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Johns Hopkins Health Alert

Could Your Pain and Stiffness Be Caused By Ankylosing Spondylitis?

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Ankylosing spondylitis is a systemic rheumatic disease characterized by inflammation of the spine and the sacroiliac joints. These joints are located in the lower back where the sacrum (the bone directly above the tailbone of your back) meets the iliac bones (bones on either side of the upper buttocks). Inflammation in these areas (spondylitis) causes pain and stiffness in and around the spine. Eventually, this can lead to a complete fusion of the vertebrae, a process referred to as ankylosis, which in turn leads to loss of spinal mobility. In addition to harming the spine, ankylosing spondylitis can inflame and injure joints in other parts of the body. Ankylosing spondylitis can also damage organs such as the heart and kidneys.

Ankylosing spondylitis is believed to be genetically inherited. The majority of people with this condition (nearly 90 percent) are born with a gene known as HLA-B27. Not everyone with the HLA-B27 gene gets ankylosing spondylitis, however. Researchers believe other conditions, perhaps environmental, are necessary for ankylosing spondylitis to become expressed.

The symptoms of ankylosing spondylitis are caused by inflammation of the spine, joints and other organs. Symptoms include pain and stiffness in the lower back and the rest of the spine, upper buttocks and neck. The pain and stiffness usually progress gradually over a matter of months, although onset can be rapid and intense. The pain and stiffness of ankylosing spondylitis are often worse in the morning or after periods of inactivity. These symptoms are sometimes relieved by motion, applied heat or a warm shower. Other areas of the body affected by inflammation include the kidneys, heart, lungs and eyes.

In advanced stages, for example, ankylosing spondylitis can lead to deposits of a substance called amyloid in the kidneys, which can cause kidney failure. Dialysis is sometimes needed to clear the kidneys. Rarely, people with ankylosing spondylitis develop scarring of the heart’s electrical system, which causes an abnormally slow heart rate. This requires correction with implantation of a pacemaker.

Posted in Arthritis on December 19, 2006
Reviewed June 2011


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Health Alerts registered users may post comments and share experiences here at their own discretion. We regret that questions on individual health concerns to the Johns Hopkins editors cannot be answered in this space.

The views expressed here do not constitute medical advice, and do not represent the position of Johns Hopkins Medicine or Remedy Health Media, LLC, which has no responsibility for any comments posted on this site.


My father had AS and he lost the use of his legs, his knees would give out, is this from the AS? I am having symptoms of AS. Seems like if I sit for very long I can't get up and get moving for the stiffness and pain. I also retain a lot of fluid around my knees and ankles by the middle of the day, especially if I am on my feet a lot. I am wondering what I can do to prevent it from crippling me? Any suggestions?

Posted by: farmgirl | May 19, 2008 2:45 PM

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