You may experience some or all the following:

• Gradual onset over months, years.
• Pain/ stiffness worse in the morning > 30 minutes.  
• Pain after sitting for long time.
• Rigid spine, curved forward. 
• Joint swelling and inflammation.
• On and off relapse/remit pattern. 
• Back pain and stiffness. 
• Enthesitis: junction of ligament or tendon to bone, common in Achilles and plantar fascia.
• Watch out for lower back, shoulders, hands, ribs, hips, thighs, feet and heels.
• Tiredness and fatigue.
• Additional symptoms in eyes: 40% get uveitis, eye inflammation with blurred vision, sensitivity to light, heart valve problems, tiredness, shortness of breath, although rarer. 

• Age. It tends to affect young teenagers and young adults.
• Gender. It is more common in men (ratio 2:1), in women it tends to be milder.
• Genes. There is a link with a gene that makes a protein called HLA-B27. This attacks some bacteria in your body and sets off the symptoms.
•  It can go and is often undiagnosed for years.

Diagnosis of Ankylosing spondylitis can be difficult because this condition has a slow develop and there’s no definitive test.

The most common test are:

GP first approach:

• what symptoms you’re experiencing
• when they started
• how long you’ve had them

Blood tests

To check for signs of inflammation in your body.

Imagery test

• an X-ray
• a MRI scan
• an ultrasound scan

Genetic testing

A genetic blood test shows if you carry the HLA-B27 gene, which is found in most people with AS.

Medical 

Your GP will refer to a specialist rheumatologist for further tests.  Medications are available, prescribed by specialists, along the lines of sulfasalazine methotrexate, NSAIDS at night, TNF blocking drugs short term in active inflammatory disease.

Surgery

To repair damaged joints or correct severe curvature but is possible but uncommon. 

Hands on 

Treatment involves exercises to reduce pain and stiffness. Physiotherapy, massage, manipulation to improve flexibility.

Cold packs on inflammation, heat on stiffness and tightness.

Timeline 

There is no cure and it’s not possible to reverse the damage but you can relieve the symptoms and prevent or delay progression. For some there is improvement after the phase of inflammation, for others it can get progressively worse.  Complications are possible: osteoporosis, gastrointestinal disorders, cardiovascular disease, chest infections. Most people are able to live a normal life with maintenance treatment.