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Could My Stiff, Aching Back Be a Sign of Ankylosing Spondylitis?

The short answer from a rheumatologist

Man in morning with chronic back pain

Q: I have chronic lower back pain that’s worse in the morning. Could it be ankylosing spondylitis?

A: Ankylosing spondylitis is a form of arthritis that causes inflammation of the spine, resulting in back pain and stiffness. It can also affect other joints.


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There are many potential causes of back pain, which can make it tricky to diagnose. But often times, people with AS experience back pain that:

  • is focused in the buttocks and low back.
  • is associated with morning stiffness.
  • improves with exercise.
  • doesn’t get better with rest.
  • feels worse during the night.

People who have AS may also experiences joint pain and swelling in other areas such as the hips or shoulders, as well as skin changes, eye changes or bowel issues.

A physician makes an AS diagnosis through a combination of a physical exam, blood work and imaging tests, such as MRI.

AS is progressive, and if it’s severe, it can cause the bones of the spine to fuse over time. So early treatment is important to prevent disability and reduce pain and stiffness. Treatment may include:

  • NSAIDs, steroids, biologics or other medications, as prescribed by a rheumatologist
  • An exercise program that includes low-impact and weight-bearing exercises
  • Regular stretching
  • A healthy, anti-inflammatory diet
  • Minimizing stress

Treatment starts with an accurate diagnosis, so talk with your doctor if you’ve been experiencing any kind of chronic pain.

Rheumatologist Margaret Tsai, MD

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