What is ankylosing spondylitis and why is early diagnosis important?

According to experts at the Mayo Clinic , “It's an inflammatory disease that, over time, can cause some vertebrae to form new bones and fuse together in an attempt by the body to heal. This fusion makes the spine less flexible and can lead to a hunched posture . If the ribs are affected, it can be difficult to breathe deeply.”

Pain and stiffness in the lower back and hips, especially in the morning, are often the first symptoms of this disease. It sometimes also manifests with neck pain and a general feeling of tiredness. Interestingly , it can also affect vision, which is why eye redness and pain, blurred vision, and increased sensitivity to light are common.

But ankylosing spondylitis doesn't just cause uncomfortable back pain; it can also be debilitating, affecting joints such as the shoulders, ribs, hips, knees, or feet. This is precisely why early detection and diagnosis are so important. Only then can the most serious consequences, which can leave the patient wheelchair-bound, be avoided.

It is estimated that around 100,000 people in our country suffer from this condition, which is more common among men than women, approximately two in every 1,000. It usually begins to manifest between the ages of 15 and 30 .

Nonspecific symptoms

There are two main reasons why early diagnosis is difficult. First, the symptoms are very nonspecific. For example, the pain may be mild and constant, but it may also occur in the form of flare-ups or attacks.

It can affect joints such as shoulders, ribs, hips, knees or feet, in addition to causing blurred vision.

On the other hand, radiological images may initially be normal, even if the disease has caused spinal fractures , due to the characteristics of these fractures. Therefore, if suspected, spine experts suggest performing a genetic test that can confirm the diagnosis.

Be alert to any suspicions

But to suspect it, you have to be informed and alert. That's why the Spanish Spine Society (GEER) emphasizes the importance of educational and awareness-raising activities related to the disease . Its president, Luis Álvarez Galovich, warns that, often, "when patients see a rheumatologist, it's too late. They come after misinterpreting their symptoms as mere back pain they 've grown accustomed to living with, despite the impact it has on their daily activities, at a key moment in their lives when they're finishing their studies or starting their careers. Or simply starting to live independently."

In this regard, Luis Álvarez Galovich explains that "prolonged lower back pain without a justified cause in a young person should raise suspicion of ankylosing spondylitis." This makes it easier to arrive at a diagnosis early, which can help maintain a good quality of life for longer.

New biological drugs

Once a diagnosis is made, treatment can begin, which typically includes medications to relieve pain and inflammation, as well as physical therapy to maintain flexibility and improve posture. Lifestyle changes, such as regular exercise , are also necessary.

In some cases, anti-inflammatory drugs don't work as intended. At this point, it's recommended to turn to new biological treatments, which have improved the prognosis for this disease, reducing the percentage—approximately 20%—of patients whose functional capacity is severely affected.