Stage 4 is the final stage of ankylosing spondylitis (AS). At this stage, the condition may cause several complications, such as bone fusion, tenderness, and chest tightness.
AS is a progressive inflammatory illness that can cause back pain, chronic inflammation, and other symptoms that can make it difficult to perform daily activities.
Chronic inflammation can lead to several complications in the later stages of AS.
Stage 4 is the last stage of AS. At this stage, the condition
People with stage 4 AS may experience a severe loss of mobility and develop kyphosis, which is a forward curvature to the spine. This curvature can limit a person’s range of movement, cause pain, and increase the risk of bone injuries.
Learn more about ankylosing spondylitis.
Bone fusion and fractures
AS
These factors can make the spine more susceptible to fractures, which may occur even after a minor trauma or fall. The increased stress the bones have to sustain can also raise the risk of developing stress fractures in the lower limb bones due to increased spinal stiffness.
A person with AS should speak with a healthcare professional immediately if they notice any of the following:
- new, unexplained pain in the spine
- numbness or tingling in their limbs
- new weakness
These may indicate a fractured bone or nerve damage or compression, which may occur when a bone in the spine breaks.
Osteoporosis
Osteoporosis occurs when the mineral density of the bones decreases, raising the risk of fractures. It is more common in people with AS due to:
- inflammation AS can cause in the bones
- long-term use of corticosteroid medications
to manage AS progression - limited physical activity due to AS pain and stiffness
Inflammation
AS may slightly increase the risk of certain health complications, such as a stroke or a heart attack. However, leading a healthy lifestyle, avoiding smoking, and taking medications to reduce inflammation can counter this risk.
Difficulty breathing
AS can cause postural problems and scarring in the chest. This
Tenderness in the ribs may make it difficult to take deep breaths, leaving people short of breath even when performing gentle activities.
People with AS may also experience pain or discomfort when coughing or sneezing. In some cases, the scarring in the chest can affect the lungs, leading to more respiratory complications. However, this is rare.
Vision problems
AS
- eye pain
- redness
- light sensitivity
- decreased vision
A person with AS should contact a doctor if they notice any new symptoms,
- severe back or joint pain
- a noticeable stiffening of the spine
- unexplained weight loss
- chest pain
- difficulties breathing
- vision problems or ocular pain
These may suggest AS progression and require a specialist’s prompt evaluation.
People with AS should also speak to a doctor after a fall to ensure they have not sustained any fractures or developed other complications linked to AS.
Read about the complications of ankylosing spondylitis.
AS treatment
- reduce pain and stiffness
- preserve the spinal motion range
- prevent AS complications
A treatment plan typically includes a combination of physical therapy and postural training alongside medication. Drugs involved in treating AS may include:
- nonsteroidal anti-inflammatory drugs (NSAIDs) for long-term pain relief
- tumor necrosis factor inhibitors (TNF-Is), such as:
- local corticosteroid injections
If NSAIDs do not help reduce symptoms within 4 to 6 weeks, doctors may recommend combining or substituting them with TNF-Is. A doctor will then reevaluate the response after 12 weeks.
Specialists may also suggest making some lifestyle changes alongside medical treatment to help manage AS. This
- practicing good posture and postural exercises
- regularly performing low impact exercise to maintain muscle tone and flexibility
- eating a healthy and balanced diet to meet all nutritional goals
- quitting smoking, if applicable, as it can cause further inflammation and speed up AS progression
- wearing assistive or support devices to provide stability and reduce the risk of injuries
- monitoring AS symptoms and promptly communicating any changes to a doctor
- managing stress and maintaining mental health through relaxation techniques and meditation
Learn more about treatment for ankylosing spondylitis.
The Spondylitis Association of America is a national nonprofit organization that offers support and important resources to people with this condition and their caregivers.
People can also join a local support group. Doctors can recommend how to find one and explain how it might benefit a person’s physical and mental well-being.
What are the 4 stages of ankylosing spondylitis?
Doctors may categorize AS into 4 progressive stages. These
- inflammatory
- early discal calcification
- fibrous ankylosis
- bony ankylosis
However, not all doctors accept the AS staging system. Some may refer to the condition’s early and late stages without a numeric system.
What is considered a severe case of ankylosing spondylitis?
In severe AS, the body forms new bone tissue in an attempt to heal the damage and inflammation that the illness can cause. This
What is the average age of death for people with ankylosing spondylitis?
A
However, this statistic does not take into account the stage of AS at diagnosis, other health conditions the people had, and their age at diagnosis.
Stage 4 is the last stage of the ankylosing spondylitis (AS). During this phase, AS may cause fusion of the vertebrae in the spine, significantly reducing spinal flexibility and range of motion.
This fusion can also cause several complications, such as difficulties breathing, pain, and an increased risk of fractures and nerve damage.
Treatment of stage 4 AS focuses on reducing symptoms while preserving mobility and reducing the risk of complications.