Managing the impact of ankylosing spondylitis on the patient and society

The purpose of this review is to consider the challenges faced by patients and clinicians in relation to long-term management of ankylosing spondylitis (AS), a common rheumatic disease with early age of onset, and to provide evidence-based recommendations for minimising the impact of AS on the patient and society. The review is organised into three main sections; the first provides a general background in relation to epidemiology, pathogenesis, clinical features, diagnosis and classification; the second considers the impacts of AS on the patient and society; the third provides recommendations for minimising these impacts. In particular we highlight the importance of patient education, group exercise, ergonomic adjustment of the work environment, psychological therapies and spa therapies. We also urgently recommend notifying patients of the advantages associated with active membership of a patient support group. Following this review, we present some general conclusions regarding the goals for long-term management of this condition and consider how the field might develop in the future. Necessary research fields for the future are highlighted.