Ankylosing Spondylitis: What to Watch For and What to Do

Do you get low back pain that wakes you up at night or feels better after moving around? That’s a classic sign of ankylosing spondylitis (AS), a long-term inflammatory condition that mostly targets the spine and sacroiliac joints. AS often starts in your late teens to 30s and can slowly stiffen the spine if untreated. The good news: early diagnosis and a mix of treatment and daily habits can keep you moving and reduce flare-ups.

Common symptoms and early clues

Look for persistent low back pain and stiffness that lasts more than three months, especially if it improves with exercise but not rest. Morning stiffness that eases after 30–60 minutes of activity is typical. You may also notice reduced chest expansion, pain in the buttock or hips, fatigue, or eye inflammation (red, painful, light-sensitive eye). Men are slightly more likely to get AS, and a family history of the condition raises the chance.

How doctors confirm the diagnosis

Diagnosis comes from combining your history, physical exam, blood tests, and imaging. Doctors often check for higher inflammation markers (like CRP) and the HLA-B27 gene, though neither alone proves AS. An X-ray may show changes in the sacroiliac joints but early disease is often missed on X-ray; MRI catches inflammation sooner. If you suspect AS, ask for a referral to a rheumatologist — they specialize in inflammatory arthritis and will map out next steps.

Treatment focuses on controlling inflammation, easing pain, and keeping your spine flexible. First-line care usually includes NSAIDs (ibuprofen, naproxen) for pain and stiffness, plus a structured physiotherapy plan. Daily exercises that stretch the chest and spine, plus posture work, are powerful—try simple chest-opening stretches, gentle spinal extensions, and regular walking. If NSAIDs and exercise aren’t enough, biologic drugs such as TNF or IL-17 inhibitors can markedly reduce inflammation and slow progression. Your rheumatologist will discuss the benefits and risks.

Practical tips for everyday life: keep moving—bed rest makes stiffness worse; sleep on a firm surface and use a thin pillow to avoid neck flexion; quit smoking because it speeds up spinal damage; protect bone health with vitamin D and calcium, especially if on long-term medications. Track flare triggers—poor sleep, stress, or skipping exercise are common culprits. Use a simple diary or an app to note pain levels, sleep, and activity; that helps your doctor fine-tune treatment.

Red flags that need urgent care include sudden severe chest pain or trouble breathing, sudden weakness or numbness in the legs, or signs of serious infection with fever. If you get an inflamed eye (red, painful, light-sensitive), see a doctor quickly to avoid complications.

Living with AS is a long game, but many people maintain active lives with the right plan: early rheumatology care, medicines when needed, daily stretching, and smart habits. If your back pain has the patterns above, don’t ignore it—ask your GP about AS and request further evaluation.