Ankylosing spondylitis

1/6 What is it?

Ankylosing spondylitis is an autoimmune disease with persistent inflammation in the spine and the sacroiliac joints.

Where the inflammation continues over years, stiffening can develop between the vertebrae, leading to restricted movement.

The disease usually starts young — most often before the age of 40.

Besides the spine, it can affect the knee, ankle and heel.

2/6 Who is it for?

Young and middle-aged people with back pain lasting more than three months.

People whose back pain is worse at night and comes with morning stiffness.

People treated for a long time under a diagnosis of disc herniation or protrusion without benefit.

People with a family history of ankylosing spondylitis, psoriasis or inflammatory bowel disease.

People who have had recurring redness and pain in the eye — uveitis.

3/6 When to seek care

This is how inflammatory back pain differs from ordinary back pain:

• The pain worsens in the second half of the night and wakes you
• Your lower back is stiff for more than half an hour each morning
• Movement eases the pain; rest makes it worse
• The pain began gradually and is not linked to a sudden injury
• The pain spreads into one or both buttock areas
• There is also pain in the heel or the chest wall

In ordinary mechanical back pain the opposite is true: it worsens with movement and eases with rest.

4/6 Why it matters

In this disease the diagnosis is often delayed by years. Back pain is treated as ordinary and the assessment put off.

Early diagnosis is more effective at preventing stiffening of the spine.

The disease can also affect the eyes, the bowel and the skin. Assessing those features together matters.

Regular movement and exercise are an inseparable part of treatment. Relying on medicines alone is not right.

5/6 How it is done

1. The conversation. The nature of the pain is established: is it worse at night, does movement ease it, how long has it lasted.
2. Physical examination. The range of spinal bending and chest expansion are measured.
3. Imaging. An X-ray of the sacroiliac joints is taken. At an early stage MRI can be more sensitive.
4. Blood tests. CRP, ESR and, where indicated, HLA-B27 are checked. That marker alone does not make the diagnosis.
5. Treatment plan. Anti-inflammatory treatment, an exercise programme and, where indicated, biological treatment are discussed.

Physiotherapy and daily exercise have a special place in this disease. The aim is to preserve the spine's mobility.

Where pain is related to nerve compression, a paravertebral block may be discussed.

6/6 Where it is done

Examination and follow-up take place in Baku, at StarLab Clinic.

Address: 20 Yanvar str. 88, 5th microdistrict, Baku, opposite the Qızıltac wedding hall.

Contact: +994 55 550 55 69.

No. HLA-B27 can be positive in healthy people too. It is only a supporting marker and does not make the diagnosis by itself.

Not always. Which investigation is needed depends on the nature of the complaint and on the examination findings.

Yes, and it is actively recommended. Swimming, stretching and posture exercises are helpful. The programme should be chosen individually.

With modern treatment, many patients continue an active life. The course differs from person to person and an exact prognosis cannot be given in advance.