Do you have low back pain that is worse at night, in the morning or after a prolonged period of inactivity? Does it improve with exercise? This type of low back pain can be an early symptom of ankylosing spondylitis, an inflammatory disease of the spine.

Ankylosing spondylitis is a type of arthritis called spondyloarthritis, and typically affects the joints of the spine. However, it can also affect the peripheral joints in the body such as the hips, knees, ankles and feet. Patients may experience problems with walking, getting out of bed, bending forward and other daily activities.

Symptoms of ankylosing spondylitis

Apart from low back pain, the symptoms of ankylosing spondylitis include:

  1. Stiffness in the back
  2. Stooped posture
  3. Back, hip and heel pain
  4. Pain and swelling in the peripheral joints eg. shoulders, knees and ankles
  5. Stiffness in​ the chest causing chest tightness and occasionally breathlessness
  6. Limited range of motion involving the spine and hips
  7. Fatigue

“Low back pain is a common symptom, but only about 5% of sufferers may have spondyloarthritis,” says Dr Warren Fong​​, Consultant at the Department of Rheumatology and Immunology and the Autoimmunity and Rheumatology Centre, ​ Singapore General Hospital (SGH), a member of the SingHealth​ group. “In Singapore, it is estimated that about 2-10 in 1,000 people suffer from ankylosing spondylitis,” says Dr Fong.​

The symptoms of ankylosing spondylitis vary between pa​tients and can be mild or severe. When the disease progresses to a severe stage, new bone called the syndesmophytes may form in the gap between the spinal vertebrae, causing them to fuse together and become rigid and inflexible. This condition is referred to as “bamboo spine”. In the worst case, the spine may be permanently in a bent position, causing severe immobility and deformity.

Fusion can also cause stiffness of the rib cage, which can affect the functioning of the lungs and causing breathing difficulties in patients.

“Several studies have shown that uncontrolled inflammation may lead to an increased risk of cardiovascular disease such as ischemic heart disease and cerebrovascular events (stroke)",” says Dr Fong.​

Patients with ankylosing spondylitis may also have inflammation in non-skeletal areas, such as the eye, skin and bowel.

Read on for the risk factors​ of a​​nkylosing s​pon​dylitis​.

Ref: O17​​