Spondylitis is an inflammatory disease that mainly affects the joints in the back but can also cause inflammation in the joints of the limbs. It is an autoimmune disease, which means that the immune system attacks the body's own tissues, causing inflammation. It belongs to a subgroup of rheumatic diseases called spondylarthritis (SpA).

Approximately 1 in every 200 people develop ankylosing spondylitis. The disease is slightly more common in men than in women. The disease most commonly appears between the ages of twenty and forty.

Heredity plays a major role, but certain genes (HLA-B27) greatly increase the chances of developing ankylosing spondylitis. Around 90% of those with ankylosing spondylitis have HLA-B27.

The symptoms of ankylosing spondylitis usually develop slowly and gradually.

• Low back pain with morning stiffness is the most common symptom. The pain can occur anywhere in the spine, but is most common in the sacroiliac joints where the pelvis connects to the sacrum. The pain often radiates down into the buttocks.
• Pain, swelling and stiffness in the hips, knees and ankles, but there can also be pain in the ribs, sternum and shoulders.
• Eye symptoms. Red, irritated or painful eyes. Sometimes vision can become blurred.
• Ankylosing spondylitis (inflammation where tendons attach to bone). Most common in the heel or sole of the foot and can cause pain when walking.
• Back pain at night or after rest.
• Muscle aches and back pain get better with exercise.
• General symptoms such as fatigue and loss of appetite.

An analysis of ankylosing spondylitis Based on an account, examination and findings.  

The analysis is based on, among other things: 

• Clinical picture, case history and family history.
• Physical examination of the back, joints, tendons, skin and nails.
• An imaging investigation, such as an MRI of the back, is very important for confirming the diagnosis if the history and examination suggest that spondylitis is present.
• Blood tests to measure inflammation and rheumatism tests to rule out other rheumatic diseases. Sometimes an HLA-B27 test is carried out.

The aim of treatment is to reduce inflammation, relieve symptoms, protect joints and improve quality of life. Treatment is individualised and depends on the severity of the disease. 

Common drug treatments include: 

• Anti-inflammatory drugs often have a very good effect on back pain and stiffness.
• Steroids in tablet form or injected into a joint are sometimes used to treat joint inflammation, for example in the knee, in the disease. 
• Disease-modifying antirheumatic drugs (DMARDs) that affect the activity and course of the disease: 
  • Biological DMARDs and targeted DMARDs which act on specific components of the immune system.

Patients can have a significant impact on their well-being with daily routines and supportive therapy: 

• Exercise and physiotherapy are one of the most important parts of the treatment for ankylosing spondylitis. This is crucial for maintaining mobility and strength, and for reducing back pain.
• Find a balance between stress and rest.
• A healthy diet and maintaining a healthy body weight.
• Avoid smoking.
• Stress reduction and plenty of sleep.
• Learn about the disease and seek support, e.g. from the Arthritis Society. 

It is important to be an active participant in your own treatment and to have a good partnership with healthcare professionals. 

The prospects are very different but most often text that to hold symptoms down with anti-inflammatory medicines and disease-modifying medicines.