Ankylosing Spondylitis

Ankylosing spondylitis (AS) is a chronic inflammatory condition that primarily affects the spine and sacroiliac joints, causing persistent back pain and progressive stiffness. It is part of a broader group of conditions called axial spondyloarthritis.

AS typically develops in late teens to early thirties and is more common in men, though it can affect anyone. The condition is strongly associated with the HLA-B27 gene, which is present in approximately 90% of people with AS. However, having this gene does not mean you will develop the condition.

The hallmark symptom is inflammatory back pain, which differs from mechanical back pain in several ways: it begins gradually, typically before age 40, improves with exercise but not with rest, causes morning stiffness lasting more than 30 minutes, and often disturbs sleep in the second half of the night.

Dr Das uses a combination of clinical assessment, blood tests (including HLA-B27, CRP, and ESR), and MRI imaging to diagnose AS early, before significant structural changes occur. Early diagnosis and treatment are crucial for preventing spinal fusion and maintaining mobility.

Treatment focuses on reducing inflammation, managing pain, and maintaining spinal mobility. Regular exercise and physiotherapy are cornerstone treatments. Medications include NSAIDs as first-line treatment, and biologic therapies (anti-TNF agents and IL-17 inhibitors) for patients who do not respond adequately. Dr Das works closely with physiotherapists to create individualised exercise programmes.