RHEUMATOLOGICAL CONDITIONS · Health guide
Ankylosing Spondylitis: Symptoms and Rehabilitation
Information on low back and mid-back stiffness in ankylosing spondylitis, rheumatological follow-up, spinal mobility and the role of rehabilitation.
Updated: · General information
What is ankylosing spondylitis?
Ankylosing spondylitis is an inflammatory rheumatic disease that can affect the spine and the sacroiliac joints. Alongside low back and mid-back pain and stiffness, other joints or areas such as the eyes may be involved. The course of the disease and its effect on movement vary from person to person.
Causes and assessment
Genetic predisposition plays a part in the development of the disease; no single gene or blood test establishes the diagnosis. Long-standing low back pain, stiffness that worsens with rest and relief with movement are enquired about during rheumatological assessment. Examination, blood tests and, where needed, imaging are interpreted together.
Treatment and follow-up
Disease-controlling medication is selected by rheumatology. Rehabilitation supports mobility, posture and daily function; the programme is adapted to disease activity. The aim of follow-up is to control inflammation and symptoms and to preserve quality of life. The same progression or outcome is not expected in everyone.
Features of inflammatory back pain
Prolonged morning stiffness, pain in the second half of the night and relief with movement may suggest inflammatory spinal disease; these features alone do not establish the diagnosis. The diagnosis is made through rheumatological assessment. If eye pain, redness and sensitivity to light develop, ophthalmological assessment is needed without delay.
How do drug treatment and exercise work together?
Rehabilitation focuses on supporting range of movement, posture, chest expansion and daily function. The programme is adjusted according to disease activity and any accompanying problems. Exercise does not replace the medication planned by rheumatology; where there is marked stiffness or bone fragility, forceful spinal techniques are avoided.
Your questions
Patient information
If the blood test is normal, does that rule the disease out?
A single normal blood test does not rule out every possibility. History, examination and any necessary imaging are assessed together.
Should I stop all exercise when the pain increases?
The programme may need to be adapted during a flare. The type and intensity of movement should be decided with the follow-up team.
