Ankylosing spondylitis/Axial spondyloarthritis

Ankylosing spondylitis (AS) is an inflammatory condition which mainly affects the spine. It usually starts in people in their teens or 20s. It’s rare for it to present after the age of 45.

Symptoms typically include stiffness and pain in the lower back and buttocks, worse in the early morning and easing throughout the day. Symptoms can be severe enough to cause patients to wake at night.

AS is associated with other conditions including:

  • inflammation in the eye (uveitis)
  • inflammation at tendons including Achilles tendonitis and plantar fasciitis
  • inflammation and swelling at other joints such as the knees

In patients who have the skin condition psoriasis, a similar condition to AS is seen. This is known as psoriatic spondyloarthropathy.

About our service

If your GP suspects you have AS you will be referred to see a rheumatologist (a doctor who specialises in rheumatic diseases).

We will ask you some questions about your back pain and examine you. If we think you might have the condition, we can arrange further tests, including X-rays and MRI scans to help confirm or exclude the diagnosis.

Treatments

Exercises and close attention to posture are important to keep the spine mobile and live a normal life. You will usually be referred to a physiotherapist for further assessment and advice.

In terms of drug treatment, non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen are usually the first choice for helping with pain and stiffness. Other similar drugs such as Naproxen, etoricoxib or celecoxib may also be tried as alternatives.

For many patients, these drugs and exercise are enough to enable patients to lead a normal life. Sometimes, stronger treatments such as 'biologic drugs' are needed.

Patient information leaflets

We produce a wide range of leaflets which provide information about our services and about the treatment you might receive in our clinics or during your stay in hospital. 

We also produce these in different formats including large print, please contact the department you are visiting for more information.

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Useful videos

We have a wide range of videos which provide information about our services and about the treatment you might receive in our clinics or during your stay in hospital. 

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Information for healthcare professionals

Nice have produced the following guidance on how to recognise inflammatory back pain. Find out more here

Last updated: September 20, 2022

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