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Stanford Health Care

Symptoms

How We Can Help You for Ankylosing Spondylitis

The doctors in the Stanford Medicine Spine Center have the experience needed to accurately diagnose and effectively treat ankylosing spondylitis (pronounced "an-kil-OH-sing spawn-duh-LY-tus" and also known as “AS”).

We help relieve symptoms, which may include pain and stiffness in the neck, shoulders, back, buttocks, chest, and other areas of the body. We also help manage complications of AS such as fatigue, anemia, and uveitis (inflammation of the eye).

Stanford Medicine Spine Center patients with AS also may have opportunities to participate in research studies of new treatment approaches not yet available anywhere else.

What We Offer You for Ankylosing Spondylitis

  • Center of Excellence for advanced care of spine-related conditions.
  • Nationally recognized expertise in treating every type of AS, no matter how complex.
  • Precise diagnosis options including the latest imaging technology.
  • Team-based treatment planning that brings together orthopaedic surgeons, neurologists and neurosurgeons, pain management specialists, rheumatologists, physiatrists, geneticists, and others to tailor care to your needs.
  • Advanced treatment options emphasizing noninvasive approaches whenever possible, including exercises, physical therapy, and medication therapy, and, when needed, spine surgery.
  • Comprehensive support services including care coordination from diagnosis to treatment to follow-up.
  • Active research program to develop new diagnostic and treatment advances.

Treatments for Ankylosing Spondylitis

The team members of the Stanford Medicine Spine Center use the most advanced techniques to effectively treat AS. We have experience with all treatment approaches and use minimally invasive techniques whenever possible.

Our team includes doctors from orthopaedics, neurology, rheumatology, physiatry, and other specialties, working together to help ensure you receive an accurate diagnosis and the most effective treatment possible.

Our team develops an AS care plan that is personalized to your unique needs.

Our AS treatments focus on:

  • Reducing pain, stiffness, and inflammation
  • Keeping your condition from getting worse
  • Helping you continue or resume doing your daily activities

Early, precise diagnosis and treatment may help reduce symptoms. Timely treatment also may reduce the risk of AS causing deformity to your spine or back.

 

Starting Treatment

Continuing Treatment

Other Treatments

 

  • AS treatment may begin with nonsteroidal anti-inflammatory drugs (NSAIDs). They can relieve pain and stiffness, and reduce inflammation.
  • Flexibility and strengthening exercises can help you stay mobile and manage your pain.
  • Physical therapy is designed to help you keep a good posture and also to build your lung capacity through breathing exercises.
  • Devices such as canes and walkers can help you continue being physically active while reducing stress on your joints.

If your first treatment does not relieve your pain and inflammation, your doctor may recommend an approach that includes one or more of the following:

  • Corticosteroids (also called epidural steroid injection) to help reduce inflammation
  • Disease-modifying antirheumatic drugs (DMARDs) to reduce pain and inflammation in joints other than the spine and pelvis
  • Treatment of complications that may occur—for example, eye inflammation (uveitis or iritis) may be treated with special eye drops

In some cases, surgery may be required to replace severely damaged joints—most commonly, hip replacement.

We perform spinal surgery for AS, but only when absolutely needed. For example, if there is loosening of vertebrae in the neck and signs of spinal pressure, such as numbness in the hands, we may recommend permanently fusing the two vertebrae together.

We also may perform surgery to treat curvature of the spine.

Starting Treatment
  • AS treatment may begin with nonsteroidal anti-inflammatory drugs (NSAIDs). They can relieve pain and stiffness, and reduce inflammation.
  • Flexibility and strengthening exercises can help you stay mobile and manage your pain.
  • Physical therapy is designed to help you keep a good posture and also to build your lung capacity through breathing exercises.
  • Devices such as canes and walkers can help you continue being physically active while reducing stress on your joints.

close Starting Treatment
Continuing Treatment

If your first treatment does not relieve your pain and inflammation, your doctor may recommend an approach that includes one or more of the following:

  • Corticosteroids (also called epidural steroid injection) to help reduce inflammation
  • Disease-modifying antirheumatic drugs (DMARDs) to reduce pain and inflammation in joints other than the spine and pelvis
  • Treatment of complications that may occur—for example, eye inflammation (uveitis or iritis) may be treated with special eye drops

close Continuing Treatment
Other Treatments

In some cases, surgery may be required to replace severely damaged joints—most commonly, hip replacement.

We perform spinal surgery for AS, but only when absolutely needed. For example, if there is loosening of vertebrae in the neck and signs of spinal pressure, such as numbness in the hands, we may recommend permanently fusing the two vertebrae together.

We also may perform surgery to treat curvature of the spine.


close Other Treatments

INTERESTED IN AN ONLINE SECOND OPINION?

The Stanford Medicine Online Second Opinion program offers you easy access to our world-class doctors. It’s all done remotely and you don’t have to visit our hospital or one of our clinics for this service. You don’t even need to leave home!

Visit our online second opinion page to learn more.

Clinical Trials

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Open Clinical Trials

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Clinical trials are research studies that evaluate a new medical approach, device, drug, or other treatment. As a Stanford Health Care patient, you may have access to the latest clinical trials.

Open trials refer to studies that are currently recruiting participants or that may recruit participants in the near future.

Closed trials are not currently enrolling, but may open in the future.

What Is Ankylosing Spondylitis?

Symptoms of Ankylosing Spondylitis

AS symptoms can vary from person to person and occur at any age, although signs of the condition usually appear first between the ages of 17 and 45.

Early ankylosing spondylitis

Early symptoms include:

  • Dull pain in the low back and back stiffness
  • "Flares" of increased pain and stiffness that may last for several weeks before decreasing again, in some people
  • Limited motion, pain, and stiffness in the low back, middle back, hips, or neck
  • Feeling very tired
  • Eyes that are red, irritated, or inflamed (uveitis or iritis)
  • Sensitivity to light

Severe or advanced ankylosing spondylitis

Severe symptoms include:

  • Scarring in the spine that causes the joints of the spine to grow together (fuse or "ankylose")
  • Problems with balance and mobility
  • Impaired vision or glaucoma
  • Trouble breathing as the upper body curves forward and the chest wall stiffens. Severe ankylosing spondylitis can also cause scarring of the lungs (pulmonary fibrosis) and an increased risk of lung infection.

The stiffening of the chest can feel like the discomfort or "heaviness" of a heart attack. Ankylosing spondylitis can also cause the heart to work less efficiently.

If you have any symptoms of heart or lung problems—including heaviness of the chest or pain with deep breathing—talk to a doctor right away. The doctor can make sure you don't have any serious heart or lung problems.

Our Clinics

Stanford Medicine Spine Center

The Stanford Medicine Spine Center is staffed by world-class spine specialists from neurosurgery and orthopaedics, who work together to offer you the world’s most advanced and effective treatment options—including those that don’t involve surgery. Our goal is to safely get you back to your normal lifestyle as soon as possible, and maintain long-term spinal health.

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To schedule an appointment, please call 650-725-1125.