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1. You notice pain moving up your spine and increased stiffness.
One of the first symptoms of ankylosing spondylitis is lower back pain. That’s because the sacroiliac joint — the point where your spine attaches to your pelvis — is located at this base position. As the condition progresses, bone growths develop along your spine. This leads to even more stiffness, loss of flexibility, and possibly development of a bend at your neck.

2. Your eyesight is getting worse.
The reason for this goes back to your immune system. Researchers presume that the same immune system response that triggers ankylosing spondylitis also triggers uveitis.

3. You feel more tired and exhausted.
Ankylosing spondylitis causes inflammation, which makes your body work harder and use more energy than is normal. Cytokines, which are discharged by cells of your immune system, play a role in causing this tiredness.

4. You have a harder time opening and closing your mouth.
A sore, tender jaw isn’t something you should ignore, especially if you have ankylosing spondylitis. Studies show that about one-third of people with this disease develop a jaw condition called TMJ. With this condition, the hinge or joint that connects your upper and lower jaw stops working, making it harder to chew and sometimes causing a clicking sound.

5. Your chest starts to feel heavy or hurt.
If you were diagnosed with ankylosing spondylitis a while ago, you may think that a new symptom is merely a sign of age, but that’s not always the case. A heavy or hurting chest, for instance, may be linked to your condition. Your rib cage and sternum can become inflamed and stiff. Also, cardiac diseases occur in about 2 to 10 percent of those with ankylosing spondylitis. Make an appointment with your doctor immediately if you start noticing any chest pain, as it may be a sign of a serious complication.

There you have it: 5 signs that it’s time to speak up and deal with the progression of your ankylosing spondylitis head on. Because while any disease progression can be worrisome, stopping it in its tracks can help with symptom management and improve your quality of life.


Your spine does more than just hold you upright. It interacts with your immune, skeletal, muscular, and nervous systems. So when something goes wrong with your spine, it may have far-reaching effects throughout your body. Keeping your spine happy is an important part of your overall health.

Ankylosing spondylitis (AS) is a case in point. It’s a form of arthritis associated with long-term inflammation of the joints in your spine. The first symptoms of AS are usually pain in your low back and hips, which you might pass off as just a “bad back.” But AS tends to worsen with time, especially if not treated. As the disease progresses, it may affect many parts of your body, including other joints and your eyes, bowels, feet, and heart.

Inflamed spinal joints

AS typically starts with pain in the low back and hips caused by inflammation of spinal joints there. As time passes, inflammation — and the symptoms caused by it — may gradually move up the spine and give rise to complications. It may also skip areas in the spine.

These are three important features of AS:

  • Sacroiliitis: An early hallmark of AS is inflammation of the sacroiliac joints, located where your spine meets your pelvis. This inflammation causes pain in your hips. Sometimes the pain radiates down your thighs, but never below your knees.
  • Enthesitis: Another characteristic of AS is inflammation of entheses — places where ligaments and tendons attach to bones. This type of inflammation causes much of the pain and loss of function that’s seen in the disease.
  • Fusion: Your body’s repeated attempts to heal inflamed entheses can lead to the scarring of tissue, followed by the formation of extra bone. Ultimately, two or more bones of your spine may become fused, limiting flexibility in your back. In severe cases, your spine may develop a forward curvature, causing a permanently stooped posture. It’s far less common to reach this stage today, thanks to treatment advances.

Beyond the spine

As time goes by, the inflammation caused by AS may affect other parts of your body as well:

  • Other joints: Inflammation may cause pain and stiffness in joints of your neck, shoulders, hips, knees, ankles, or, rarely, fingers and toes.
  • Your chest: About 70 percent of people with AS develop inflammation at the junction of the ribs and spine. The point where your ribs meet your breastbone in front may also be affected, leading to chest pain. Eventually, stiffening of your ribcage may limit how much your chest can expand, reducing how much air your lungs can hold.
  • Your eyes: Up to 40 percent of people with AS develop inflammation of the eye, called uveitis or iritis. This inflammation may cause eye pain and redness, sensitivity to light, and blurred vision. If not treated promptly, it can lead to vision loss.
  • Your feet: Inflamed entheses may occur at the back or base of your heel. The pain and tenderness can seriously hamper your ability to walk.
  • Your bowels: Inflammation may cause symptoms of inflammatory bowel disease, including abdominal cramps and diarrhea, sometimes with blood or mucus in the stool.
  • Your jaw: Inflammation of your jaw is uncommon, affecting no more than 15 percent of AS patients. But it can be especially troublesome, making it difficult to eat.
  • Your heart. In rare cases, your body’s largest artery, called the aorta, becomes inflamed. It may enlarge so much that it distorts the shape of the valve connecting it to your heart.

