Five Myths About Ankylosing Spondylitis Debunked



Myth 1- Ankylosing Spondylitis is a Disease Men Get. Both genders can get Ankylosing Spondylitis. While it is true there were more men, statistically speaking, who developed the disease, the number of women diagnosed has been on a fast increase. Sometimes their disease manifests in a slightly different way than what is considered typical. For example, some women may have significant more neck/cervical involvement, and they also tend to have more peripheral joint pain than men.




Myth 2- AS is Rare. In the U.S., a disease is considered rare if it has affected less than 200,000 people. Ankylosing Spondylitis is in a class of diseases termed “Spondyloarthritis”, which affects an estimated 2.7 million American adults. This is far more than 200,000. In fact, that makes Spondyloartritis disease more common than multiple sclerosis (MS), rheumatoid arthritis (RA), and amyotrophic lateral sclerosis (ALS) combined. The exact number of people with Ankylosing Spondylitis in the Unites States remains unknown. However, it is estimated to affect 1-2% of the population in the UK and United States combined (393 million). That would be 3.9- 7.8 million people. This estimate is considered conservative because it is believed that a number of individuals are undiagnosed and may not be aware that they have Ankylosing Spondylitis.  In the UK, twice as many people who have Parkinsons have Ankylosing Spondylitis.  Rather than calling AS "rare", perhaps it would be more accurate to call it "under-recognized".




Myth 3- If One of My Parents Has AS, I Am Going to Get AS. While it is true there is a genetic factor, people with the same genetic markings do not always go on to develop Ankylosing Spondylitis. Therefore, it is a combination of a genetic factor, which makes one more predisposed to develop the disease, combined with environmental factors that activate these genes. The most common gene involved is HLA-B27 (about 90% of people with AS have this gene). Other genes have also been identified as having involvement: ERAP1, IL1A, and IL23R. The presence of these genes can increase the likelihood of being diagnosed, with the correct environmental trigger. It is interesting to note, that although 90% of people with AS have the HLA-B27 gene, this same gene exists in over 6% of the general population and the majority of these individuals never go on to develop Ankylosing Spondylitis.




Myth 4- AS is Just Another Type of Rheumatoid Arthritis. Both types of arthritis are inflammatory and systemic, but they are entirely separate and unrelated diseases, except they both fall under the broad umbrella of “arthritis”. Rheumatoid arthritis is characterized primarily by inflammation inside the joints, otherwise known as synovitis. This is not the case with Ankylosing Spondylitis. Rather, AS is characterized by inflammation at the attachment site where ligaments and tendons connect to bone, otherwise known as enthesitis. AS has been linked to a particular bacteria called Klebsiella, whereas Rheumatoid Arthritis has not been linked to this microbe. The HLA B27 gene is associated with 90% of patients who have Ankylosing Spondylitis, and this gene is not associated with Rheumatoid Arthritis. And, finally, there is no association between AS and rheumatoid factor, whereas, as the name implies, the rheumatoid factor (Rh factor) is an antibody associated with Rheumatoid Arthritis (in 80% of the cases).




Myth 5- AS Just Affects Your Back. Ankylosing Spondylitis is a systemic disease, meaning that it can affect multiple parts of your body, including the peripheral joints of your feet and hands, shoulders and hips, as well as your organs (heart, kidneys and lungs particularly). The eyes are also often involved. Fatigue and sleep interference are also common factors, and a large percentage of individuals with AS also have IBD (inflammatory bowel disease).