How To Prevent Ankylosing Spondylitis

Medically reviewed by Anita C. Chandrasekaran, MD

Ankylosing spondylitis (AS) is not preventable, but early diagnosis and treatment can help stop or slow its progression. AS is an inflammatory arthritis that primarily affects the spine, causing pain and stiffness in the lower back.

People with AS may also experience pain in their neck, shoulders, hips, and heels. Maintaining a healthy lifestyle—like exercising regularly and eating a balanced diet—can help prevent joint damage and reduce complications of AS.

Related: Can You Get Arthritis in Your 20s?

Who Is Most at Risk?

AS can affect anyone. Certain people are at a higher risk, including:

• Age: AS symptoms often begin before age 45. Children and older adults can also develop the condition, although it's rare.

• Family history: People with a family history of AS are most likely to develop the disease.

• Medical history: People with other autoimmune disorders, such as inflammatory bowel disease (IBD) or psoriasis, are more likely to get AS than others.

• Sex: This type of arthritis has also been shown to be more prevalent in men than women.

Genetics

AS has a strong genetic component. This means if you have a parent or sibling with the condition, you have a high chance of developing AS yourself.

Certain inherited genes, such as the HLA-B27 gene, may raise the risk of developing the condition. More than 90% of White people with AS have the HLA-B27 gene. The gene is less common in people of other races with AS, but it's unclear why. Having specific gene mutations is also associated with how your immune system functions. These genes include the ERAP1, IL1A, and IL23R genes.

It's important to note that having an inherited gene linked to AS or having a family history of AS does not guarantee that you will develop it. Research has shown about 75% of people who inherit the HLA-B27 gene do not develop AS.

Genetic testing can be a helpful tool for identifying your risk. A healthcare provider may refer you to a genetic counselor who can help you understand your test results and personal risk of AS if you have a family history.

HLA-B27 Blood Test

One genetic test is the human leukocyte antigen B27 (HLA-B27) blood test, which is a simple test that checks for HLA-B27 proteins. HLA-B27 is a protein located on the surface of white blood cells.

HLA genes help the immune system tell the difference between harmful pathogens (e.g., viruses and bacteria) and healthy tissues. HLA-B27 is associated with immune system dysfunction, which can cause inflammation and increase the risk of AS.

You may be at an increased risk of an inflammatory autoimmune disorder if your blood test shows you have HLA-B27. Having the HLA-B27 gene means that your immune system is more likely to attack healthy tissue within your body than people who don't have this gene.

Genetic Risk Scoring

Genetic risk scoring (GRS) is a form of testing that involves obtaining a sample of a person's DNA, either through a blood test or a cheek swab. The goal of GRS is to look for gene mutations that are linked to different health conditions.

A polygenic risk score (PRS) can help predict your risk of developing AS. The lab technician or genetic counselor in charge of your test will analyze your DNA for gene mutations. A healthcare provider will weigh your results with how certain gene mutations influence the onset of AS symptoms.

They will give you a score that estimates your overall risk of the condition. This lets you know if you're at a high risk or low risk of AS. The score can't tell you if or when you will develop AS or how the condition will progress.

How To Reduce Risk

Researchers have not yet identified a surefire way to prevent AS. There are still several ways to help reduce your risk, from avoiding tobacco use to exercising regularly.

Tobacco Use Reduction

Smoking has been identified as a significant risk factor for the onset and progression of AS. People who smoke tend to receive an AS diagnosis earlier in life than those who don't smoke. You'll likely have a faster disease progression, more pain, and a lower quality of life if you smoke.

Regular Exercise

Regular exercise won't prevent AS, but it can help you increase strength, endurance, and flexibility. These aspects are all important for maintaining your physical functioning and reducing pain. Regular exercise can also help you maintain a healthy weight and keep your bones strong, which can improve overall health.

Healthy Weight Maintenance

Research has shown that being underweight or having obesity can worsen symptoms in people with AS. Obesity may also worsen treatment outcomes if you develop AS.

Balanced Diet

The foods you eat can help prevent or contribute to inflammation in your body. AS is an inflammatory disease. Eliminating foods that trigger inflammation can reduce the inflammation in your body. Eating a diet rich in fruits, vegetables, whole grains, and omega-3 fatty acids (e.g., salmon) may help.

Discuss With Your Healthcare Provider

Don't wait for things to worsen before seeing a healthcare provider if you experience AS symptoms. Early diagnosis and treatment can help slow disease progression, reduce the risk of complications, and help you maintain a good quality of life.

Related: How To Prevent Psoriatic Arthritis

A Quick Review

There's no known way to prevent AS. A combination of genetic and environmental risk factors seem to play a role in the development of the disease. Going in for genetic testing can help you understand your risk of AS. Implementing healthy lifestyle changes can prevent or delay the onset of AS symptoms. 

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