Ankylosing spondylitis (AS) is a form of arthritis that mostly affects the spine. In AS, the joints and ligaments of your spine become inflamed and can ultimately become calcified. This can cause back pain and stiffness.

In time, the bones may fuse together, making it difficult to bend and move. AS can affect other joints, and in some cases, it can damage your eyes, heart, or lungs.

Although AS has been historically recognized more in men than in women, it’s being increasingly diagnosed in women. AS is typically diagnosed in the teen years or young adulthood. Its cause is not entirely understood yet, but genetic predisposition is a factor in developing AS.

Read on to learn more about how AS can affect various body systems.

The main area of AS inflammation is in your spine, particularly your lower spine.

AS bone pain and stiffness

Pain and stiffness are generally greater in the morning or after a long period of sitting. Moving around usually alleviates the symptoms. Over many years, AS can lead to curvature of your spine, resulting in a stooped posture.

AS skeletal involvement may cause stiffness and pain in the:

  • spine
  • neck
  • hands
  • chest
  • hips
  • jaw

Chronic inflammation can cause bones to fuse together, restricting your ability to move. If bones in your chest fuse, it could affect your breathing. In some cases, inflammation also occurs in other joints, such as your shoulders, hips, knees, or ankles. This can cause pain and reduced mobility.


Treatment revolves around reducing inflammation, easing pain, and slowing disease progression. Early treatment may help prevent permanent damage to joints.

  • Posture: Maintaining good posture is key, even when you sleep. Choose a hard mattress and avoid thick pillows. Sleeping with your legs straight rather than curled is a good idea. Avoid stooping or slouching when standing or sitting.
  • Exercise: You can complement medication with performing low impact exercises regularly to help maintain flexibility and reduce pain and stiffness. Swimming and other water exercises are often recommended for people with AS.
  • Surgery: In severe cases, reconstructive surgery might be considered. But because this surgery may stimulate extra bone growth, its risks need to be carefully weighed against its benefits.

Over many years, severe cases of AS can form scars in the bundle of nerves at the spine’s base.

AS nerve damage symptoms

Nervous system damage can lead to problems such as urinary incontinence, lack of bowel control, and sexual dysfunction.

AS is more likely to affect your eyes than any other organ. Eye inflammation, or uveitis, is a problem for about 1 in 3 people with AS. The result of this inflammation is pain and redness in the eye. It intensifies in bright light and can cause vision problems if not treated.


Report eye pain or vision problems to your doctor immediately. Blindness is a rare complication, but early treatment is needed to help prevent permanent damage to your eye.

While AS affects the bones and joints, it can increase the risk of conditions that affect the skin, hair, and nails.

AS skin rash and psoriasis risk

In a rare number of cases, people with AS may also develop psoriasis. Psoriasis is an autoimmune skin condition that causes discolored, scaly patches of skin.

These patches can appear anywhere on your body but are more common on the scalp, elbows, and knees. Sometimes, skin can blister or form lesions. Symptoms include itchiness, tenderness, burning, and stinging. Topical medications can help ease discomfort.

Psoriatic arthritis (PsA) occurs in almost 30% of people with psoriasis. It can affect peripheral joints (the hands, knees, elbows, shoulders, and feet) and the spine.

Spinal involvement occurs in 25–70% of people with PsA. In some instances, it’s hard to differentiate from AS.

General inflammation from AS can cause complications in several body systems, including the circulatory system.

AS inflammation, anemia, and fatigue

Some people with AS may develop anemia or general fatigue. A deficiency of red blood cells due to chronic inflammation or blood loss from inflammation in the intestine can cause it.

Rarely, inflammation caused by AS can affect the area where your aorta and heart connect.

This can cause your aorta to enlarge. People with AS are also at increased risk of cardiovascular disease, which can lead to angina, stroke, or heart attack.


You can manage your risk by seeing your doctor regularly if you have high cholesterol, high blood pressure, or diabetes. Try to maintain a moderate weight through a nutrient-rich diet and regular exercise. Avoid use of tobacco products.

Only rarely does AS affect the lungs. Inflammation or fusing in joints where your ribs meet your spine can result in poor chest wall movement. This may lead to you having difficulty taking deep breaths.

A small number of people develop scarring or fibrosis at the top of their lungs. This can make it difficult to fight off respiratory infections and colds. People with AS should not smoke.


Your doctor can listen to your breathing during a physical exam to check for problems. Damage to the upper portion of your lungs can be seen on a chest X-ray.

Fatigue is a commonly reported symptom in people with AS. This may be due to the efforts of fighting chronic pain. Pain-disrupted sleep may also be a contributing factor to fatigue.

Eating a balanced diet, avoiding smoking, and other healthy lifestyle choices can help promote overall wellness.

AS is a chronic disease, but most people who have it are able to continue leading active lives.

Doctors recommend people with AS pay special attention to posture. Performing daily stretching and breathing exercises can be helpful.

Long-term treatment involves symptom management, maintaining spine flexibility, and preventing disease progression.

If you have questions about AS, talk with a healthcare professional.