Ankylosing spondylitis (AS) can increase your risk of developing osteoporosis. Some lifestyle changes may help delay or prevent its development.
AS is a chronic, inflammatory condition that causes stiff, painful joints, often in the lower back. In more advanced cases, it can lead to fusing joints and reduced mobility.
AS is also associated with reduced bone mineral density, which can increase a person’s chances of a fracture or break.
Keep reading for more information on how AS and osteoporosis are connected, treatment options, when to contact a doctor, and more.
A note about sex and gender
Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Learn more.
Research indicates AS increases a person’s chances of developing osteoporosis compared with the general population, according to a 2023 study. In the study, researchers found a significant increase in the number of people who developed osteoporosis who were also living with AS.
They also noted earlier development of osteoporosis in people living with AS.
Their findings are similar to earlier studies on AS and bone density complications and comorbidities. A 2016 study noted that low bone mineral density is common in people with AS.
The decreased bone mineral density puts a person with AS at a higher risk of developing a fracture.
Low bone mineral density can be a common issue in people with AS.
In a 2022 study, researchers assessed people with AS for fracture risk using the World Health Organization (WHO) criteria and fracture risk assessment tool (FRAX). They found that around 13% to 20% of people met the criteria for WHO and FRAX to begin bone density-increasing treatment.
Anywhere from 39.1% to 75% of the people assessed who tested positive for requiring treatment actually received treatment for bone density.
The previously discussed 2023 study also found that people with AS are more likely to develop osteoporosis compared with other populations.
People with AS may want to discuss their risk of developing osteoporosis with their doctor. They may be able to take steps to help reduce their chances of developing it.
Learn more about how common osteoporosis is.
Osteoporosis is a condition in which a person’s bone density is low. This increases the risk of fractures, or broken bones.
Osteoporosis is a “silent” condition, which means that a person may not know they have it until they experience a fracture.
A person with osteoporosis
- spontaneously
- when bending over or lifting a heavy object
- due to a minor fall
If a break occurs in the back, a person may experience deformity (hunched back), back pain, or loss of height.
It is best to contact a doctor if there are concerns about osteoporosis. If a person is at risk, the doctor may order tests.
In most cases, doctors diagnose osteoporosis during routine screenings.
The U.S. Preventive Services Task Force recommends screenings for people assigned female at birth over age
As part of diagnosis, a doctor will review a person’s health history and family history. They may also perform a physical examination, checking for possible signs such as:
- changes in posture
- overall muscle strength
- gait or poor balance
- height reduction
They may also order testing to check bone density as part of the diagnostic process.
A doctor may also order tests to check for osteoporosis if a person experiences a fracture.
A person with both osteoporosis and AS has several treatment options.
Home remedies
They may also be able to make some lifestyle changes to help,
- taking calcium and vitamin D supplements
- exercises such as resistance training
- avoiding smoking and secondhand smoke
- avoiding alcohol or consuming it in moderation
Medical treatments
Medical treatments can also help. Bisphosphonates can help with reducing bone density loss.
Other medications that may help include:
- calcitonin
- estrogen agonists/antagonists
- estrogen and combined estrogen and progestin
- parathyroid hormone (PTH) analog and parathyroid hormone related-protein (PTHrP) analog
- RANK ligand (RANKL) inhibitors
- sclerostin inhibitors
Protecting against falls
Several measures may help reduce the chances of falls, which may help reduce the likelihood of a fracture.
Some recommendations
- using assistive devices, such as walkers or canes
- installing bars in the shower or tub
- using nonslip rubber mats around wet areas, such as in a bathroom
- avoiding walking in socks or other slippery footwear
- lighting all stairs well
- wearing shoes or sturdy footwear around the home
A person may also wish to consider getting a personal alarm system in case of falls.
A person with AS should consider discussing their chances of developing osteoporosis with a doctor at the time of diagnosis or any time afterward.
A doctor can review additional risk factors and help determine if they should take additional steps to help reduce the risk.
Some other risk factors for osteoporosis
- lifestyles involving chronic heavy drinking, smoking, and low levels of physical activity
- taking certain medication, such as proton pump inhibitors and cancer-treating drugs
- living with other medical conditions, such as HIV and endocrine diseases
- not getting enough low vitamin D and calcium
- body size, as people with slender and thin bones have a higher risk
- older age
- sex, as females have a higher risk compared with males
- changes in hormone levels
- family history of osteoporosis
A 2021 literature review notes that AS occurs more often in white and Asian populations (primarily people of Chinese descent) compared with people of African descent. Research suggests this may be due to the presence of the human leukocyte antigen (HLA)-B27.
Learn more about possible complications of AS.
Ankylosing spondylitis (AS) can increase the likelihood of developing osteoporosis. It is also associated with lower bone density.
A person with AS may want to discuss their risk of developing osteoporosis with a doctor. The doctor may recommend lifestyle changes or possible preventive treatments to help with bone density.
Anyone can take certain steps to reduce the likelihood of osteoporosis. These include avoiding drinking alcohol, quitting smoking if you smoke and avoiding secondhand smoke, getting enough physical activity, such as regular exercise, and getting enough calcium and vitamin D.