SUBJECTIVE EXAMINATION:

• Gradual onset of low back pain/ buttock/hip and stiffness > 3 months. 
• Poorly localized pain at the beginning. In general, becomes bilateral and persistent. 
• Pain with rest/ inactivity which gets better with active movement. 
• Tenderness in different body parts ( GT, Spinous process, ligaments attachments at the calcaneus) 
• Loss of spine mobility. 
• Loss of lordosis, development of kyphosis 
• Loss of chest wall excursion 
• Morning stiffness > 1 hour 

ASSESSMENT:

- Assess spine and peripheral joints’ ROM, and strength 

Schober test:

Assessment of lumbar spine flexion 

-Chest expansion 

Hip flexion contractions 

(30- 50% of patients with AS will develop hip deformities, and may need total hip arthoplasty)

Type of exercises: 

ROM and Core strengthening 

Gentle Stretching

Pulmonary exercises 

Hydrotherapy –an excellent type of exercise

Avoid high impact activities and contact sports (skiing, football)