What is ankylosing spondylitis?
Ankylosing spondylitis (AS) is a form of axial spondyloarthritis, an inflammatory condition involving joints and ligaments in the spine and pelvis. It can produce ongoing back and buttock pain, stiffness and reduced flexibility.
Mechanical back pain, injury and many other problems are more common reasons for back discomfort in the general population. Proper evaluation helps identify the cause.
Possible inflammatory symptoms
Patients may report pain or stiffness after prolonged rest, discomfort at night and improvement with movement.
- Morning stiffness in the back or pelvis.
- Lower-back or alternating buttock pain.
- Symptoms that improve during suitable physical activity.
- Occasional inflammation at the heels, hips or other joints.
Symptoms alone cannot confirm ankylosing spondylitis.
What do HLA-B27 and imaging show?
A clinician may examine movement, discuss the pattern and family history, and order selected blood tests, X-rays or MRI of the sacroiliac joints.
HLA-B27 positivity does not automatically mean ankylosing spondylitis. The marker is associated with the disease, but many people who carry it never develop AS. An MRI may help detect inflammatory changes in some cases.
Treatment and monitoring
Management frequently involves exercise and physiotherapy, with medicines selected according to disease activity. Some patients may require biologic or targeted treatments and regular safety monitoring.
Associated conditions can affect the eyes, skin or bowel; mention new symptoms promptly.
A red, painful eye with light sensitivity or blurred vision needs urgent ophthalmology assessment, as it may indicate uveitis.
Frequently asked questions
Is all chronic back pain ankylosing spondylitis?
No. Many common mechanical conditions can cause chronic back pain.
Is a positive HLA-B27 test enough for diagnosis?
No. Diagnosis depends on the symptoms, examination and any relevant imaging or tests.
Does everyone need surgery?
No. AS is generally managed medically, with activity and rehabilitation; surgery is reserved for selected problems.
Sources and editorial review status
Medical background information is available from these specialist and public-health organizations:
This page is general patient education and has not yet been individually medically reviewed or approved by Dr O P Garg. It does not replace clinical assessment, diagnosis or personal treatment advice.