Ankylosing spondylitis is an inflammatory condition that mainly affects the joints of the spine and
the sacroiliac joints (joints between the sacrum and spine). It is characterised by back pain and
stiffness that is caused by an inflammatory arthritis reaction. Over time, the affected joints start
to fuse together, leading to pronounced stiffness and decreased range of motion in the spine.
Ankylosing spondylitis is 3 times more common in males, and typically presents during late teen
to early adult years. It is interesting to note that about 90% of people with ankylosing spondylitis
will have a gene called the HLA B27 gene, although only 2% of people with the gene will
develop ankylosing spondylitis.
Symptoms of ankylosing spondylitis:
● Typically develops over more than 3 months
● Often goes through fluctuations in severity, with flare-ups commonly experienced
● Back pain and stiffness (mostly in the lower back)
● Pain over the sacroiliac joints (between sacrum and spine)
● The stiffness is usually worse in the morning or during the night
● Morning stiffness takes more than 30 minutes to resolve
● Movement improves stiffness
● Other symptoms: Pain in the chest at the costovertebral (between the ribs and spine) or
costosternal (between the ribs and breastbone) joints, systemic symptoms such as
weight loss or fatigue, enthesitis (such as plantar fasciitis or achilles tendonitis), dactylitis
(inflammation of finger or toe joints), and other less common systemic symptoms
affecting the lungs or heart.
Your physiotherapist will take a full history of your complaint and will then perform a physical
evaluation to form a diagnosis. The mobility of your spine and sacroiliac joints will be assessed
and special tests can be performed to determine if your symptoms are potentially due to
ankylosing spondylitis. You might be referred for further investigations, such as x-rays or blood
tests, to confirm a diagnosis.
Based on the assessment findings, your physiotherapist will discuss the management options
and might recommend that you are referred to other specialists as well. Physiotherapists work
closely with other healthcare professionals to ensure you get the best treatment and outcome.
Physiotherapy is very important for people with ankylosing spondylitis to treat spinal mobility
and also strengthen supporting structures of the spine. Physiotherapy is also effective in
managing and treating pain in both acute and chronic conditions. It is important to have any
associated symptoms treated professionally, and your doctor can prescribe the appropriate
treatments such as medications or injections. A healthy lifestyle is one of the most effective
ways you can manage this condition, by avoiding smoking and excessive alcohol consumption
as well as by doing regular exercise and eating a balanced diet.