Ankylosing spondylitis

Symptoms of ankylosing spondylitis include mild to severe pain in the low back and buttocks that is often worse in early morning. Some people have more pain in other areas, such as the hips or heels. The pain usually gets better slowly as you move around and are active.

Early symptoms include:

• Dull pain in the back.
• Flares of increased pain.
• Limited motion.
• Feeling tired.
• Eye problems.

Advanced symptoms include:

• Scarring in the spine that causes the joints to grow together.
• Problems with balance and movement.
• Trouble breathing.
• Vision problems that get worse.

Treatment for ankylosing spondylitis focuses on:

• Relieving pain and stiffness.
• Reducing inflammation.
• Keeping the condition from getting worse.
• Helping you to keep doing your daily activities.

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, seem to work best for pain and stiffness. Treatment also includes exercise and physical therapy. They will help reduce stiffness so that you can move around better.

You'll need to get regular eye exams to check for inflammation in your eye, called iritis.

Surgery for the spine is rarely needed. You may want to think about hip or knee replacements if you have severe arthritis in those joints.

There is no cure for this disease. But early diagnosis and treatment can help you to keep doing your daily activities for as long as possible.

• Take medicines for pain and stiffness exactly as directed.
  • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, seem to work best for ankylosing spondylitis. If you can't take NSAIDs, talk to your doctor about other options. Read and follow all instructions on the label.
• If your doctor says it is okay, try some exercises to keep your joints moving well.
• Ask your doctor about other activities and exercise. If your doctor says it is okay, you may want to take yoga or Pilates classes. These can help make your belly, back, and hips strong.
• You may want to try a cane or walker. These can help reduce pain when you walk.
• Because people with this condition may be at a higher risk for spinal cord injury, it's important to wear a seat belt every time you drive or ride in a car.
• Keep good posture. It can help keep your spine straighter. Try to lie on your stomach a few times a day to keep your spine and hips extended. Sleep on a firm mattress. And use a small pillow that supports your neck.
• Follow your doctor's advice about physical therapy. A physical therapist can move your joints to improve their motion. The therapist can also show you how to stretch your joints. You may also learn exercises to do at home. And you may learn how to use heat or ice to help pain and stiffness.
• Get regular eye exams. These can check for an eye problem called iritis that may happen with this condition.
• Do not smoke. People with this condition are at risk for lung infections. And smoking can make it harder to breathe. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.

Call your doctor now or seek immediate medical care if:

• You have new or worse symptoms in your arms, legs, chest, belly, or buttocks. Symptoms may include:
  • Numbness or tingling.
  • Weakness.
  • Pain.
• You lose bladder or bowel control.
• You have bad eye pain and your eyes are red and sensitive to light.

Watch closely for changes in your health, and be sure to contact your doctor if:

• You are not getting better as expected.