Ankylosing spondylitis (AS) is a chronic inflammatory condition affecting the axial joints, including the spine and sacroiliac joints. AS causes eventual fusion of the spine. Peripheral joints may be involved. The inflammation at the insertion of the ligament and tendons into the bone is the primary site of the pathology. The condition is skeletal with ankylosing of the spine. The nonskeletal problems with AS include iritis, aoristic, pulmonary fibrosis and inflammatory bowel disease. These conditions occur more in males than females. Clients are usually in their twenties or thirties and present with low back pain over 3 months. The pain is better with activity and worse with rest and in the mornings. The pattern is gradually ascending from the lumbar to thoracic regions. The loss of lumbar range of motion and the gradual positioning of the trunk in a fixed flexion posture is common with AS. The fixed posture results in the client’s inability to look at the horizon. 90-95% of AS clients have the HLA-B27 antigen in their bloodstream.
