Ankylosing Spondylitis
The established form of axial spondyloarthritis in which inflammation has produced visible changes on X-ray, potentially reducing spinal flexibility over time.
Is this what you are experiencing?
Back pain that improves when you move and worsens when you rest is the opposite of mechanical back pain, and it is the single most useful clue to inflammatory back disease. Add morning stiffness over thirty minutes, pain that wakes you in the second half of the night, and an age of onset under 45, and axial spondyloarthritis becomes likely.
What symptoms should prompt an assessment?
You do not need to have every symptom below — and having one does not mean you have a particular disease. These are the patterns that commonly lead to a rheumatology consultation:
- Long-standing lower-back or deep hip pain.
- Morning stiffness in the back, hips or pelvis.
- Pain or stiffness that improves with movement and feels worse after rest.
- Night or early-morning pain that interrupts sleep.
- Alternating pain from one side of the hips to the other.
- Reduced spinal flexibility or difficulty bending and turning.
- Back symptoms occurring with heel pain, eye inflammation, psoriasis or bowel inflammation.
Which conditions does this cover?
Non-radiographic Axial Spondyloarthritis
An earlier or milder form of axial spondyloarthritis where X-rays remain normal but inflammation is detectable on MRI, causing the same symptoms.
Axial Spondyloarthritis
A group of inflammatory conditions affecting the spine and sacroiliac joints, causing chronic back pain and stiffness that improve with activity.
How is it diagnosed and treated?
Dr. Ashish Baweja combines a detailed clinical assessment with targeted investigations — blood tests and inflammatory markers, imaging, and where relevant procedures such as joint aspiration, nail fold capillaroscopy or biopsy — to reach an accurate diagnosis. Treatment plans follow current international (EULAR/ACR) guidelines and are personalised to your condition, lifestyle and goals, with an emphasis on achieving long-term remission and protecting quality of life.
Common questions
How is inflammatory back pain different from ordinary back pain?
Ordinary back pain is usually worse with activity and better with rest. Inflammatory back pain is the reverse: it is worse after rest, stiff for more than half an hour in the morning, often wakes people in the second half of the night, and eases with movement. It usually starts before the age of 45 and builds up over months.
Can a normal X-ray rule out ankylosing spondylitis?
No. Changes in the sacroiliac joints can take years to show on an X-ray. An MRI can show active inflammation much earlier, which is why a normal X-ray does not end the assessment when the symptoms fit.
Does a positive HLA-B27 test confirm the diagnosis?
No. HLA-B27 is a genetic marker carried by many people who never develop the disease, and some people with axial spondyloarthritis test negative. It adds weight when the symptoms and imaging fit, but it is never a diagnosis on its own.
This page is general information to help guide a consultation. It is not a diagnosis.
Further reading
Articles on Back Pain & Spondyloarthritis
Inflammatory back pain: when rest makes it worse
Back pain that improves when you move and worsens when you lie still behaves the opposite way to a strained muscle or a worn disc. That rev…
Read articleJoint pain with normal blood tests: why the report is not the last word
A normal report is not the same as a normal joint. What blood tests can rule out, what they cannot, and what should happen next.
Read articleVitamin D deficiency and joint pain: what it explains
A low vitamin D result rarely explains sore joints. The pain a real deficiency causes has a distinct pattern, and mistaking one for the oth…
Read articleBook your consultation
Consult Dr. Ashish Baweja at Artemis Hospitals, Sector 51, Gurugram, Haryana 122018.