Myths and Misconceptions

Reviewed by: HU Medical Review Board | Last reviewed: February 2019 | Last updated: October 2022

Ankylosing spondylitis (AS) is not a well-known condition, and when someone is first diagnosed with the disease, they may not understand much about it. Learning about the condition and understanding the truth versus myths or misconceptions that are out there can help empower people with AS to make informed decisions about their health. Some common myths and misconceptions about AS are described below.

Myth: AS is rare

While the exact number of people who are affected by AS isn't well known, a study published in 2012 with data from the U.S. National Health and Nutrition Examination Survey (NHANES) estimated that up to 1% of U.S. adults may have spondyloarthritis, which includes AS as well as other forms of arthritis that affect the spine.1 Other organizations have estimated the incidence of AS to be between 1.1 million to 2.7 million Americans.2,3

Myth: AS only occurs in men

AS is more common in men than in women, and recent estimates suggest it occurs in 2-3 men for every 1 woman with AS.3 However, there is some concern that women may be underdiagnosed. Women with AS may present with different symptoms than men, and there may be a bias among healthcare professionals that AS is a disease that mainly occurs in men. Studies have found that men with AS have more evidence of disease on x-rays than women, and men also have higher levels of inflammatory markers than women with AS. Women may have more functional impairment than men with AS.4,5

Myth: AS is hereditary

Although having a family member increases a person's risk of developing AS, the disease is believed to be caused by a combination of genetic and environmental factors. Also, just because someone inherits a genetic predisposition for AS, it doesn't mean they will develop the condition.2

Myth: AS only affects the spine

AS primarily affects the spine, but other parts of the body can also be affected. The sacroiliac joints (also called the SI joints), located where the pelvis meets the base of the spine, are often the first area where symptoms of pain and stiffness are felt. Many other areas of the body can also be affected, including2,6:

  • Neck
  • Hips
  • Shoulders
  • Heels
  • Toes
  • Ribs or chest
  • Knees
  • Jaw
  • Wrists
  • Fingers

Myth: If your joints ache from AS, you should rest more

The joint pain from AS typically is worse in the morning after a night's sleep or after periods of inactivity, and exercise and physical therapy can actually help improve symptoms.

Myth: There is no effective treatment for AS

While there isn't yet a cure for AS, there are a variety of treatment methods that can help manage the disease and its symptoms. Treatment for AS usually involves a combination of medications, physical therapy, and exercise. In certain people with AS, treatment may induce periods of remission, where their disease stops progressing, and symptoms are minimal.

Myth: AS always progresses to a fused spine

There is wide variability between different individuals with AS. Some people may experience rapid progression while others experience a mild or slower progression. While the disease is chronic and may progress and cause fused joints in the spine in some people, some with AS may never experience significant joint damage. Early and effective treatment may help prevent or slow joint damage.7

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