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Latest Research on Ankylosing Spondylitis

Reviewed by Michael W. Smith, MD on November 11, 2020

Ankylosing spondylitis can create uncomfortable pain or stiffness in your back, neck, hips, and other areas of your body. We’ve learned a lot about AS in recent years but there’s still a lot we don’t know.

Experts continue to find new data about the possible causes and treatment options for ankylosing spondylitis.

What May Cause Ankylosing Spondylitis

Scientists don’t yet know the exact cause of ankylosing spondylitis. But they think that a mix of environmental and genetic factors are involved.

One key finding centers on an antigen called HLA-B27. Antigens are structures that may trigger an immune response in your body. Most people with ankylosing spondylitis -- 90% -- have a particular antigen called HLA-B27.

HLA stands for human leukocyte antigen. There are many of them. Usually, HLAs tell your immune system the difference between healthy body tissue and foreign things inside of you that could cause issues. But unlike other HLAs, HLA-B27 attacks your healthy tissues and cells.

Since so many people with this condition have this antigen, it may be a sign that someone is more likely to develop ankylosing spondylitis. A blood test can show if you have it.

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But just because someone has HLA-B27 doesn’t mean that they will definitely get AS. It’s not yet clear what role it plays in causing the condition. Many things are probably involved, since you can have HLA-B27 and not have AS. Plus, there are people with AS who don’t have HLA-B27. HLA-B27 is also linked with other conditions, including psoriatic arthritis.

Doctors continue to study the role of HLA-B27 and how it relates to ankylosing spondylitis.

There are other risk factors linked to AS, including sex and age. While both men and women can develop ankylosing spondylitis, it’s more common among men than women.

Anyone at any age can have ankylosing spondylitis, but it usually starts around the late teenage years or in early adulthood.

Why Diagnosing AS Can Take So Long

Doctors still have a lot to learn about how best to diagnose AS. There’s no perfect test for this condition, which can make it hard to pinpoint.

To identify this condition, your doctor will ask about your symptoms and take blood tests and imaging tests. The testing process itself take very little time. But finding out you have AS can take years because doctors don’t always recognize the condition, note the symptoms as possibly being due to AS, and order the right tests.

Treatment Option Advancements

There’s no cure for ankylosing spondylitis but there are things you can do to slow down the progression of your condition. If you have symptoms of AS, research supports treating it with:

Nonsteroidal anti-inflammatory drugs (NSAIDs). Doctors don’t usually prefer one type of NSAID over another to treat this condition. They recommend that you take these drugs as a continuous treatment, instead of only as needed. But some studies have linked the constant use of NSAIDs to a higher risk of high blood pressure.

TNF inhibitors. These are medications that treat ankylosing spondylitis and other inflammatory conditions. They lower inflammation and stop your disease from getting worse. It’s safe to combine these with NSAIDs.

Physical therapy. This form of treatment can help you with pain relief and better your flexibility and strength. Your therapist can show you exercises to help maintain your mobility and posture.

IL-17 inhibitors. These types of medications help your body fight inflammation. You can also take these along with NSAIDs.

Surgery. You most likely won’t need surgery with ankylosing spondylitis. But if you have extreme joint damage, hip issues, or other severe pain your doctor might suggest an operation for your condition.

Best Ways to Manage

Researchers have found that lifestyle changes can help you manage your symptoms.

Quit smoking. You probably know it’s bad for your whole body, especially if you have ankylosing spondylitis. It can create more issues tied to your condition like breathing issues.

Sit up straight. If you practice standing and sitting straight, you can help prevent some posture problems related to ankylosing spondylitis. Physical therapy can help with this.

Use cold and heat. Ice packs can help lower swelling while heating pads can relieve stiffness. Warm baths and showers can also help.

Exercise. Regular physical activity will help you stay flexible and ease pain, and is good for your whole body.

Eat healthy. A diet full of processed, fried, and fatty foods can make your inflammation worse. Fill your meals with anti-inflammatory foods, like fruits, vegetables, and whole grains.

WebMD Medical Reference

Sources

Mayo Clinic: “Ankylosing spondylitis.”

Arthritis National Research Foundation: “Ankylosing Spondylitis (AS) Affects An Estimated 1 Million+ Americans,” “Joerg Ermann – Spine-tingling AS Research.”

Spondylitis Association of America: “Continuous NSAID Use in Ankylosing Spondylitis Linked to Increased Risk of Hypertension.”

CDC: “Influenza (Flu).”

Arthritis Care & Research: “2019 Update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis.”

American College of Rheumatology: “TNF Inhibitors.”

Cleveland Clinic: “Ankylosing Spondylitis (AS): Management and Treatment.”

NHS: “Diagnosis.”

Journal of the Royal Society of Medicine: “The ramifications of HLA-B27.”

 

 

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