Ankylosing Spondylitis
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Your Personalized Treatment Plan
Do not limit your treatment options only to the nearest hospital.
We offer the most effective, quick and affordable treatment for ankylosing spondylitis,
thanks to the world’s largest hospital network.
Ankylosing spondylitis, also known as axial spondyloarthritis, is an inflammatory disease that, over time, can cause some of the bones in the spine, called vertebrae, to fuse. This fusing makes the spine less flexible and can result in a hunched posture. If ribs are affected, it can be difficult to breathe deeply.
As ankylosing spondylitis worsens, new bone forms as part of the body’s attempt to heal. The new bone gradually bridges the gaps between vertebrae and eventually fuses sections of vertebrae together. Fused vertebrae can flatten the natural curves of the spine, which causes an inflexible, hunched posture.
Axial spondyloarthritis has two types. When the condition is found on X-ray, it is called ankylosing spondylitis, also known as axial spondyloarthritis. When the condition can’t be seen on X-ray but is found based on symptoms, blood tests and other imaging tests, it is called nonradiographic axial spondyloarthritis.
Symptoms typically begin in early adulthood. Inflammation also can occur in other parts of the body — most commonly, the eyes.
There is currently no definitive cure for ankylosing spondylitis, but treatments can lessen symptoms and possibly slow progression of the disease.
Complete Recovery
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Leading Surgeons
Private treatment in our hospital network allows you skip waiting lists while at the same time reducing the costs treatment considerably, up to 50% cheaper, in countries that are just a short flight from home. The countries listed below make excellent choices with modern hospitals and well-trained English speaking surgeons.
Our medical consultants will advise you on the best choice for your ankylosing spondylitis in one of our leading hospitals. We will evaluate your current condition, expectations and other related factors, and offer you the most suitable option, respecting your health and the individual needs of your body and lifestyle. Your health is unique and so should be your solution.
- Berlin
- Zurich
- Vienna
- Paris
- Madrid
- Milan
- Warsaw
- Istanbul
Treatment of Ankylosing Spondylitis
Anti-TNF medicine
If your symptoms cannot be controlled using NSAIDs and exercising and stretching, anti-tumour necrosis factor (TNF) medicine may be recommended. TNF is a chemical produced by cells when tissue is inflamed. Anti-TNF medicines are given by injection and work by preventing the effects of TNF, as well as reducing the inflammation in your joints caused by ankylosing spondylitis.
If your rheumatologist recommends using anti-TNF medicine, the decision about whether they’re right for you must be discussed carefully, and your progress will be closely monitored. In rare cases anti-TNF medicine can interfere with the immune system, increasing your risk of developing potentially serious infections.
Monoclonal antibody treatment
Monoclonal antibodies, such as secukinumab and ixekizumab, may be offered to people with AS who do not respond to NSAIDs or anti-TNF medicine, or as an alternative to anti-TNF medicine. This type of treatment works by blocking the effects of a protein involved in triggering inflammation.
JAK inhibitors
JAK inhibitors are a type of medicine that may be offered to people with AS who do not respond to anti-TNF medicine or cannot take it. They work by blocking enzymes (proteins) that the immune system uses to trigger inflammation. They’re taken as tablets.
Corticosteroids
Corticosteroids have a powerful anti-inflammatory effect and can be taken as injections by people with AS. If a particular joint is inflamed, corticosteroids can be injected directly into the joint. You’ll need to rest the joint for up to 48 hours after the injection. It’s usually recommended to limit corticosteroid injections to no more than 3 times in one year, with at least 3 months between injections in the same joint.
This is because corticosteroid injections can cause a number of side effects, such as:
- infection in response to the injection
- the skin around the injection may change colour (depigmentation)
- the surrounding tissue may waste away
- a tendon near the joint may burst (rupture)
Disease-modifying anti-rheumatic drugs (DMARDs)
Disease-modifying anti-rheumatic drugs (DMARDs) are an alternative type of medicine often used to treat other types of arthritis. DMARDs may be prescribed for AS, although they’re only beneficial in treating pain and inflammation in joints in areas of the body other than the spine. Sulfasalazine and methotrexate are the main DMARDs sometimes used to treat inflammation of joints other than the spine.
