Understanding the Basics of Ankylosing Spondylitis | Causes, Symptoms, and Diagnosis healthcare nt sickcare

What is Spondyloarthritis? Ankylosing Spondylitis

Ankylosing Spondylitis (AS) is a type of arthritis that mainly affects the spine and can lead to severe pain and stiffness. It's a chronic inflammatory disease that can also affect other joints in the body. AS is more commonly seen in young adults and can often go undiagnosed for several years. 

In this article, we will explore the symptoms, causes, and diagnosis of Ankylosing Spondylitis and discuss how Healthcare nt sickcare can help diagnose it.

What is Spondyloarthritis?

Spondyloarthritis refers to a group of inflammatory rheumatic diseases that primarily cause pain and inflammation in the spine and sacroiliac joints of the pelvis. Key features include:

  • Inflammation of the spine (spondylitis) and sacroiliac joints, leading to back/neck pain and stiffness.
  • Potential inflammation of other joints like the knees, ankles, and shoulders.
  • Enthesitis - inflammation where tendons and ligaments attach to bones.
  • May involve other areas like the eyes, bowel, and skin.
  • Genetic association with HLA-B27 gene.

Types of Spondyloarthritis

There are two main types of spondyloarthritis:

  • Ankylosing spondylitis - This chronic form impacts the spine and sacroiliac joints, causing eventual fusion of the vertebrae in advanced cases. It typically begins in the late teens to 40s.
  • Non-radiographic axial spondyloarthritis - Similar symptoms as ankylosing spondylitis but without clear structural damage visible on x-rays. Often an earlier form.

Other spondyloarthritis diseases include psoriatic arthritis, reactive arthritis, and enteropathic arthritis associated with inflammatory bowel disease.

Treatment focuses on relieving pain and stiffness through NSAIDs, DMARDs, biologics, physiotherapy, and lifestyle changes. Early diagnosis and management help improve function and quality of life.

What is Undifferentiated Spondyloarthritis?

Undifferentiated spondyloarthritis refers to a form of spondyloarthritis that doesn't fit clearly into a specific subtype like ankylosing spondylitis or psoriatic arthritis. Key features:

  • Symptoms of spondyloarthritis like inflammatory back pain, enthesitis, and arthritis are present.
  • Diagnostic criteria for a defined spondyloarthritis subtype are not fully met.
  • May represent an early or incomplete form of a subtype that hasn't yet fully manifested.
  • Approximately 15-30% of spondyloarthritis cases are considered undifferentiated.
  • More common in younger patients, often preceding development of ankylosing spondylitis.
  • Frequently involves sacroiliitis and spinal inflammation visible on MRI but not x-ray.
  • HLA-B27 genetic marker is often positive.
  • May evolve into a specific subtype over time. Requires ongoing monitoring.
  • Managed similarly to other forms of spondyloarthritis with NSAIDs, DMARDs, biologics, physiotherapy.

The diagnosis of undifferentiated spondyloarthritis is made by a rheumatologist after evaluating a patient's signs, symptoms, family history, labs, and imaging like MRI and ruling out other potential causes.

What is Ankylosing Spondylitis?

AS is a type of arthritis that causes inflammation in the joints and ligaments of the spine. The inflammation can lead to new bone formation, which can cause the spine to become stiff and inflexible over time. AS can also cause inflammation in other joints, such as the hips, knees, and shoulders. The exact cause of AS is unknown, but it is believed to be an autoimmune disorder, where the body's immune system attacks its own tissues.

Symptoms of Ankylosing Spondylitis

The symptoms of AS can vary from person to person and can be mild or severe. Some common symptoms of AS include:

  • Back pain and stiffness, particularly in the morning or after periods of inactivity
  • Pain and stiffness in other joints, such as the hips, knees, and shoulders
  • Fatigue
  • Reduced flexibility in the spine
  • Difficulty taking deep breaths

How to Test for Ankylosing Spondylitis?

Here are some of the main ways that doctors test for ankylosing spondylitis:

  • Medical History - Looking for symptoms like chronic lower back pain and stiffness that improves with activity, fatigue, joint pain or swelling, and eye inflammation. Family history is also considered.
  • Physical Exam - Checking for limited range of motion in the spine, reduced chest expansion, and inflammation in joints like the knees, hips, shoulders and heels.
  • Imaging Tests - X-rays can detect joint damage and fusing of the spine and sacroiliac joints. MRI can also assess inflammation early on.
  • Blood Tests - A blood test called HLA-B27 can indicate a genetic predisposition for AS. Complete blood count and inflammatory markers may also be elevated.
  • Eye Exam - A slit lamp exam by an ophthalmologist can reveal uveitis, or swelling of the eye's middle layer. This can be an early symptom.
  • Range of Motion Tests - Measuring ability to bend and rotate the spine assesses stiffness and reduced mobility from inflammation.

Early diagnosis and monitoring of progression is important to prevent permanent joint fusion and disability. A combination of imaging, exams, blood work and assessment of symptoms helps confirm an ankylosing spondylitis diagnosis.

