Ankylosing spondylitis: night-time back pain
An inflammatory spinal rheumatism
Dr. Marc Lefèvre
Rheumatologist
In simple terms
NSAIDs, anti-TNF, IL-17 inhibitors: progress in ankylosing spondylitis.
A chronic inflammatory disease
Ankylosing spondylitis affects 0.3% of the population, typically young men. Inflammation of sacroiliac joints, spine, sometimes peripheral joints. Strong association with HLA-B27 (80-90%).
Symptoms
Inflammatory low back pain (night-time, morning stiffness >30 min, improves with activity), buttock pain alternating from side to side, enthesitis (Achilles), uveitis, psoriasis or IBD possible.
Diagnosis
Pelvic MRI (sacroiliitis), HLA-B27, CRP. ASAS classification criteria.
Treatments
- NSAIDs: first-line, often continuous
- Physical therapy daily: essential to prevent ankylosis
- Anti-TNF (adalimumab, etanercept): very effective
- IL-17 inhibitors (secukinumab, ixekizumab) and JAK inhibitors (upadacitinib)
Lifestyle
Quit smoking (worsens progression), regular physical activity (swimming, yoga), preserve good posture.
The words explained
Medical terms used above, in everyday language.
- Chronic
- A problem that lasts a long time, usually more than three months, and often comes back.
- Inflammation
- The body's reaction to injury or irritation: redness, swelling, heat or pain.
- Symptom
- A sign you can feel or see that something is wrong, like pain, tiredness or a rash.
- Diagnosis
- The moment a doctor identifies which illness is causing your symptoms.
- Prevention
- Steps taken before a problem starts, to make it less likely.
When should you see a doctor?
- Your symptoms last more than a few weeks or keep coming back.
- They get worse quickly, or stop you doing everyday things.
- You notice sudden pain, breathing trouble, fainting or bleeding — seek urgent care.
- You already take medication and want to change anything about it.
This article explains general health information. It does not replace advice from your own doctor.
Frequently asked questions
- What is Ankylosing spondylitis: night-time back pain?
- NSAIDs, anti-TNF, IL-17 inhibitors: progress in ankylosing spondylitis.
- What are the main symptoms or signs of Ankylosing spondylitis: night-time back pain?
- Common signs vary from person to person. The article above lists the symptoms to watch for, how they progress, and when they need medical attention.
- When should you see a doctor for Ankylosing spondylitis: night-time back pain?
- See a doctor if symptoms last more than a few weeks, get worse quickly, stop you doing everyday things, or if you notice sudden pain, breathing trouble, fainting or bleeding.
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