Health and Me

Rachel V Thomas

How Ankylosing Spondylitis Goes Beyond Just Chronic Back Pain: Doctors Explain

Persistent back pain in young adults is often dismissed as poor posture, long hours at a desk, or muscle strain. But doctors are warning that in some cases, it could be a sign of <a href="https://www.healthandme.com/health/ankylosing-spondylitis">ankylosing spondylitis</a> — a chronic inflammatory autoimmune disease that affects the spine and can silently progress for years before diagnosis.

In India, 16.5 lakh people suffer from the condition, with an average diagnostic gap of nearly seven years from the time symptoms first appear. During that window, the disease continues to silently progress, and the burden is far from small.

“Ankylosing Spondylitis is one of the most underdiagnosed conditions we encounter in clinical practice, and the consequences of that delay are real,” Dr. Arvind Mehra, Senior Director and HOD - Orthopaedics at Paras Health Gurugram, told HealthandMe.

Moreover, “It takes several years of pain and stiffness before people seek treatment, and by then, the diagnosis comes too late, and there has already been damage to the spine,” added Dr. Ashish Tomar, Director - Orthopaedics &amp; Minimally Invasive Spine Surgery at Sarvodaya Hospital, Faridabad.

Ankylosing spondylitis, also known as axial spondylo<a href="https://www.healthandme.com/health/arthritis">arthritis</a>, is a type of arthritis that primarily targets the spine but can also affect other joints. The term “ankylosing” means stiff or rigid, “spondyl” refers to the spine, and “itis” indicates inflammation.

The inflammatory disease causes some of the bones in the spine to fuse over time. This fusing not only makes the spine less flexible but can also cause issues while breathing.

Ankylosing spondylitis leads to inflammation in the spine and large joints, causing stiffness and pain. It can also impact the joint between the spine and the hipbone, potentially resulting in additional symptoms such as digestive issues, rashes, and weight loss.

What makes ankylosing spondylitis difficult to spot is that it often feels like ordinary back pain — but there are warning signs that set it apart.

According to experts, ankylosing spondylitis-related pain typically:

<ul><li>Causes maximum stiffness early in the morning</li><li>Gets worse after long periods of rest</li><li>Improves with physical activity or exercise</li><li>Persists for months rather than days or weeks</li><li>Often begins in young adults, especially in their 20s and 30s</li></ul>

This pattern is very different from mechanical back pain, which usually worsens with movement and improves with rest.

Dr. Tomar told HealthandMe that ankylosing spondylitis is not simply a musculoskeletal problem — it is an autoimmune disease, where the body’s immune system mistakenly attacks healthy tissues, particularly around the spine and joints.

“Ankylosing spondylitis is not just another musculoskeletal disease. It requires the attention given to autoimmune disorders because it may affect the chest, hips, shoulders, and even the eyes, while also causing severe posture problems in advanced stages,” he said.

Beyond the spine, the disease may affect:

<ul><li>Chest joints</li><li>Hip joints</li><li>Shoulders</li><li>Eyes</li><li>Posture, causing severe problems in the advanced stages</li></ul>

Who Is At Most Risk? How To Treat?

Young adults, typically in their twenties, are more likely to experience this condition because people often overlook its existence or mistakenly identify it as something else.

The combination of early diagnosis, structured physiotherapy, and suitable medications allows for effective disease progression control.

“When a young adult presents with inflammatory back pain, especially in the gluteal area, that persists beyond three months, the reflex should not be to prescribe a painkiller and wait. It should be investigated further. That shift in approach can make an extraordinary difference to someone’s long-term quality of life,” Dr. Tomar said.

