Ankylosing spondylitis (AS) is a form of inflammatory arthritis that primarily affects the spine and the sacroiliac joints where the spine meets the pelvis. Over time, inflammation can cause pain, stiffness, and in some cases fusion of the vertebrae.
AS often begins in early adulthood and develops gradually, which is why it is frequently mistaken for ordinary back pain at first. Morning stiffness that lasts more than 30 minutes and pain that improves with activity are classic clues.
Common symptoms
- Back stiffness that’s worst in the morning
- Pain that improves with movement, not rest
- Gradually decreasing flexibility in the spine
- Hip or buttock pain that alternates sides
How interventional pain physicians treat it
AS is usually managed in partnership with a rheumatologist, who treats the underlying inflammation. Interventional pain physicians typically focus on relieving the pain itself so patients can stay active. Care may include:
- Medication management
- Physical therapy
- SI joint and facet injections
- Radiofrequency ablation
Treatment is always determined by a physician based on individual evaluation. This page is general information, not medical advice.
Frequently asked questions
How is ankylosing spondylitis different from regular back pain?
AS is inflammatory rather than mechanical. It tends to be worse with rest and better with movement, the opposite of most muscle-related back pain, and it often starts before age 45.
Do I still need a rheumatologist if I see a pain specialist?
Yes. Rheumatologists treat the underlying disease with anti-inflammatory and biologic medications, while pain specialists focus on controlling pain and preserving function. The two work together.
Can staying active really help?
For most people with AS, yes. Regular movement and posture-focused exercise help maintain flexibility, and a pain specialist can help reduce pain enough to make consistent activity realistic.
Independent, physician-owned practices in the DxTx network provide this kind of care across 11 states. One call connects you to the practice closest to you.