Nerve root involvement

People with very advanced AS may develop cauda equina syndrome, a disorder affecting a bundle of nerve roots at the bottom of your spinal cord. These nerve roots transmit messages between your brain and lower body. When damage caused by AS compresses the nerve roots, it can impair functioning of your pelvic organs or sensation and movement in your lower limbs.

Be alert for warning signs of cauda equina syndrome:

  • Problems with bladder or bowel function: You might either retain waste or be unable to hold it.
  • Severe or progressively worsening problems in your lower limbs: You may experience loss of or changes in sensation in key areas: between your legs, over your buttocks, on the backs of your legs, or in your feet and heels.
  • Pain, numbness, or weakness spreading to one or both legs: The symptoms may make you stumble when you walk.

If you develop these symptoms, it’s crucial to seek prompt medical attention. Left untreated, cauda equine syndrome can lead to impaired bladder and bowel control, sexual dysfunction, or paralysis.

What’s the good news?

This long list of potential complications can be intimidating. However, treatment for AS may be able to prevent or delay many problems. In particular, a group of medications called tumor necrosis factor (TNF) inhibitors are able to change the course of the disease.

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Ankylosing Spondylitis: Much More Than Back Pain

Ankylosing spondylitis is a form of arthritis caused by inflammation of the joints.

Patients often begin experiencing painful symptoms in early adulthood, including aches and stiffness in the lower back and hips. These are often the worst after periods of inactivity or immediately after waking up.

Unlike typical back pain one might experience from injury or spending too many hours in a chair, ankylosing spondylitis can affect other joints, particularly joints in the spine at the lower back and pelvis. The hip and shoulder joints can also be affected as well.

The vertebrae in the back are of particular concern because, if left untreated, these joints can fuse together. This can cause a person to have a hunched over posture and may affect a person’s ability to breathe.

While many patients endure these painful symptoms for up to 10 years before receiving a proper diagnosis, those who work with their doctors to find proper treatment experience a much greater quality of life.

Experts agree that ankylosing spondylitis and other related diseases can run in families, so if you have relatives with a history of immune problems, you may be more likely to develop ankylosing spondylitis.

If you’re experiencing lasting pain for more than three months that feels worse in the morning and better with movement, you should talk to your doctor about ankylosing spondylitis as the potential cause of your symptoms.

Your doctor will perform a physical exam and ask you about your symptoms and whether you have a history of injuries in the affected joints. Your doctor may order imaging tests, such as an X-ray or MRI, to get a better look at what’s causing your pain. You can also expect a simple blood test to check for signs of inflammation, as well as to rule out other potential illnesses.

Your family doctor may initially diagnose you with inflammatory back pain, and refer you to a rheumatologist, a doctor who specializes in medicine related to joints and autoimmune diseases. As ankylosing spondylitis is not associated with mechanical issues that occur with injury-related back pain, it cannot be simply remedied with surgery and requires other therapies.

While scientists continue to look for a cure for ankylosing spondylitis, there are many effective therapies that can relieve pain, improve dexterity, and delay advanced complications, such as joint damage.

Doctors often rely on drugs to reduce the painful and destructive joint inflammation with ankylosing spondylitis. These include nonsteroidal anti-inflammatory drugs, known as NSAIDs, and TNF, or tumor necrosis factor, blockers. TNF blockers are part of class of medications called biologics that suppress aspects of the body’s inflammatory response and may slow the progression of ankylosing spondylitis.

Many patients also benefit from regular exercises with a physical therapist. Patients often find that stretching and rage-of-motion exercises, such as yoga or pilates, can help relieve pain, increase flexibility in joints, and improve physical strength.

Ankylosing spondylitis may be a lifelong condition, but it doesn’t have to be a life-limiting one.

Working closely with your doctor about latest treatments and making smart lifestyle choices can help keep painful symptoms at bay so you can live your life as you see fit.

To learn more about Ankylosing Spondylitis, take a look at the information we have here at Healthline or make an appointment with your doctor.