This article discusses the differences between ankylosing spondylitis (AS) and scoliosis, including their symptoms, causes, diagnosis, and treatment.
Symptoms
Ankylosing spondylitis is arthritis that most often affects the spine, causing inflammation in the joints and tissue attaching bone to bone (ligaments). As the disease progresses, it also leads to stiffness. In severe cases, people with AS can become “stuck” in a bent-over posture.
Scoliosis is an abnormal sideways curve that develops in the spine. This condition is most commonly identified in childhood or early teenage years. It affects around 6 to 9 million people in the United States.
The primary symptom of AS is back pain and stiffness. Other AS symptoms include:
Pain and stiffness in other joints of the bodyDifficulty breathingDecreased appetiteWeight lossDiarrheaStomach painFatigueVision changes
Most people with scoliosis do not have pain when they are first diagnosed. The symptoms of scoliosis are primarily structural—meaning they affect the “shape” of the body—and can cause the following:
The head is positioned “off center"One shoulder blade is higher than the otherA “hump” on one side of the back when bending forwardUneven sides of the pelvisArms hang asymmetrically on the sides of the bodyRibs protrude on one sideThe body leans to one side
Causes
Ankylosing spondylitis (AS) is an autoimmune disorder in which the body attacks its own joints and soft tissues. The cause of AS is unknown, but there are risk factors that can increase your chances of getting AS.
Around 80% of scoliosis cases happen without a specific cause (idiopathic). Scoliosis can also be part of a birth defect (congenital) or develop as a side effect of another disease that affects the muscles or nervous system.
Diagnosis
Diagnosis of ankylosing spondylitis or scoliosis begins with a physical exam. AS can cause difficulty moving the affected joints, which leads to decreased range of motion. Scoliosis can be detected by looking at the angle of the spine when a person is bent over.
Imaging is an important part of diagnosing both conditions. Imaging tests can include:
X-rays: Used to detect and monitor joint damage from AS and assess the severity of the deformity in the spine from scoliosis Computed tomography (CT scan): Provides more detail about bone damage and assesses the spinal canal that runs through the bones of the spine Magnetic resonance imaging (MRI): Uses magnets and radio waves to produce images that can be used to assess soft tissue and nerve damage that can occur with scoliosis or AS
Treatment
The treatment for either ankylosing spondylitis or scoliosis depends on how severe the condition is but can include medications, physical therapy, and in some cases, surgery.
Medications
Ankylosing spondylitis is an inflammatory condition. Medications that decrease inflammation are used for treatment. Medications that can be used for AS include:
Non-steroidal anti-inflammatory drugs (NSAIDs) Biologics Janus kinase (JAK) inhibitors Corticosteroids
Medication is not used to treat scoliosis.
Physical Therapy
People with AS and scoliosis can both benefit from physical therapy treatment, which can include:
Stretching exercises to reduce stiffness Strengthening exercises Education about proper posture Pain management techniques (e. g. , electrical stimulation, ultrasound, heat/ice) Massage Training with assistive devices, if needed (e. g. , cane, walker)
Surgery
Surgery can be a treatment option for ankylosing spondylitis or scoliosis—but only if the condition is severe.
For most young people, wearing a brace can help prevent the curve from getting worse—as long as it is worn 16 to 23 hours per day until they’re done growing.
Surgery can help stabilize joints in the spine or straighten it out in people with AS. If AS affects other joints, joint replacement surgery might be required.
Surgery is not usually indicated for scoliosis in children unless the curve of the spine is more than 40 degrees and continues to get worse. For adults, a spinal curve of more than 50 degrees, with nerve damage, can indicate that surgery is needed.
Summary
Ankylosing spondylitis (AS) and scoliosis are conditions affecting the spine, eventually leading to deformities. However, AS can spread to other areas of the body. The exact cause of these conditions is not known. Diagnosis of AS and scoliosis is made through a combination of physical examination and imaging.
Treatment for AS typically includes medication to decrease inflammation. Both conditions are treated with physical therapy and surgery in severe cases.
A Word From Verywell
Ankylosing spondylitis and scoliosis can cause spine deformities that can significantly affect your quality of life. Compliance with your treatment is key for managing symptoms and, in some cases, can slow the progression of the disease. Talk to your healthcare provider about additional treatment options, such as physical therapy, to improve your overall function.
