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  • Q&A with Australian Health Practitioners

    What are the symptoms of ankylosing spondylitis?

    Related Topics
    Ankylosing Spondylitis Rheumatology
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    Dr Ryan Hislop

    Chiropractor

    Ryan Hislop is the Clinical Director at the Orange Chiropractic Health and Wellness Centre. As an experienced and evidence-based diagnostician, Ryan works largely by medical … View Profile

    The clinical features usually occur between the ages of 15-35 years and will often begin with discomfort in the sacroiliac region . 
    This often progresses to pain and tenderness over bony protuberances in the spine (the bumps you can feel on your back) in conjunction with increasing stiffness. Occasionally sciatica (pain down the legs due to nerve involvment) is present in both legs or may alternate from side to side. This may be accompanied by heel pain, muscle spasm and possible atrophy.

    There are also some classical features apart from spinal pain and stiffness that are important to note and are due to physiological complications from the chronic inflammatory disorder which is defined as Ankylosing Spondylitis. These include:
    - iritis
    - aortitis
    - valvular incompetence,
    - aneurysms
    - conduction blocks
    - upper lobe pulmonary fibrosis
    - inflammatory bowel disease (18% of AS patients suffer this)
    - carrot stick fractures
    - Anderson lesions
    - prothesis ankylosis.

    (just to name a few…)

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    Dr Irwin Lim

    Rheumatologist

    Irwin has been a rheumatologist in Sydney since 2003. He is a co-founder and medical director of BJC Health, which consists of a team of … View Profile

    The symptoms and features Ryan has listed above can all occur.

    Inflammatory spinal pain in a young patient needs to trigger a consideration of Ankylosing Spondylitis and related spondyloarthritis.

    I just want to highlight that the 10:1 ratio mentioned is not correct. It is now believed that the condition is probably as common in females (has been under-recognised in the past). Ankylosing Spondylitis therefore needs to also be considered in females.

    Features differentiating inflammatory from mechanical causes of back pain are discussed in this post -  http://bjcconnectedcare.com/2011/01/back-pain-inflammatory-vs-mechanical/ 

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    Dr Aaron Albrecht

    Chiropractor

    Dr. Aaron Albrecht works at Body Wise Chiropractic in Bibra Lake, Western Australia. The clinic is located within a gym, and Dr. Albrecht is the … View Profile

    In addition to Dr. Hislop's comments there are also some temporal factors to watch out for in regards to ankylosing spondylitis (AS). One should note the timing of the joint stiffness, as classic presentations exhibit morning stiffness that lasts for approximately 20 minutes, and resolves gradually with movement.

    All the best.

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