Symptoms of Ankylosing Spondylitis

Ankylosing spondylitis (AS) is a chronic disease that develops slowly. In the early stages of the disease, the sacroiliac joints (located at the back of the pelvis) become inflamed and painful. In fact, one of the earliest signs of AS is tenderness around the sacroiliac joints. Another early symptom is low back pain that may spread down into the buttocks and thighs. Pain varies in intensity and duration, and it is episodic (comes and goes). Stiffness is usually worse in the morning and improves with exercise.

sacroiliac joints, sacrum, tailbone

Anklylosing Spondylitis is a Progressive Disease
As the disease progresses, ossification (new bone growth) is triggered by the body's defense mechanism. Your body knows that joint movement is causing pain, so it attempts to limit movement by forming new bone that will stop movement. Ossification causes new bone to grow between vertebrae, eventually fusing them together and increasing the risk for fracture. Furthermore, ossification may affect spinal ligaments, causing spinal stenosis (narrowing of nerve passageways, spinal canal), which can result in neurologic deficit (problems related to the nerves, such as weakness or loss of function).

Other symptoms of ankylosing spondylitis:

  • Limited motion in the lumbar spine
  • As the disease progresses, the patient may notice the discomfort moves up the spine. AS generally starts in the low back (lumbar spine) and gradually moves up to the neck (cervical spine).
  • The mid-back (thoracic spine) may be affected by pain, stiffness, and limited chest expansion when breathing.

skeleton of the upper body

  • Pain, tenderness, and stiffness in the shoulders, hips, knees, and heels
  • Cauda equina syndrome (specific nerve compression) may develop, causing lower extremity numbness, weakness, and incontinence.
  • Inflammation of the intervertebral disc or disc space (spondylodiscitis) is a common complication caused by the hardening/thickening of fibrous tissue (sclerosis) affecting vertebral end plates. The resultant abnormal vertebral motion almost always causes pain.
  • