Ankylosing Spondylitis & Axial Spondyloarthritis

Ankylosing spondylitis (AS) and axial spondyloarthritis are chronic inflammatory conditions that primarily affect the spine and sacroiliac joints, the joints that connect the spine to the pelvis. Over time, ongoing inflammation can cause stiffness, pain, and reduced flexibility in the back and neck.

At The Medical Group of New Jersey, our rheumatology specialists focus on early detection and evidence-based treatment to preserve mobility and prevent long-term complications.

Symptom Onset & Initial Evaluation

Symptoms often develop gradually, typically beginning in young adulthood, and are sometimes mistaken for mechanical back strain. Common features include:

• Chronic back pain and stiffness that worsens in the morning or after inactivity
• Improvement with movement or exercise, rather than rest
• Alternating buttock pain from inflammation in the sacroiliac joints
• Reduced chest expansion, leading to tightness or mild shortness of breath

During your evaluation, your rheumatologist at The Medical Group of New Jersey will review your symptoms, family history, and daily activity patterns, followed by a physical exam to assess spinal mobility and flexibility.

Diagnosis

Diagnosis involves a combination of clinical assessment, imaging, and laboratory testing to confirm inflammation and exclude other causes of back pain. Diagnostic steps may include:

• HLA-B27 blood test, identifying a genetic marker commonly associated with AS
• X-rays or MRI scans of the sacroiliac joints and spine to detect inflammation or early structural changes
• Exclusion of mechanical or degenerative back conditions that can mimic inflammatory disease

Treatment & Ongoing Management

Management focuses on reducing inflammation, relieving pain, and maintaining spinal flexibility through a personalized, multidisciplinary plan:

• Regular exercise and posture training to maintain movement and prevent stiffness
• NSAIDs as first-line therapy for pain and inflammation
• Biologic medications, such as TNF or IL-17 inhibitors for more advanced or refractory disease
• Lifestyle strategies, including smoking cessation, ergonomic support, and bone health optimization

At The Medical Group of New Jersey, our team collaborates with physical therapy and rehabilitation specialists to help patients stay active and maintain optimal spinal health.

Follow-Up & Outlook

Consistent follow-up is essential for monitoring disease activity, adjust medications, and screening for related conditions such as eye inflammation (uveitis), bowel inflammation, or psoriasis. With early diagnosis, targeted therapy, and regular movement, most patients can maintain strong posture, flexibility, and a high quality of life.