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Condition and Treatment for Ankylosing Spondylitis (AS)

What is Ankylosing Spondylitis (AS)?

Ankylosing Spondylitis, recently renamed “Axial Spondyloarthritis”, affects the spine and the sacroiliac joints, causing both inflammation as well as new bone formation. The latter process is “silent”, but eventually leads to profound disability due to fusion (“ankylosis”) of the entire spine.

1 out of 5 people will develop uveitis, an inflammation of the eye which can permanently impair vision. Another association is with Inflammatory Bowel Diseases like Crohn Disease and Ulcerative Colitis. It is also related to Psoriatic Arthritis and Reactive Arthritis. 3 to 4 out of 5 people of AS patients carry the gene, HLA-B27, varying with ethnicity.

What are the Symptoms of Ankylosing Spondylitis (AS)?

AS often presents insidiously as early morning back stiffness and buttock pain in otherwise healthy young people in their late teens or early twenties. As such, the symptoms are often dismissed and the diagnosis missed, resulting in eventual irreversible spinal fusion, lifelong disability, and even eye and heart complications.

Males appear to be more severely affected than females, especially by ankylosis.

What are the Treatments Available for Ankylosing Spondylitis (AS)?

Like its cousin, Psoriatic Arthritis, TNF and IL17 inhibitors are very effective for pain relief and inflammation control. Prolonged treatment to ensure no or little inflammation (at least 2 years in early disease, and over 4 years for established disease) is key to prevent or slow down the progression to ankylosis.

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