How to Diagnose of Ankylosing Spondylitis?

Diagnosing AS can be difficult, as its symptoms can be similar to other types of arthritis. A doctor may suspect AS based on a patient's symptoms and medical history. They may also conduct a physical exam to check for signs of inflammation, such as swelling, tenderness, and restricted mobility. In addition to these, they may also order several diagnostic tests, such as:

  • Blood tests: These tests can check for signs of inflammation and specific antibodies that are commonly associated with AS.
  • X-rays: X-rays of the spine can show changes that are indicative of AS, such as the presence of new bone formation.
  • MRI: MRI scans can detect early signs of inflammation and damage to the spine and other joints.

What is Shoulder Pain?

Shoulder pain is a common problem that can affect people of all ages. It can be caused by a variety of things, including injury, overuse, and underlying medical conditions.

The shoulder is a complex joint that is made up of three bones: the humerus (upper arm bone), the scapula (shoulder blade), and the clavicle (collarbone). The shoulder joint is also supported by several muscles, tendons, and ligaments.

When any of these structures are injured or overused, it can cause shoulder pain. The pain may be sharp or dull, and it may be worse with certain activities, such as reaching overhead or lifting heavy objects.

In some cases, shoulder pain may be a sign of a more serious underlying medical condition, such as arthritis, rotator cuff tear, or a fracture. If you have shoulder pain that is severe or does not improve with rest, it is important to see a doctor to get a diagnosis and treatment.

Here are some of the most common causes of shoulder pain:

  • Injury: Shoulder injuries can be caused by a variety of things, such as a fall, a sports injury, or overuse. Common shoulder injuries include:
    • Rotator cuff tear: The rotator cuff is a group of muscles and tendons that help to stabilize the shoulder joint. A rotator cuff tear can cause pain, weakness, and loss of range of motion in the shoulder.
    • Dislocation: A shoulder dislocation occurs when the humerus (upper arm bone) pops out of the socket. This can cause severe pain, swelling, and difficulty moving the arm.
    • Impingement syndrome: Impingement syndrome occurs when the tendons of the rotator cuff rub against the bones of the shoulder joint. This can cause pain, inflammation, and weakness in the shoulder.
  • Overuse: Overuse of the shoulder can cause pain and inflammation. Common activities that can lead to overuse of the shoulder include:
    • Sports that involve overhead movements, such as baseball, tennis, and volleyball.
    • Heavy lifting.
    • Repetitive motions, such as typing or painting.
  • Underlying medical conditions: Some underlying medical conditions can cause shoulder pain, such as:
    • Arthritis: Arthritis is a condition that causes inflammation of the joints. Shoulder arthritis can cause pain, stiffness, and loss of range of motion in the shoulder.
    • Bursitis: Bursitis is a condition that causes inflammation of the bursa, which is a fluid-filled sac that helps to cushion the bones and tendons in the shoulder. Bursitis can cause pain, swelling, and redness in the shoulder.
    • Tendinitis: Tendinitis is a condition that causes inflammation of the tendons, which are the tough bands of tissue that connect muscles to bones. Tendinitis can cause pain, swelling, and tenderness in the shoulder.

If you have shoulder pain, it is important to see a doctor to get a diagnosis and treatment. The doctor will likely ask you about your medical history, your symptoms, and any activities that you have been doing that may have caused the pain. The doctor may also perform a physical exam of your shoulder.

If the doctor suspects that you have an underlying medical condition, they may order tests, such as an X-ray, an MRI, or an ultrasound. These tests can help the doctor to see the structure of your shoulder and to diagnose any underlying conditions.

The treatment for shoulder pain will vary depending on the cause of the pain. In some cases, the doctor may recommend rest, ice, compression, and elevation (RICE). The doctor may also prescribe medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids. In more severe cases, the doctor may recommend surgery.

With proper treatment, most people with shoulder pain can get relief and return to their normal activities.

Is Shoulder Pain Related to Spondylitis?

Yes, shoulder pain can be a symptom of spondylitis. Spondylitis is a group of diseases that affect the spine and joints. One type of spondylitis, ankylosing spondylitis, can cause inflammation and pain in the spine, neck, and shoulders. Shoulder pain from ankylosing spondylitis is usually worse in the morning and gets better with movement. Other symptoms of ankylosing spondylitis include:

  • Back pain
  • Neck pain
  • Hip pain
  • Knee pain
  • Fatigue
  • Weight loss
  • Low-grade fever
  • Reduced range of motion in the spine

If you have shoulder pain, it's important to see a doctor to get a diagnosis and treatment. Treatment for shoulder pain from ankylosing spondylitis may include:

  • Medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or biologics
  • Physical therapy
  • Exercise
  • Surgery, in rare cases

With proper treatment, most people with shoulder pain from ankylosing spondylitis can manage their symptoms and live a normal life.

