Ankylosing spondylitis is a chronic inflammatory disease of the skeletal system. Especially affecting the spine and Sacro-illiac joint. The early symptom starts with pain in either or both of the SI joint. Later the lower part of spine and /or the upper part of spine gets involved with pain and stiffness. Morning stiffness, mild feverishness are often complained by patients in the initial stage. Gradually it spreads to the other vertebral levels, intercostal joints on chest, resulting to limitted mobility with severe pain, postural abnormalities, buttock pain, hip pain, peripheral arthritis. This being an auto-immune disease and a systemic disease, any coexistence of other disorders involving other joints and systems cant be ruled out. Systemic inflammation is evident as the extra articular manifestations, like Irritable Bowel Syndrome, Acute Uvitis, Psoriasis, cardiovascular disease. In modern medicine the anti-inflammatory drugs, steroids and Biologics are being advised which may coverup the inflammation, pain but they suppress the immune function of the body as well. Patients with presenting complaints of pain in the sacro-iliac joint and stiffness in the spine are advised for tests like HLA B27, CRP to rule out AS. if they come up as positive, an effective treatment could be provided to arrest and reverse at an earier stage itself by observing the diet and lifestyle as practiced in ayurveda for the kind of disturbance in the bio-energies basically all the three dosha and dhatu like Asthi and Majja. The therapies and medications followed in ayurveda here are proven to be effective in reversing the disease. In the initial week, the anti-inflammatory medicines and steroids are withdrawn as the pain subsides and the flexibility in spine and joints improves to a good extent. Further, the posture and the general well being of the patient improves well. The systemic involvement also subsides and patient start leading a normal life without any support of pain killers.

The fact that we have'nt ever realised is that 95 % of the joint diseases do not require surgery. Any kind of inflamation associated with or without pain in joints are called as Arthritis. Among the types of arthritis, the commonly seen are - Osteo-arthritis, Rheumatoid arthritis, Gout arthritis, Psoriatic arthritis and Septic arthritis. Dificiencies in vitamins & minerals  especially calcium and vitamin-D can also lead to certain joint diseases.  There are few viral diseases that affect the immunity, cause weekness and debilitate the joint function like chikungunia. Joint deformity caused over a period of time either due to excess wear and tear or as a result of chronic degenerative joint diseases  may require surgical intervention to restore mobility. Therefore in such cases partial or total joint replacement are recommended. Majority of the cases who are recommended with Joint replacement surgery are Osteo arthritis or AVN sufferers. Osteo- arthritis is a degenerative joint disease. Osteo arthritis in the initial and 2nd degree can be treated and restored to its normal function and in 3rd degree  the process of degeneration could be arrested /deleyed and maintained with effective ayurvedic therapies and certain exercises. In 4th degree of OA where the miniscus  between the knee joints are worn out and the bones touch each other to erode their surfaces and the joint goes out of alignment then knee replacement is the last resort. It is true that maximum of the joint diseases do not require surgery but among the rest of them which required surgery some are because of our negligence, ignorance  and lack of awareness about the disease and its proper treatment. If proper measures are taken in the very early stage, we can arrest or deley even the degenerative joint diseases like osteo-arthritis and Avascular-necrosis which are  recommended with surgery after the condition deteriorates to the 3rd or 4th stage. Thus preserving and maintaining the wellness of joints should be given a priority.