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What You Need To Know

Ankylosing spondylitis (AS) is a chronic inflammatory condition that primarily affects the spine, causing inflammation, pain, and stiffness. The inflammation leads to pain, stiffness, and eventual fusion of the affected joints. It belongs to a group of diseases known as spondyloarthritis, which involves inflammation of the joints and ligaments.


Ankylosing spondylitis can have extra-articular manifestations, meaning it can affect organs and tissues outside the joints. These may include inflammation of the eyes (uveitis or iritis), heart complications, lung involvement, and inflammatory bowel disease (such as Crohn's disease or ulcerative colitis). 


Ankylosing spondylitis typically begins in late adolescence or early adulthood, with symptoms developing gradually over time. The condition varies in its progression and severity among individuals. In some cases, it may cause significant disability, while others may experience milder symptoms.


The conventional treatment for ankylosing spondylitis (AS) typically involves a combination of medication, physical therapy, exercise, and lifestyle modifications. Here are some common approaches used in the conventional management of AS:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation.

  • Disease-modifying antirheumatic drugs (DMARDs) such as sulfasalazine or methotrexate to modulate the immune system and slow disease progression.

  • Biologic medications like adalimumab, etanercept, and infliximab, which target specific molecules involved in inflammation and can help manage symptoms and slow spinal damage.

  • Physical therapy and exercise to improve flexibility, range of motion, and strengthen supporting muscles.

  • Lifestyle modifications such as maintaining good posture, avoiding activities that strain the spine, applying heat or cold packs for relief, and quitting smoking.

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  • Back pain and stiffness: Persistent pain and stiffness in the lower back and buttocks are the most prominent symptoms of AS. The pain is typically dull and is often worse in the morning or after periods of inactivity.

  • Reduced flexibility: AS can lead to reduced flexibility in the spine and joints. Over time, the stiffness and inflammation can cause a loss of mobility, making it challenging to bend or twist the spine.

  • Pain and stiffness in other areas:  such as the hips, shoulders, ribs, heels, and small joints of the hands and feet. Inflammation in these joints can cause pain, swelling, and stiffness.

  • Fatigue: Many individuals with AS experience fatigue, which can be related to inflammation, disrupted sleep due to pain, or the body's immune response.

  • Changes in posture: As AS progresses, it can lead to changes in posture. The spine may become more rigid, resulting in a stooped or hunched-forward posture. This is often a result of spinal fusion, where the vertebrae fuse together due to inflammation.

  • Eye inflammation:  Symptoms can include eye pain, redness, sensitivity to light, and blurred vision.

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Ankylosing spondylitis (AS) is associated with several other conditions, including both related autoimmune conditions and extra-articular manifestations. Here are some conditions commonly associated with AS:

  • INFLAMMATORY BOWEL DISEASE (IBD): There is a strong association between AS and inflammatory bowel diseases such as Crohn's disease and ulcerative colitis. It is estimated that up to 10-20% of individuals with AS also have IBD.

  • PSORIASIS: Psoriasis is a chronic skin condition characterised by patches of red, scaly skin. It is an autoimmune disorder that shares some genetic and immunological factors with AS. The prevalence of psoriasis is higher in individuals with AS compared to the general population.

  • REACTIVE ARTHRITIS: Reactive arthritis, also known as Reiter's syndrome, is a form of arthritis that occurs as a reaction to an infection in another part of the body. It typically involves joint inflammation and can be associated with urogenital or gastrointestinal infections. AS can be a part of reactive arthritis in some cases.

  • UVEITIS: Uveitis is inflammation of the uvea, the middle layer of the eye. It can cause eye redness, pain, and blurred vision. Uveitis is more common in individuals with AS and can occur as an extra-articular manifestation of the disease.

  • CARDIAC COMPLICATIONS: AS is associated with an increased risk of certain cardiac complications, including aortic valve inflammation (aortitis), aortic regurgitation, and conduction abnormalities.

  • OSTEOPOROSIS: Individuals with AS may be at an increased risk of developing osteoporosis, a condition characterised by reduced bone density and an increased risk of fractures.

  • LUNG INVOLVEMENT: AS can affect the lungs in some individuals, leading to conditions such as fibrosis, restrictive lung disease, or inflammation of the lung lining (pleuritis).



A Functional Medicine Approach to Ankylosing Spondylitis (AS)

Our approach to ankylosing spondylitis (AS) focuses on identifying and addressing the underlying factors that contribute to the condition. While individualised treatment is essential in functional medicine, here are some principles that may be considered:

  • IDENTIFYING FOOD SENSITIVIES: Identifying and addressing food sensitivities or intolerances can be important in managing AS symptoms. An elimination diet or food sensitivity testing may be used to identify trigger foods that contribute to inflammation and immune system activation.

  • DIET AND NUTRITION: A nutrient-dense, anti-inflammatory diet is often emphasised in functional medicine. Reducing or eliminating processed foods, sugar, and potentially inflammatory foods may be recommended. Addressing nutrient deficiencies and providing targeted nutritional support may be recommended. Supplements such as omega-3 fatty acids, vitamin D, curcumin, and other anti-inflammatory nutrients may be suggested based on individual needs.

  • GUT HEALTH SUPPORT: We recognise the gut-spondylitis connection and the potential role of gut health in autoimmune conditions like AS. Addressing gut issues such as dysbiosis, leaky gut, or imbalances in gut bacteria can help reduce inflammation and support immune system balance.


  • ENVIRONMENTAL TOXINS REDUCTION: We recognise the impact of environmental toxins on overall health and immune function. Reducing exposure to toxins in personal care products, household cleaners, and the environment may be recommended.

  • STRESS MANAGEMENT: Chronic stress can worsen autoimmune conditions. Stress reduction techniques such as mindfulness practices, relaxation exercises, and counseling may be employed to support emotional well-being and reduce stress.

  • EXERCISE AND MOVEMENT: Regular exercise and movement are important in managing AS. We may provide guidance on appropriate exercise routines, stretching exercises, and movement therapies to improve flexibility, strengthen muscles, and support joint health.


  • IMPROVING SLEEP: Prioritising good sleep hygiene and addressing sleep disturbances is important for immune system regulation and overall health.​​

To take a proactive role in managing your health, we encourage you to reach out to our team. We have extensive experience assisting individuals with conditions such as ankylosing spondylitis and are dedicated to helping you improve your symptoms and overall well-being.



 We offer a range of appointments in-person or online. 
You will receive the same service and expertise from us through our virtual, online clinic, just as you would if you visited us at our London clinic.

To discuss how we can assist you, call us on 020 3886 1339, or email us at

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