Here are some additional information about spondylitis:

  • Spondylitis is a chronic condition, which means it lasts for a long time.
  • There is no cure for spondylitis, but it can be managed with treatment.
  • Spondylitis can affect people of all ages, but it is most common in young adults.
  • Spondylitis is more common in men than women.
  • The exact cause of spondylitis is unknown, but it is thought to be an autoimmune disease.
  • Autoimmune diseases occur when the body's immune system attacks healthy tissue.
  • In the case of spondylitis, the immune system attacks the joints in the spine and other parts of the body.
  • Spondylitis can cause inflammation, pain, and stiffness in the joints.
  • The inflammation can damage the joints and lead to bone growth.
  • This bone growth can cause the spine to become fused.
  • The fusion of the spine can limit the range of motion and cause pain.
  • There is no cure for spondylitis, but it can be managed with treatment.
  • Treatment for spondylitis usually includes medication, physical therapy, and lifestyle changes.
  • Medications can help to reduce inflammation and pain.
  • Physical therapy can help to improve range of motion and strength.
  • Lifestyle changes, such as losing weight, quitting smoking, and getting regular exercise, can also help to manage spondylitis.

If you have any of the symptoms of spondylitis, it is important to see a doctor for diagnosis and treatment.

What Causes Frozen Shoulder?

Frozen shoulder, also known as adhesive capsulitis, is a condition that causes pain and stiffness in the shoulder. The shoulder joint is surrounded by a capsule of tissue that helps to keep the bones in place and allows for movement. In a frozen shoulder, this capsule becomes inflamed and thickened, which limits the range of motion and causes pain.

The exact cause of frozen shoulder is unknown, but it is thought to be caused by a combination of factors, including:

  • Injury or surgery to the shoulder
  • Immobilization of the shoulder for a long period
  • Certain medical conditions, such as diabetes, thyroid problems, or Parkinson's disease
  • Age (frozen shoulder is more common in people over age 40)
  • Gender (women are more likely to develop frozen shoulders than men)

Frozen shoulder typically develops in three stages:

  • Freezing stage: This is the first stage, and it usually lasts for 3 to 6 months. During this stage, the shoulder becomes increasingly stiff and painful.
  • Frozen stage: This stage lasts for 4 to 12 months. During this stage, the shoulder is very stiff and painful. It can be difficult to even put on a shirt or reach for something overhead.
  • Thawing stage: This stage lasts for 6 to 12 months. During this stage, the shoulder slowly regains its range of motion and flexibility. However, it may take up to 2 years for the shoulder to fully recover.

There is no cure for frozen shoulder, but there are treatments that can help relieve pain and improve range of motion. These treatments may include:

  • Physical therapy: A physical therapist can help you stretch and strengthen the muscles around your shoulder.
  • Medication: Your doctor may prescribe pain medication or anti-inflammatory medication to help relieve pain and inflammation.
  • Surgery: In rare cases, surgery may be necessary to release adhesions in the shoulder capsule.

If you are experiencing pain and stiffness in your shoulder, it is important to see a doctor to get a diagnosis and treatment.

How healthcare nt sickcare Can Help Diagnose Ankylosing Spondylitis?

At Healthcare nt sickcare, we offer a range of diagnostic tests to help diagnose Ankylosing Spondylitis. Our expert team of healthcare professionals can conduct a physical examination and order the necessary tests to diagnose the condition accurately. Our diagnostic tests include:

  • Complete Blood Count (CBC): This test can help detect signs of inflammation and anaemia, which is commonly seen in patients with AS.
  • Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP) tests: These tests can help detect signs of inflammation in the body.
  • HLA-B27 test: This genetic test can detect the HLA-B27 gene, which is commonly seen in patients with AS.
  • X-rays and MRI scans: These imaging tests can detect changes in the spine and other joints that are indicative of AS.

Is ankylosing spondylitis an autoimmune disease?

Yes, ankylosing spondylitis is classified as a systemic autoimmune disease. It occurs due to the body's immune system attacking its own healthy tissues, specifically targeting the spine joints and ligaments causing inflammation and progressive fusing.

What type of doctor diagnoses ankylosing spondylitis?

Rheumatologists are specialized in diagnosing and treating ankylosing spondylitis through analysis of reported symptoms, a detailed physical exam, medical history review and the ordering of confirmatory diagnostic tests like imaging and blood work.

Can cracking back cause ankylosing spondylitis?

No, cracking one's back does not cause or aggravate ankylosing spondylitis. Ank. spondylitis stems from an inherited gene called HLA-B27 that triggers the immune reaction targeting the spine. Factors like back trauma, posture stress or lifestyle do not impact its onset although they can exacerbate pain.

Is ankylosing spondylitis considered a disability?

Yes, advanced ankylosing spondylitis that fuses and stiffens the spine over time is considered a physically disabling condition, significantly impacting mobility and function. It also has high comorbidity with issues like uveitis, inflammatory bowel disease, psoriasis, and chronic fatigue.


Ankylosing Spondylitis is a chronic inflammatory disease that affects the spine and other joints. It can cause severe pain and stiffness, and can often go undiagnosed for several years. Understanding the symptoms and causes of AS is crucial for early diagnosis and treatment.


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