Ankylosing spondylitis (AS) is known for complications related to inflammation of the spine.

While the pain and discomfort may disrupt your daily activities, you could be contending with another debilitating side effect: fatigue.

According to the National Ankylosing Spondylitis Society, fatigue is one of the most common concerns among AS patients. The inflammatory process of AS can lead to fatigue.

Keep reading to learn what’s causing your fatigue and how to stop it in its tracks.

The biggest culprit behind AS-related fatigue is inflammation.

Inflamed tissues within your spine release small, protein-based chemicals called cytokines, considered to play a major role in fatigue, pain, and psychological disturbances.

Cytokines, which are produced by cells in your immune system, react in your body similarly to those produced when you have a cold or flu. This is why you may feel like you have a viral illness when you really don’t.

Treating inflammation with medications can help reduce the excessive fatigue. But keep in mind that prescription drugs that contain opioids or codeine may increase tiredness, and don’t decrease inflammation.

1. Aim for sound sleep

In some cases, fatigue isn’t exclusively related to inflammation. Pain and discomfort can make it difficult to fall asleep at night, adding fuel to exhaustion. Your pain may also cause you to wake up during the night.

Here are a few ways to help ensure you get a more restful night’s sleep:

  • Go to bed at the same time every night, including weekends.
  • Take breaks throughout the day instead of naps.
  • Do relaxing pre-bed activities, such as deep breathing exercises.
  • Avoid sleeping in on the weekends or vacation days.
  • Take a warm bath before bed.
  • Add thicker curtains in your bedroom so the sunlight is less likely to awaken you.
  • Regulate the temperature in your bedroom.

2. Check for anemia

Inflammation from AS increases your risk for anemia, a condition marked by a lack of healthy numbers of red blood cells. These cells are responsible for transporting oxygen to organs.

Fatigue is one of the first signs of anemia. Other symptoms of anemia include:

  • frequent headaches
  • dizziness
  • shortness of breath
  • pale skin
  • hair loss due to iron deficiency

Anemia is diagnosed with a blood test. If you’re diagnosed with anemia, your doctor may prescribe an iron supplement to help restore your red blood cell levels.

Your doctor will also want to make sure you don’t have ulcers or bleeding from nonsteroidal anti-inflammatory medication use or heavy menstrual periods.

3. Monitor your weight

A lack of energy can lead to decreased activity and trigger weight gain. Being overweight can present long-term health concerns and can also make your AS symptoms worse.

Extra fat adds more stress to your spine and worsens inflammation. Being overweight can also make everyday tasks more difficult to complete.

If you notice you’re gaining weight despite eating a healthy and balanced diet, and exercising regularly, talk with your doctor.

They may order additional tests, such as thyroid function tests, to find out the cause.

4. Dietary considerations

Weight gain often calls for changes to your diet. But when it comes to addressing AS-related fatigue, dietary changes mean much more than cutting calories.

It’s important to eat nutrient-dense foods as often as possible. They’ll keep your energy high all day.

Fill up on whole grains and carbs derived from produce rather than foods filled with sugars or refined flours. Also, swap caffeinated beverages for water.

That extra latte may give you a boost now, but the caffeine, cream, and sugar will ultimately make you feel run down.

5. Exercise tips

When you’re feeling run down, working out is likely the furthest thing from your mind. Still, regular workouts can help improve energy levels and flexibility over time.

Exercise is also important for keeping your bones strong against osteoporosis, a condition that people with AS are at an increased risk for developing later in life.

Start with short walks and work your way up to longer, higher-intensity exercises.

Swimming is a great exercise for people with AS.

Also, you may find it easier to fall asleep at night if you’ve worked out that day. Just make sure not to exercise too late in the evening as it can actually disrupt your sleep.

Because there’s currently no cure for AS, managing related symptoms requires diligence.

If you frequently don’t have enough energy to perform daily activities, it may be time to review and evaluate your current treatment plan with your doctor.

A different approach to treating AS may be enough to keep fatigue at bay.

Above all else, set a goal to try to remain positive and calm. Stress only adds to feelings of tiredness. So cut yourself some slack as you aim for more rest.