Ankylosing spondylitis (AS) is more than painful. It can be debilitating.

AS is an inflammatory, autoimmune condition that typically begins in young adulthood, but often gets overlooked, or incorrectly diagnosed as pain from a previous injury or aging. It’s an underdiagnosed form of arthritis that creates inflammation in the spinal joints and causes chronic back pain and stiffness.

AS is progressive. People may begin feeling pain in the lower back or buttocks region, and it can migrate to other areas of the body like the hips, neck, or shoulders. For some, if left untreated, the inflammation caused by AS may cause your spine to fuse, resulting in what some people have referred to as "bamboo spine."


refers to abnormal stiffening and immobility of a joint because of fused bones.


is defined as inflammation of the spine.


AS is difficult to diagnose


Average number of years from onset of symptoms to diagnosis


Average age at diagnosis


Estimated number of people in the United States with AS and related conditions


What are the symptoms of AS?

Signs and symptoms of AS will commonly develop along the spine, but may progress over the course of the disease. People with AS often experience spinal stiffness and loss of spinal mobility due to inflammation.

To better understand inflammation and AS symptoms, and the role the immune system plays in both, we’ve enlisted Dr. Elizabeth Perkins, a practicing rheumatologist, for help.

Dr. Elizabeth Perkins, Rheumatologist

“It really starts with how we look at the immune system. You basically have different cytokines circulating throughout the body. But in autoimmune diseases, those cytokines can be out of balance.

In our healthy state, that balance is nice and orchestrated—think of it like musical instruments. Everything sounds just right. But in states like AS, some of those cytokines get turned on and overproduce. They get very noisy. And that overproduction of cytokines causes inflammation that can be felt as lower back pain and stiffness.”

—Dr. Elizabeth Perkins, a Practicing Rheumatologist

Chronic pain and stiffness

An overall sense of discomfort that may come and go but never really goes away (chronic).

“With AS, you’re always stiff. You can’t really move.”

Pain and stiffness in the lower back and buttocks

Inflammation of the sacroiliac (SI) joints that results in pain where the spinal joints meet the pelvis.

“Pain started in my lower back and it was chronic, it never stopped.”

Inflammation, dull pain, and stiffness, often worse in the morning

May affect the shoulders, hips, ribs, knees, heels, and neck.

“Waking up with stiff joints and lower back pain—it’s the first thing I feel when I open my eyes.”


What’s the difference between mechanical and inflammatory back pain?

Mechanical back pain

Mechanical back pain

This is a common form of back pain, and may be caused by an injury or overuse. It usually goes away after 6 weeks.

Inflammatory back pain

Inflammatory back pain

This is usually caused by certain diseases and begins to appear in people under the age of 35. The symptoms may last 3 months or longer and tend to come and go, but never really improve. Inflammatory back pain is a chronic condition, which means that it never really goes away. The pain and stiffness often come back.


AS affects men and women differently

Compared with men, women with AS typically:

  • Are younger at onset
  • Are diagnosed later
  • Have more neck and peripheral joint pain, which is pain in the joints further away from the spine (like in the knees, elbows, and ankles), and could have less spinal involvement.
Actual Patient Wendy
Actual Patient

Individual results may vary. Wendy was compensated for her time.

"I just started noticing a lot of joint pain that didn't really seem to make sense. At first I thought I had overdone it at the gym."

Who’s at risk of developing AS?


There is a potential genetic link.


This is a gene that has been associated with AS.


The HLA-B27 gene is detected in a blood test among certain people with AS, but it’s possible to have AS and not test positive for HLA-B27.

Find a Doctor

Real people taking COSENTYX® are moving and feeling better.

Find a rheumatologist in your area who has experience prescribing biologics as well as other treatments for ankylosing spondylitis.

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COSENTYX® (secukinumab) is a prescription medicine used to treat:

  • people 6 years of age and older with moderate to severe plaque psoriasis that involves large areas or many areas of the body, and who may benefit from taking injections or pills (systemic therapy) or phototherapy (treatment using ultraviolet or UV light alone or with systemic therapy)

  • people 4 years of age and older with active enthesitis-related arthritis

  • people 2 years of age and older with active psoriatic arthritis

  • adults with active ankylosing spondylitis

  • adults with active non-radiographic axial spondyloarthritis and objective signs of inflammation

Important Safety Information

Do not use COSENTYX if you have had a severe allergic reaction to secukinumab or any of the other ingredients in COSENTYX. See the Medication Guide for a complete list of ingredients.

COSENTYX is a medicine that affects your immune system. COSENTYX may increase your risk of having serious side effects such as:


COSENTYX may lower the ability of your immune system to fight infections and may increase your risk of infections, sometimes serious.

  • Your doctor should check you for tuberculosis (TB) before starting treatment with COSENTYX.
  • If your doctor feels that you are at risk for TB, you may be treated with medicine for TB before you begin treatment with COSENTYX and during treatment with COSENTYX.
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Before starting COSENTYX, tell your doctor if you:

  • are being treated for an infection
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  • have TB or have been in close contact with someone with TB
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After starting COSENTYX, call your doctor right away if you have any signs of infection listed above. Do not use COSENTYX if you have any signs of infection unless you are instructed to by your doctor.

Inflammatory bowel disease

New cases of inflammatory bowel disease or “flare-ups” can happen with COSENTYX, and can sometimes be serious. If you have inflammatory bowel disease (ulcerative colitis or Crohn’s disease), tell your doctor if you have worsening disease symptoms during treatment with COSENTYX or develop new symptoms of stomach pain or diarrhea.

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Serious allergic reactions can occur. Get emergency medical help right away if you get any of the following symptoms: feeling faint; swelling of your face, eyelids, lips, mouth, tongue, or throat; trouble breathing or throat tightness; chest tightness; skin rash or hives (red, itchy bumps). If you have a severe allergic reaction, do not give another injection of COSENTYX.  

Before starting COSENTYX, tell your doctor if you:

  • have any of the conditions or symptoms listed above for infections.

  • have inflammatory bowel disease (Crohn's disease or ulcerative colitis).

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Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Know the medicines you take. Keep a list of your medicines to show your doctor and pharmacist when you get a new medicine.

How should I use COSENTYX?

See the detailed Instructions for Use that comes with your COSENTYX for information on how to prepare and inject a dose of COSENTYX, and how to properly throw away (dispose of) used COSENTYX Sensoready pens and prefilled syringes.

  • Use COSENTYX exactly as prescribed by your doctor.

  • If your doctor decides that you or a caregiver may give your injections of COSENTYX at home, you should receive training on the right way to prepare and inject COSENTYX. Do not try to inject COSENTYX yourself, until you or your caregiver has been shown how to inject COSENTYX by your doctor or nurse.

The most common side effects of COSENTYX include: cold symptoms, diarrhea, and upper respiratory infections. These are not all of the possible side effects of COSENTYX. Call your doctor for medical advice about side effects.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit, or call 1-800-FDA-1088.

 Please see full Prescribing Information, including Medication Guide.