Surgery
Most people with AS will not need surgery. However, joint replacement surgery may be recommended to improve pain and movement in the affected joint if the joint has become severely damaged. For example, if the hip joints are affected, a hip replacement may be carried out. In rare cases corrective surgery may be needed if the spine becomes badly bent.
Complications of Ankylosing Spondylitis
Complications
Types
Causes
Symptoms
Diagnosis
Complications
With modern treatments, AS does not normally affect life expectancy significantly, although the condition is associated with an increased risk of other potentially life-threatening problems.
In severe ankylosing spondylitis, new bone forms as part of the body’s attempt to heal. This new bone gradually bridges the gap between vertebrae and eventually fuses sections of vertebrae. Those parts of the spine become stiff and inflexible. Fusion also can stiffen the rib cage, restricting lung capacity and function. Some people eventually become severely disabled as a result of the bones in their spine fusing in a fixed position and damage to other joints, such as the hips or knees.
Other complications might include:
- Eye inflammation, called uveitis. One of the most common complications of ankylosing spondylitis, uveitis can cause rapid-onset eye pain, sensitivity to light and blurred vision.
- Compression fractures. Some people’s bones weaken during the early stages of ankylosing spondylitis. Weakened vertebrae can crumple, increasing the severity of a stooped posture. Vertebral fractures can put pressure on and possibly injure the spinal cord and the nerves that pass through the spine.
- Heart problems. Ankylosing spondylitis can cause problems with the aorta, the largest artery in the body. The inflamed aorta can enlarge to the point that it distorts the shape of the aortic valve in the heart, which impairs its function. The inflammation associated with ankylosing spondylitis increases the risk of heart disease in general.
Types
Your doctor will use a mix of imaging tests like X-ray or MRI, physical exams, and blood tests, along with other factors like your family history and genes, to diagnose you and determine which type you have.
- Nonradiographic axial spondyloarthritis (nr-axSpA). This is the less severe form of spondyloarthritis. “Nonradiographic” means that something is not easily visible on an X-ray. If you’re feeling pain in your back and some of the other common symptoms, your doctor may order an X-ray to look for the cause. But if the test doesn’t show any notable changes in the joints connecting your spine and pelvis, called the sacroiliac joints, you may need a more sensitive test like the MRI to detect issues.
- Radiographic axial spondyloarthritis. This is the first phase of ankylosing spondylitis. It happens when nr-axSpA gradually gets worse and affects the sacroiliac joints and the bones of the spine. Your doctor will be able to see noticeable changes in these joints on an X-ray.
Causes
Ankylosing spondylitis has no known specific cause, though genetic factors seem to be involved. In particular, people who have a gene called HLA-B27 are at a greatly increased risk of developing ankylosing spondylitis. However, only some people with the gene develop the condition. Onset generally occurs in late adolescence or early adulthood.
Symptoms
Early symptoms of ankylosing spondylitis might include back pain and stiffness in the lower back and hips, especially in the morning and after periods of inactivity. Neck pain and fatigue also are common. Over time, symptoms might worsen, improve or stop at irregular intervals.
The areas most commonly affected are:
- The joint between the base of the spine and the pelvis.
- The vertebrae in the lower back.
- The places where tendons and ligaments attach to bones, mainly in the spine, but sometimes along the back of the heel.
- The cartilage between the breastbone and the ribs.
- The hip and shoulder joints.
Diagnosis
X-rays allow doctors to check for changes in joints and bones, also called radiographic axial spondyloarthritis, though the visible signs of ankylosing spondylitis, also called axial spondyloarthritis, might not be evident early in the disease.
Magnetic resonance imaging (MRI) uses radio waves and a strong magnetic field to provide more-detailed images of bones and soft tissues. MRI scans can reveal evidence of nonradiographic axial spondyloarthritis earlier in the disease process, but they are much more expensive.
There are no specific lab tests to identify ankylosing spondylitis. Certain blood tests can check for markers of inflammation, but many different health problems can cause inflammation.
Blood can be tested for the HLA-B27 gene. But many people who have the gene don’t have ankylosing spondylitis, and people can have the disease without having the HLA-B27 gene.
