Ankylosing Spondylitis Treatment
Inflammatory arthritis of the spine — diagnosis and treatment at Arthritis Care of Texas.
Long-lasting inflammation affects the spine and the joints where the spine meets the pelvis. Over time, the spine can become stiff. Treatment reduces inflammation, eases pain and stiffness, and helps you stay flexible.
There is no cure yet — the goal is control: calming spinal inflammation so pain and stiffness ease and the spine keeps its flexibility. Success looks like waking without an hour of stiffness, sleeping through the night, exercising and working normally, and no new fusion (stiffening) of the spine on imaging over time.
Ankylosing spondylitis (AS) is a progressive disease that causes spinal vertebrae to slowly begin fusing together — especially those in the lower back near the base of the spine. The inflammation that affects the joints can also gradually affect other areas of the body, such as the hip and shoulder joints, the eyes, or the bowels. Symptoms are usually relatively minor in the earliest stages and may only present as decreased flexibility or a slightly "hunched" posture. However, progression can lead to an inability to lift the head to a forward-looking position.
Did you know… the average age of onset for ankylosing spondylitis is between 17 and 45? Older people and children are also susceptible. AS is found in people of all ages and backgrounds, but occurs more frequently among men than women. One of the greatest risks for AS is among individuals who test positive for the HLA-B27 gene, which is easily identified in a diagnostic blood test.
Am I at risk for developing ankylosing spondylitis?
There are no known lifestyle risk factors for ankylosing spondylitis — only age, genetics and gender play a role. However, you may want to see a rheumatologist if you have a history of frequent gastrointestinal infections or a family history of ankylosing spondylitis.
What types of treatments are available?
There is currently no cure for ankylosing spondylitis, but anti-inflammatories, TNF-blockers, physical therapy, and sometimes surgery can help manage pain, reduce stiffness, and potentially delay the progression of spinal deformity.
Is there anything I can do to help facilitate treatment?
If you are diagnosed with ankylosing spondylitis, avoid smoking, which can significantly complicate the disease.
Did you know?
- “Ankylosing” comes from the Greek ankylos, meaning bent or fused — a nod to the stiffening this condition can cause in the spine.
- Ankylosing spondylitis plays by opposite rules from a back strain: it feels worst after rest and better once you get moving.
- More than 9 out of 10 people with this condition carry a gene marker called HLA-B27 — yet most people who have the marker never develop the condition.
Common worries
Will my spine fuse solid and leave me stooped?
That was the fear of a previous era. With modern treatment controlling inflammation, plus posture and exercise habits, most patients keep a flexible, upright spine. Preventing fusion is precisely why we treat inflammation even when pain feels tolerable.
Why genetic testing (HLA-B27)?
The HLA-B27 gene is strongly associated with this condition — a positive result supports the diagnosis when symptoms and imaging fit. It is a clue, not a verdict: many people with the gene never develop the disease, and some patients test negative.
Is it safe to exercise with an inflamed spine?
Exercise is treatment, not a risk: daily movement and extension exercises preserve flexibility and posture. Your physiotherapist tailors the programme; the danger to the spine is stiffness, not motion.
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What counts as a flare: back pain and stiffness clearly worse than usual for more than a few days, night pain in the second half of the night returning, or new pain in the buttocks, heels, or chest wall — sometimes with a red, painful eye, which always needs prompt attention.
What to do: keep moving — gentle exercise and stretching usually help more than bed rest — and call us at (361) 400-7700 if it is not settling, so treatment can be reviewed. A red or painful eye needs same-day care.
Do not adjust steroids on your own: steroids are not a mainstay for spinal inflammation — do not start leftover tablets without calling; there are better-targeted options we should discuss instead.
What isn’t a flare: backache after lifting or gardening that eases in a day or two, or stiffness that clears quickly once you move. Mechanical pain behaves differently from inflammatory pain — and your pattern notes help us tell them apart.
Ready to be seen? New patients are seen within 2–4 weeks.