• Vertigo can affect your balance and raise your risk of falls and accidental injuries.
  • Some inner ear conditions that can cause vertigo may be more common in people with ankylosing spondylitis.
  • Ankylosing spondylitis treatments reduce the risk of inflammation and lower the risk of complications.

Ankylosing spondylitis (AS) is a type of autoimmune arthritis that involves inflammation in the spine, hips, and other joints. People with AS may also develop inflammation in other parts of the body.

Some people with AS experience vertigo. This is a sensation of motion in which it feels like the world around you is moving or spinning. It can cause dizziness and balance problems, which raises your risk of falls and accidental injuries.

Vertigo is caused by changes in your inner ear or brain that affect how you process sensory information. Several inner ear disorders may lead to vertigo, including:

  • Meniere’s disease
  • benign paroxysmal positional vertigo (BPPV)

Although more research is needed, some evidence suggests that these conditions are more common than average in people with AS.

A small 2012 study of 59 patients with AS and 46 without, found 6 people with AS experienced vertigo, while only 2 people without AS developed the condition. Research published in 2011 involving 690 people showed a higher prevalence of AS in people with Meniere’s disease, which sometimes manifests as vertigo.

“These studies are all very small, and it is hard to make a definitive conclusion that conditions that cause vertigo are more common in AS,” says Dr. Dalit Ashany, a rheumatologist at Hospital for Special Surgery in New York City.

Given the lack of clear evidence linking the two conditions, “I would recommend being evaluated by either a neurologist or ENT who would look for known causes that could possibly be addressed,” says Dr. Ashany.

Read on to learn more about the potential link between vertigo and AS.

A wide variety of conditions can cause vertigo, some of which may be more common than average in people with AS.

Meniere’s disease

Meniere’s disease is an inner ear disorder that can cause episodes of vertigo, as well as ringing in the ears (tinnitus) and hearing loss. It tends to develop gradually over time.

People with Meniere’s disease have a buildup of endolymph in the inner ear. Endolymph is a type of fluid that helps your ear process sound waves. It also plays a role in balance.

Some research has linked Meniere’s disease to inflammatory arthritis, including AS. A small 2011 study found that AS was more common than average in people with Meniere’s disease.

More research is needed to test the potential link between AS and Meniere’s disease, including the potential causes. Immune changes may play a role.

Benign paroxysmal positional vertigo (BPPV)

BPPV happens when tiny calcium-carbonate crystals or other substances come loose within your inner ear. Often, these crystals move into the posterior semicircular canal, which is a tube inside your inner ear. This causes short but frequent bouts of vertigo when you change the position of your head. These episodes typically last for a few minutes or less.

Very limited evidence suggests that people with AS may have an increased risk of BPPV. One 2011 study compared the incidence of BPPV in 59 people with AS and 46 people without AS. The researchers found that 10 percent of people with AS and 2 percent of people without AS had BPPV.

This study is not definitive. Larger studies are needed to evaluate the potential link between AS and BPPV, including its potential causes.

It’s possible that AS-related blood vessel changes, autoimmune processes, or both may contribute, according to research published in 2020.

Other causes of vertigo

Vertigo may also be caused by other conditions, such as:

  • fistulas, cysts, or bony growths in your inner ear
  • certain viral infections, including herpes zoster osticus (shingles)
  • certain neurological conditions, including vestibular migraine, stroke, tumors, and multiple sclerosis
  • head trauma, whiplash, and concussion
  • a ministroke in the arterial system to the brain, or
  • vertebrobasilar insufficiency
  • psychological conditions, such as anxiety and somatization disorders

Noting the above conditions, AS raises the risk of stroke and anxiety.

AS may suggest a higher risk of inner ear problems such as hearing loss and balance issues.

Over time, AS can cause scar tissue to form in the ligaments, tendons, and soft tissue that attach to the spine. This can affect the cervical spine, or what we know as our neck.

For decades, researchers have been interested in the link between vertigo and cervical spondylosis, described as osteoarthritis in the neck.

One idea is that bone spurs in the cervical spine compress the cervical nerve roots, which causes vertigo. Another idea holds that bone spurs in the cervical spine put pressure on the vertebral artery, causing vertigo.

The exact mechanism for degenerative neck pain to cause vertigo has not been proven.

Vertigo is also a potential side effect of certain medications.

Vertigo is only one of the potential causes of balance problems in people with AS.

Chronic inflammation in AS can damage joints in your spine, known as vertebrae. Over time, this may cause your back to become stiff and rounded. AS-related inflammation may also cause pain and stiffness in other joints of your body, such as your hips, knees, and ankles. These changes can negatively affect your posture, ability to move, and balance.

Some people with AS also develop inflammation in the eye, which can cause vision loss. Even small changes in your vision can make it harder to keep your balance.

AS-related fatigue may also contribute to feelings of dizziness and poor balance.

If you develop vertigo, let your doctor know.

To determine the underlying cause, they will:

  • ask you about your symptoms, including when they started, how frequent they are, and how long they last
  • review your medical history, including recent and current health conditions and any medications that you’re taking
  • conduct a physical exam

In some cases, they may order tests to check for potential causes or refer you to a specialist for diagnosis.

Your recommended treatment plan will depend on the underlying cause of your vertigo. Depending on the cause, your doctor may prescribe one or more of the following:

Making certain lifestyle changes may also help limit vertigo symptoms. If certain activities, foods, or drinks seem to worsen your vertigo, try to avoid or limit those triggers.

Following your recommended treatment for AS is also important for reducing inflammation, relieving symptoms, and lowering your risk of complications, including possible inner-ear–related complications.

In vertigo, it feels like the world around you is moving or spinning. This can negatively affect your balance and raise your risk of falls and accidental injuries.

Vertigo may be caused by a wide variety of conditions, some of which may be more common than average in people with AS.

Depending on the underlying cause of your vertigo, your doctor may prescribe rehabilitative exercises, medication, or surgery to treat it. Lifestyle changes may also help.