You may be wondering what that means if you’ve received a diagnosis of ankylosing spondylitis (AS). AS is a type of arthritis that usually affects the spine, causing inflammation of the pelvis’s sacroiliac (SI) joints. These joints connect the sacrum bone in the lower part of the spine to your pelvis.

AS is a chronic disease that can’t yet be cured, but it can be managed with medication and, in rare instances, surgery.

Although AS affects people differently, certain symptoms are usually associated with it. These include:

  • pain or stiffness in your lower back and buttocks
  • gradual onset of symptoms, sometimes starting on one side
  • pain that improves with exercise and worsens with rest
  • fatigue and overall discomfort

AS is a chronic, debilitating disease. This means it can get progressively worse. Serious complications can arise, especially if the disease is left untreated.

Eye problems

Inflammation of one or both eyes is called iritis or uveitis. The result is usually red, painful, swollen eyes and blurred vision.

About half of patients with AS experience iritis.

Eye issues associated with AS should be treated promptly to prevent further damage.

Neurological symptoms

Neurological problems can develop in people who have had AS for a long time. This is due to cauda equina syndrome, caused by boney overgrowth and scarring of the nerves at the base of the spine.

Though the syndrome is rare, serious complications can arise, including:

  • incontinence
  • sexual problems
  • urine retention
  • severe bilateral buttock/upper-leg pain
  • weakness

Gastrointestinal problems

People with AS can experience inflammation of the gastrointestinal tract and bowels either before the onset of joint symptoms or during the expression of this disease. This can result in stomach pain, diarrhea, and digestive problems.

In some cases, inflammatory bowel disease, ulcerative colitis, or Crohn’s disease may develop.

Fused spine

New bone can form between your vertebrae as the joints become inflamed and damaged. This can cause your spine to fuse, making it more difficult to bend and twist. This fusing is called ankylosis.

The fused spine can result in a stooped posture fixed in place in people who don’t maintain a neutral (“good”) posture. Focused exercise can also help prevent this.

Advances in treatments such as biologics are helping to prevent the progression of ankylosis.


People with AS also experience thinning bones, or osteoporosis, especially those with fused spine issues. This can lead to compression fractures.

About half of AS patients have osteoporosis. This is most common along the spine. In some cases, the spinal cord may become damaged.

Heart and lung problems

Inflammation can sometimes spread to the aorta, the biggest artery in your body. This can prevent the aorta from functioning properly, leading to heart problems.

Heart problems associated with AS include:

  • aortitis (inflammation of the aorta)
  • aortic valve disease
  • cardiomyopathy (disease of the heart muscle)
  • ischemic heart disease (resulting from reduced blood flow and oxygen to the heart muscle)

Scarring or fibrosis in the upper lungs may develop, as well as ventilatory impairment, interstitial lung disease, sleep apnea, or collapsed lungs. Quitting smoking is highly recommended if you are a smoker with AS.

Joint pain and damage

According to the Spondylitis Association of America, about 15% of people with AS experience jaw inflammation.

Inflammation in the areas where your jawbones meet can cause serious pain and difficulty opening and closing your mouth. This could lead to problems with eating and drinking.

Inflammation where ligaments or tendons attach to the bone is also common in AS. This type of inflammation can occur in the back, pelvic bones, chest, and especially the heel.

Inflammation may spread to the joints and cartilage in your ribcage. Over time, the bones in your ribcage may fuse, making chest expansion difficult or breathing painful.

Other affected areas include:

  • chest pain that mimics angina (heart attack) or pleurisy (pain when breathing deeply)
  • hip and shoulder pain


Many AS patients experience fatigue, which is more than just being tired. It often includes a lack of energy, severe tiredness, or brain fog.

Many factors related to AS can cause fatigue, including:

  • loss of sleep from pain or discomfort
  • anemia
  • muscle weakness making your body work harder to move around
  • depression, other mental health issues, and neurological changes
  • certain drugs used to treat arthritis

Your doctor may suggest more than one type of treatment to address fatigue issues.

If you are experiencing back pain, it’s important to contact a healthcare professional as soon as you can. Early treatment is beneficial for reducing symptoms and slowing disease progression.

AS can be diagnosed with an X-ray and MRI scan showing evidence of inflammation and a lab test for a genetic marker called HLA B27. Indicators of AS include inflammation of the SI joint at the lowest part of the back and the ilium on the upper part of the hip.

AS risk factors include:

  • Age: Typical onset is late adolescence or early adulthood.
  • Genetics: Most people with AS have the HLA-B27 gene. This gene doesn’t guarantee you’ll get AS, but it can help diagnose it.

What are the long-term effects of ankylosing spondylitis?

Many factors will contribute to the long-term effects of AS, including whether you’re actively treating the condition, can engage in physical activity, and how your body responds to treatment and disease progression.

While the initial discomfort of AS usually occurs in the lower back, pain can spread over time to various areas, including the jaw, chest, legs, and feet. As the joints are damaged over time, they may fuse, causing additional discomfort and stooped posture.

Long-term inflammation in the body can impact heart and lung health, lead to anemia and fatigue, and contribute to other conditions, such as psoriasis or psoriatic arthritis.

What is a serious complication of ankylosing spondylitis?

Many complications of AS can affect your quality of life, including eye inflammation, pain, and reduced mobility.

Some of the complications that may be considered to be medical emergencies may include:

  • cauda equina: In this rare condition, swelling and pressure in the spinal cord can cause leg weakness, tingling, or numbness and may cause bladder or bowel dysfunction.
  • bone fractures: Weak and broken bones can cause pain, and damage to the ribs may impair lung function.
  • spondylodiscitis: This rare complication involves an infection in the vertebral discs or disc spaces.

Is ankylosing spondylitis a serious illness?

Though AS isn’t a life threatening disease, treatment is important to maintain quality of life. Untreated AS can have serious complications.

However, working with your doctors to manage symptoms and following a treatment plan can help control the progression and limit complications.

What organs does ankylosing spondylitis affect?

Since AS is an inflammatory illness, it can affect many organs throughout the body, including but not limited to the:

  • eyes
  • lungs
  • kidneys
  • bowels
  • heart