Common treatments for ankylosing spondylitis include:

<ul><li>Regular physical activity can reduce stiffness and prevent worsening of ankylosing spondylitis </li><li>Over-the-counter painkillers for pain and inflammation</li><li>Biologic DMARDs to reduce inflammation and pain, potentially halting disease progression.</li><li>Corticosteroids are prescription anti-inflammatory medications</li><li>Surgery is rarely suggested for severe symptoms unresponsive to other treatments.</li></ul>

Health Conditions A-Z

health

spondylitis

arthritis

Chronic Back Pain

ankylosing spondylitis

autoimmune disease

inflammation

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Persistent back pain in young adults is often dismissed as poor posture, long hours at a desk, or muscle strain. But doctors are warning that in some cases, it could be a sign of ankylosing spondylitis — a chronic inflammatory autoimmune disease that affects the spine and can silently progress for years before diagnosis.In India, 16.5 lakh people suffer from the condition, with an average diagnostic gap of nearly seven years from the time symptoms first appear. During that window, the disease continues to silently progress, and the burden is far from small.“Ankylosing Spondylitis is one of the most underdiagnosed conditions we encounter in clinical practice, and the consequences of that delay are real,” Dr. Arvind Mehra, Senior Director and HOD - Orthopaedics at Paras Health Gurugram, told HealthandMe.Moreover, “It takes several years of pain and stiffness before people seek treatment, and by then, the diagnosis comes too late, and there has already been damage to the spine,” added Dr. Ashish Tomar, Director - Orthopaedics & Minimally Invasive Spine Surgery at Sarvodaya Hospital, Faridabad.What Is Ankylosing Spondylitis?Ankylosing spondylitis, also known as axial spondyloarthritis, is a type of arthritis that primarily targets the spine but can also affect other joints. The term “ankylosing” means stiff or rigid, “spondyl” refers to the spine, and “itis” indicates inflammation.The inflammatory disease causes some of the bones in the spine to fuse over time. This fusing not only makes the spine less flexible but can also cause issues while breathing.Ankylosing spondylitis leads to inflammation in the spine and large joints, causing stiffness and pain. It can also impact the joint between the spine and the hipbone, potentially resulting in additional symptoms such as digestive issues, rashes, and weight loss.Not Your Typical Back PainWhat makes ankylosing spondylitis difficult to spot is that it often feels like ordinary back pain — but there are warning signs that set it apart.According to experts, ankylosing spondylitis-related pain typically:Causes maximum stiffness early in the morningGets worse after long periods of restImproves with physical activity or exercisePersists for months rather than days or weeksOften begins in young adults, especially in their 20s and 30sThis pattern is very different from mechanical back pain, which usually worsens with movement and improves with rest.Pain Beyond The SpineDr. Tomar told HealthandMe that ankylosing spondylitis is not simply a musculoskeletal problem — it is an autoimmune disease, where the body’s immune system mistakenly attacks healthy tissues, particularly around the spine and joints.“Ankylosing spondylitis is not just another musculoskeletal disease. It requires the attention given to autoimmune disorders because it may affect the chest, hips, shoulders, and even the eyes, while also causing severe posture problems in advanced stages,” he said.Beyond the spine, the disease may affect:Chest jointsHip jointsShouldersEyesPosture, causing severe problems in the advanced stagesWho Is At Most Risk? How To Treat?Young adults, typically in their twenties, are more likely to experience this condition because people often overlook its existence or mistakenly identify it as something else.The combination of early diagnosis, structured physiotherapy, and suitable medications allows for effective disease progression control.“When a young adult presents with inflammatory back pain, especially in the gluteal area, that persists beyond three months, the reflex should not be to prescribe a painkiller and wait. It should be investigated further. That shift in approach can make an extraordinary difference to someone’s long-term quality of life,” Dr. Tomar said.Common treatments for ankylosing spondylitis include:Regular physical activity can reduce stiffness and prevent worsening of ankylosing spondylitis Over-the-counter painkillers for pain and inflammationBiologic DMARDs to reduce inflammation and pain, potentially halting disease progression.Corticosteroids are prescription anti-inflammatory medicationsSurgery is rarely suggested for severe symptoms unresponsive to other treatments.