Ankylosing Spondylitis Treatment in Guntur

What is ankylosing spondylitis?

Ankylosing spondylitis is a chronic inflammatory arthritis of the spine and sacroiliac joints, part of the axial spondyloarthritis family. Inflammation where ligaments and tendons attach to bone provokes new bone formation, and over years segments of the spine can fuse, reducing movement and posture.

It usually starts before 45, is strongly associated with the HLA-B27 gene, and is frequently mistaken for mechanical back pain for years. The distinguishing features are the pattern — pain worse with rest, better with activity, plus prolonged morning stiffness and night pain — and involvement outside the spine, such as heel pain, a swollen finger or toe, eye inflammation, psoriasis or inflammatory bowel disease.

Symptoms to watch for

• Low back and buttock pain lasting more than three months, beginning before 45
• Pain and stiffness worse after rest and in the early morning, easing with exercise
• Waking in the second half of the night with back pain
• Morning stiffness lasting more than 30 minutes
• Reduced spinal movement or a stooped posture over time
• Heel pain, chest wall pain, or a whole finger or toe swelling (dactylitis)
• Painful red eye with light sensitivity (uveitis)
• Marked improvement in pain with anti-inflammatory medication

How it is diagnosed

Investigation is chosen to answer a specific question rather than as a blanket screen. For ankylosing spondylitis that usually means:

• Clinical assessment of inflammatory back pain features and spinal mobility measurement
• Inflammatory markers (ESR, CRP)
• HLA-B27 testing as a supporting, not confirmatory, result
• X-ray of the sacroiliac joints for established structural change
• MRI of the sacroiliac joints and spine to detect active inflammation before X-ray changes appear
• Assessment for uveitis, psoriasis and bowel symptoms

Treatment options at Siva Sakthi

Which of these applies to you depends on what the assessment shows. The options are discussed with you, including what each involves and what recovery looks like.

• Exercise and physiotherapyDaily spinal extension, mobility and posture work is a core treatment, not an optional extra — it preserves movement that medication alone does not.
• NSAIDsRegular anti-inflammatory therapy is first-line and often substantially effective, used at the lowest effective dose with gastric and renal monitoring.
• Biologic therapyTNF and IL-17 inhibitors are considered where NSAIDs fail to control active disease, after screening for tuberculosis and hepatitis.
• Targeted synthetic therapyJAK inhibitors are an option in selected patients for whom biologics are unsuitable.
• Treatment of peripheral diseaseSulfasalazine or local injection for peripheral joints, enthesitis or dactylitis.
• Managing associated conditionsPrompt ophthalmology referral for uveitis, with attention to bone density, cardiovascular risk and bowel disease.

Common questions