Frequently Asked Questions

Spondylitis refers to a group of chronic inflammatory diseases (Spondyloarthritis or Spondyloarthropathy) that primarily affect the spine, and sometimes other joints and organs. This family includes Ankylosing Spondylitis (AS), Undifferentiated Spondyloarthropathy (USpA), Juvenile Spondyloarthropathy (JSpA), Psoriatic Arthritis (PsA), Reactive Arthritis (ReA), and Enteropathic Arthritis.

A rheumatologist specializes in diagnosing and treating AS and other autoimmune or musculoskeletal disorders. Physical therapists and occupational therapists may also support management.

While the exact cause is unknown, genetics—especially the HLA-B27 gene—play a key role. Over 95% of people of European descent with AS have this marker, though additional genes and environmental triggers (e.g. infections) contribute.

Present in about 8% of the general population, the HLA-B27 gene does not directly cause spondylitis. However, those with the gene have a higher susceptibility—only around 2% will actually develop the condition.

Under age 40, your risk increases to approximately 20%. If you’re over 40, the risk becomes very low. Children of an HLA-B27 positive parent have a 50% chance of inheriting the gene—but only a small fraction will develop AS.

Diagnosis typically involves a physical exam, medical and family history, blood work including HLA-B27 testing, and imaging such as X-rays.

Currently, there is no cure. However, treatments—including newer biologic medications—can manage symptoms and may slow the disease progression in some individuals.

An effective management plan includes medication, regular exercise, physical therapy, and maintaining good posture.

Low-impact activities such as water therapy, Tai Chi, and walking are often helpful. Always consult your physician or physical therapist first to tailor an exercise plan to your needs.

Proper posture may influence the way spinal bones fuse. Fusion in a poor posture can lead to long-term disability—so maintaining upright posture is encouraged.

AS severity varies significantly. Some people only experience occasional back pain, while others may face severe, widespread pain and stiffness over time.

TNF-α blockers are the only treatment shown to slow or halt radiographic progression of fusion in many AS patients. These drugs, though promising, are expensive and lack long-term safety data.

Exercise, physical therapy, and NSAIDs are effective for many (possibly up to 50% of patients). TNF-blockers are expensive and carry potential side effects—so they are reserved for cases where simpler therapies fail.

Increased susceptibility to infections (including TB, bronchitis, pneumonia) is common, so TB must be tested and treated prior. Investigated risks include lymphoma, heart failure, and multiple sclerosis.

Concerns exist about pre-existing cancers (e.g., prostate or cervical), but limited data is available. There is no current evidence indicating an increased cancer risk in the younger patient groups treated with these drugs, and systematic monitoring is not standard—reliance is mostly observational.

These interventions help individuals cope, improve quality of life, and address the emotional impact of chronic illness. Biomedical treatments are limited—they don’t address psychological or behavioral needs.

Mindful meditation, Tai Chi, and other lifestyle practices have shown positive effects on pain and inflammation in rheumatic conditions.

The optimal model is a multi-disciplinary clinic with biomedical, psychological, and social support professionals working together within the same setting.

Key obstacles include fragmented care, limited insurance coverage, time constraints, misperceptions about mental health interventions, and lack of coordination between healthcare providers.

Yes—AS may strain relationships. Family-based interventions can foster healthier coping strategies, hope, and optimism.

Areas such as pain management, mood, sleep, and self-esteem benefit greatly from behavioral support—it enhances overall quality of life.

Genetics account for approximately 97% of AS risk. In identical twins, if one has AS, the other’s risk is about 63%. Multiple genes are involved.

Historically, certain painkillers like phenacetin led to kidney damage—this is rare now. While long-term NSAID use can cause kidney issues, such risks are small; overall, the benefits typically outweigh risks.

No compelling evidence supports that food triggers AS symptoms—some anti-inflammatory dietary theories (like omega-3 fats) have not proven effective.

CRP (reactive protein) is a useful marker but not reliable when AS is limited to the spine. It should not be overly relied upon alone to assess inflammation.

X-rays detect minimal changes only after about two years. MRI is a more sensitive tool early on for detecting active disease.

Yes—AS progression varies. Even if you feel well, periodic monitoring (e.g., every couple of years) is advisable to detect changes early.

Stress—physical or emotional—can indeed trigger AS flare-ups, even within hours. While mechanisms are not fully understood, stress management can be beneficial.

Patients must meet the New York modified criteria, score ≥4 on BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) for at least four weeks, and have failed at least two NSAIDs. Comorbidities like infections or cancer are also considered. If no improvement is seen in 6–12 weeks, treatment is likely ineffective.

MRI can help confirm inflammation, especially in locations like the foot or heel. TNF-α blockers may be used off-label and often work, though insurance coverage may vary.

Lower barometric pressure (e.g., during storms) tends to worsen arthritis symptoms. The impact of humidity is unclear; the belief that dry climates help is not strongly supported.

Meta-analysis (1945–1998) shows closing-wedge osteotomy can correct curvature by ~37°–40°. Mortality around surgery was ~4%, and risks include spinal cord damage. The closing-wedge method has the lowest chance of postoperative correction reversal.