Back Pain : What is the outlook (prognosis)?

What is the outlook (prognosis)?
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Although there is no cure for AS, the outlook is quite good for most people with the disease. After an initial period of inflammation, in many people with AS the disease settles down to a low level of activity. Flare-ups of symptoms occur from time to time, but are often mild or moderate. In most people with AS, regular exercise and medication keep symptoms away, or much reduced. The lower spine tends to become more stiff and less flexible over the years. In some people, the stiffness is more severe than in others.

About 8 in 10 people with AS remain fully independent or minimally disabled in the long term. This is despite eventual severe restriction of spinal flexibility that occurs in about 4 in 10 people with AS. Most people with AS are able to work full-time for the whole of a normal working life. However, heavy manual work may become difficult. If spinal deformities do arise, they do so after at least 10 years.

About 1 in 10 people with AS have a severe form of the disease, and may become quite disabled over time. However, the recent introduction of treatment with TNF-alpha antagonists (described above) seems to have improved the outlook for people with more severe AS.

In most cases, episodes of arthritis outside the spine and/or eye inflammation do not occur, or only occur now and again. In a small number of cases, these problems outside the spine recur frequently, or become severe. Uveitis (eye inflammation) may lead to blindness if not treated promptly.

People with established AS have an increased risk of fracturing the spine if they are involved in a high-impact accident such as a car crash. This is because the spine becomes more easy to fracture as it becomes more stiff and rigid.