How is ankylosing spondylitis treated?

Written by Yang Ya Meng
Rheumatology
Updated on March 17, 2025
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The treatment of ankylosing spondylitis mainly consists of three types:

The first is anti-inflammatory pain relief, primarily using non-steroidal pain relief medications, such as sustained-release diclofenac sodium tablets.

The second is the selection of disease control medications, mainly involving drugs like sulfasalazine tablets.

For ankylosing spondylitis, the most effective and economically expensive treatment is biological agents therapy. We commonly use drugs such as tumor necrosis factor antagonists. Patients with ankylosing spondylitis during acute pain periods are advised not to engage in intense exercise. However, during remission periods, appropriate functional exercises are recommended to prevent the adhesion and stiffness of spinal joints.

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Written by Yang Ya Meng
Rheumatology
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What to check for ankylosing spondylitis?

The examination for ankylosing spondylitis mainly includes blood tests. The main components of the blood tests are erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), ANA along with CCP antibodies, and AKA antibodies, and of course, the most crucial test related to the gene - HLA-B27. Imaging exams can include the following: First, an X-ray of the pelvis, or an MRI of the sacroiliac joints. If the disease has been present for a longer time, a CT of the sacroiliac joints can be chosen. If the patient has elevated ESR and CRP, a positive B27, and lesions in the sacroiliac joints, then the diagnosis of ankylosing spondylitis can be confirmed.

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Written by Li Jing
Rheumatology
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Does ankylosing spondylitis cause buttock pain?

Ankylosing spondylitis may cause buttock pain. It primarily affects the axial joints, and can be accompanied by extrarticular manifestations. This condition leads to stiffening and deformity of the spine, and it cannot be cured, only managed with medication to slow the progression of the disease, delay joint deformity, improve quality of life, and reduce disability rates. Its clinical manifestations vary widely, and its onset is often insidious. Men are more commonly affected and tend to experience more severe symptoms. The most common symptoms include stiffness in the neck or pain in the lumbar and back areas. However, some people may experience pain in the lower back, accompanied by morning stiffness, or alternating pain in the buttocks, or radiating pain from the groin to the lower limbs. This pain is often worse at night or after prolonged sitting, but symptoms can lessen after activity.

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Written by Li Jing
Rheumatology
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What should I do in the late stage of ankylosing spondylitis?

Firstly, ankylosing spondylitis is an autoimmune disease primarily affecting the axial joints, but it can also present with extra-articular manifestations. Severe cases can lead to ankylosis and deformities of the spine, which are complications of late-stage ankylosing spondylitis. At this stage, surgery is needed to manage the activity of the disease. If the activity of the disease is not controlled, even joint replacement can still lead to the progression of the disease and further damage to the joint structures. For severe disabling deformities, spinal orthopedic surgery can be considered, and spinal surgery is required when an acute fracture occurs.

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Written by Li Jing
Rheumatology
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What causes ankylosing spondylitis?

Ankylosing spondylitis is primarily an autoimmune disease affecting the axial joints, which may also manifest with extra-articular symptoms. In severe cases, deformities and stiffening of the spine can occur. The cause of the disease is attributed to the interactive effects of genetics and environmental factors, making it a multi-gene inherited disorder. However, for some individuals, it may also be related to infections such as Ureaplasma urealyticum, Shigella, Salmonella, and Escherichia coli in the urinary and genital tracts. These pathogens trigger the body's inflammatory immune response, resulting in tissue damage and contributing to the onset and progression of the disease. There is a notable familial aggregation in the occurrence of this disease.

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Written by Li Jing
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What department should I go to for ankylosing spondylitis?

Ankylosing spondylitis is an idiopathic systemic disease primarily characterized by chronic inflammation of the axial joints, mainly involving the sacroiliac joint. The typical onset age ranges from 10 to 14 years, and it is more common in males. It is not hereditary, but there is a familial predisposition. If there is a family history, and localized pain or discomfort is present, especially if there is difficulty turning over at night, stiffness after waking or after prolonged sitting or standing, which eases with activity, it is important to be alert. This condition falls under rheumatic immune diseases, therefore, it should be managed by a rheumatology immunology department, not orthopedics.