The age of onset of ankylosing spondylitis is usually between 15 and 20 years. patients under 16 years of age with the first onset of ankylosing spondylitis are designated as juvenile-onset ankylosing spondylitis. The unconscious onset of lower back pain often signals the beginning of ankylosing spondylitis. The pain is often accompanied by stiffness and may involve the buttocks or the back of the thighs. It is episodic, and the degree and duration of pain can vary from person to person. Later, the patient feels increased pain and morning stiffness in the morning, when the lesion is more defined. In addition, the patient may experience discomfort that progresses up the spine to the thoracic and shoulder joints. Stiffness and pressure in the peripheral joints can occur, especially in the early stages of the disease. Most symptoms resolve when the disease process appears to limit spinal motion, and by the age of 40-50 the verification process has ceased. Patients with advanced ankylosing spondylitis are easier to diagnose based on their forward-bending lumbar posture and stiff spinal kyphosis. The patient has increased thoracic lordosis and decreased normal lumbar lordosis when standing upright. As the disease progresses, the patient loses the normal curve in the sagittal position and the spine becomes retroflexed. Eighty percent of patients with ankylosing spondylitis present with elevated blood sedimentation, and some patients may be normal despite active inflammation. Even in patients with active arthropathy, rheumatoid factor tests are negative. If a patient has suspicious clinical symptoms and no characteristic findings on X-ray, a negative rheumatoid factor and a positive HLA-B27 are diagnostic for ankylosing spondylitis. For the discomfort caused by ankylosing spondylitis, nonsteroidal drugs are the main treatment. Generally, Protaxon is the most effective, anti-inflammatory pain is comparable in effectiveness with fewer side effects, and aspirin is ineffective in patients with ankylosing spondylitis. Part of the goal of medication is to enable the patient to participate in a regular exercise program. Spinal and hip pathologies cause kyphosis and stiff flexion deformities of the thoracolumbar spine. A postural exercise program should be designed to keep the spine and hip joints in extension. If completed carefully, extension exercises can increase and maintain hip motion in patients with ankylosing spondylitis. Patients must embrace a lifestyle that is appropriate for the shape and normal activity of the spine. Most patients with ankylosing spondylitis do not require surgical treatment; spinal surgery is necessary for correction of fixed flexion deformities that often occur in ankylosing spondylitis, stabilization of spinal fractures and treatment of their sequelae, and spinal discitis. The fact that patients with ankylosing spondylitis are prone to fractures early in life is also a major factor in the development of flexion deformities later in life.