• Ankylosing Spondylitis

    (Marie-Strumpell Disease)


    Ankylosing spondylitis is a chronic inflammatory disease of the attachment points between tendons, ligaments, or capsule and bone. It causes arthritis of the joints, mainly the spine and pelvis (sacroiliac joints). Ankylosing spondylitis can also cause inflammation of the eyes, lungs, or heart valves.
    In severe cases, new bone may develop between the spinal bones. This can cause some areas of the spine to fuse. This fusion will decrease the flexibility and movement of the spine.
    Ankylosing Spondylitis
    Nucleus factsheet image
    Copyright © Nucleus Medical Media, Inc.


    The cause of ankylosing spondylitis is not known. Some cases may be associated with a problem in a specific gene.

    Risk Factors

    Factors that may increase your chance of ankylosing spondylitis include:


    The severity of symptoms can vary from mild to very severe.
    Common symptoms may include:
      Stiffening and pain (arthritis) of the:
      • Lower back
      • Sacroiliac joint, where the back and hip meet, possibly radiating down the legs
    • Pain that is often worse at night
    • Stiffness that is worse in the morning
    • Symptom improvement with exercise or activity
    • Occasionally, pain and stiffness in other joints:
      • Knee
      • Upper back
      • Rib cage
      • Neck
      • Shoulders
      • Feet
    • Chest pain, which may suggest heart, heart valve, or lung problems
    • Eye pain, visual changes, increased tearing
    Less common symptoms may include:
    • Fatigue
    • Loss of appetite or weight loss
    • Fever
    • Numbness (if arthritic spurs compress the spinal nerves)
    • Blood in the urine or swelling from kidney disease
    • Irregular heart beat


    The doctor will ask about your symptoms and medical history. A physical exam will be done. Diagnosis is based on common symptoms of ankylosing spondylitis, such as:
    • Dramatic loss of motion of the lower back and spine
    • Pain in the lower back
    • Limited chest expansion when taking deep breaths
    Blood tests may be done to check for:
    • HLA-B27 gene marker
    • Abnormalities in the blood
    • Signs of autoimmune disease
    Images of involved joints may be taken with:


    There is no cure for ankylosing spondylitis. Treatment is aimed at providing education and relieving the symptoms.
    Treatments may include:


    Medication may help to control pain and inflammation. They may include:
    • Over-the-counter medication such as nonsteroidal anti-inflammatory drugs (NSAIDs)
    • Prescription medication that suppresses the inflammation such as:
      • Prescription NSAIDs
      • Corticosteroids
      • Disease-modifying antirheumatic drugs (DMARDs)
      • Tumor necrosis factor (TNF)-inhibitors

    Physical Therapy

    Physical therapy may help prevent progression and worsening of symptoms. Treatment may include:
    • Learning proper posture and the best positions for sleeping
    • Exercise program that includes:
      • Abdominal and back exercises (to decrease back stiffness and maintain good posture)
      • Stretching exercises
      • Water exercises
      • Breathing exercises (in cases where the rib cage is affected)


    In severe cases, hip or joint replacement surgery may be needed. It will be done to relieve pain and help you move around easier. In some instances, spinal surgery is needed to allow an upright posture.


    There are no guidelines for preventing ankylosing spondylitis because the cause is unknown.


    Arthritis Foundation http://www.arthritis.org

    Spondylitis Association of America http://www.spondylitis.org


    The Arthritis Society http://www.arthritis.ca

    Canadian Spondyloarthritis Association http://www.spondylitis.ca


    Ankylosing spondylitis. Spondylitis Association of America website. Available at: http://www.spondylitis.org/about/as.aspx. Accessed December 17, 2014.

    Ankylosing spondylitis. University of Washington Orthopedics and Sports Medicine Department website. Available at: http://www.orthop.washington.edu/?q=patient-care/articles/arthritis/ankylosing-spondylitis.html. Accessed December 17, 2014.

    Firestein ED et al. Kelley’s Textbook of Rheumatology. 8th ed. Philadelphia: Saunders; 2008.

    10/2/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: FDA approves new drug to treat psoriasis. US Food and Drug Administration website. Available at: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm183851.htm. Updated April 17, 2013. Accessed December 17, 2014.

    Revision Information

  • LiveWell personal health survey

    How healthy are you really? Find out – free.Learn more

    It's time to stop guessing. If you want to make some changes but just aren't sure how, the free personal health survey from LiveWell is a great place to start.

  • HeartSHAPE Spotlight

    At risk for a heart attack? Learn more

    Fight heart disease and prevent heart attacks. HeartSHAPE® is a painless, non-invasive test that checks pictures of your heart for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.

  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.