem causes clinical admissions to the patient. Cases of interference on the rhythm of the heart are just as rare. In the most advanced phase of an insufficiently cured ankylosing spondylitis, it may also be the cause of a reduction in physical resistance, even for less excessive efforts. In this case, the trouble could be caused by an involvement of the joints of the rib cage and the muscles of the ribs, even here there is pain,

Diagnosis and treatment for ankylosing spondylitis

Diagnosis of ankylosing spondylitisIt is generally done on the basis of the clinical picture, the results of laboratory tests and instrumental examinations. The rheumatologist will consider all three of these elements and will verify that they are in agreement with the suspicion of the diagnosis. Although medicine has made enormous progress today, there is no definitive therapy to treat ankylosing spondylitis, but there are excellent therapies to limit the disease and reduce its symptoms. The primary objective of the therapy is to treat the disease, try to reduce pain as much as possible and reduce stiffness to restore and maintain the best posture leading to good joint mobility. 

An adequate medicinal therapy is certainly needed, it is essential, because it is necessary to remove the inflammation, allowing to remove the pain and stiffness of the back. In this way the patient can find correct postures and perform all the days of the exercises for recovery and muscle strengthening. Drug therapy consists of using anti-steroidal anti-inflammatory drugs.

In the case of involvement of the other joints or tendons, the use of cortisone-based drugs is indicated, with a non-elevated use by oral or infiltration and the use of traditional anti-rheumatic drugs. 

Furthermore, some positive lifestyle habits can help to influence health in the right way, such as a balanced diet, peaceful rest and moral support from family or friends. Finally, physical activity can be an integral part of managing each program to treat ankylosing spondylitis. 

It if practiced every day, helps to maintain a correct posture, helps to improve the joints and performs a recovery action. It is very important to get help especially at the beginning, from the doctor and the physiotherapist in order to get the maximum benefit. 

Through these rehabilitation programs and taking the necessary precautions to avoid relapse, the patient can return over time to perform a normal life, defeating once and for all this pathology, even if you have to be patient.