A month ago, Mr. Li, a young man from Anhui Province, visited our pain clinic. He complained that for the past 3 months, he had been waking up early every morning at 3:00 or 4:00 a.m. because of back pain and stiffness, which affected his work life during the day. After careful history taking and physical examination, combined with imaging and hematology, the diagnosis of ankylosing spondylitis was confirmed. Mr. Li actively cooperated with the doctor’s treatment, and the symptoms of low back pain and stiffness improved significantly in the early morning. We often hear people talk about low back pain in our daily lives, and we all experience low back pain throughout our lives, but if you have regular morning back pain and stiffness, you must be highly alert to the possibility of developing ankylosing spondylitis (or spondylitis for short). Ankylosing spondylitis is a chronic immune pain disorder that begins in the sacroiliac joints and gradually causes spinal ankylosis and fibrosis, resulting in impaired bending and movement. It is important to note that this disease is easily overlooked and misdiagnosed and mistreated. Many patients have been misdiagnosed as rheumatoid arthritis, rheumatoid arthritis, lumbar strain, disc herniation, etc. for a long time. In the advanced stage of the disease, the patient’s waist will become curved and form a hunchback, causing a huge mental and economic burden to the patient, family and society. Therefore, the early diagnosis and reasonable, timely and standardized treatment of this disease is particularly important. In the early stages of the disease, the symptoms of spondylitis are insidious, and most patients present with swelling and pain in the hip and knee joints of the lower extremities, or with complaints of iritis of the eye, which are most likely to be misdiagnosed as other diseases. Is there anything that can be done to avoid misdiagnosis? The answer is yes. The most significant differentiator is “low back pain in the early morning”, and the majority of patients with ankylosing spondylitis have this symptom, which is characterized by stiff back pain in the morning that appears insidiously and decreases with activity. Jay Chou, the king of the singing world, has ankylosing spondylitis, but who would believe he is a patient when you see his dazzling dance moves and perfect performances on stage? The current treatment of ankylosing spondylitis is mainly in terms of drug therapy, generally can be taken first with the willow sulfadiazine pyridine with Chinese medicine, acupuncture, physical therapy and other methods, such as poor results can be used to the latest international first-line drugs – biological agents. Jay Chou is taking biological agents to get significant control of his condition without affecting his acting career. Therefore, ankylosing spondylitis is not terrible, early diagnosis, timely and effective treatment, the disease can be well controlled.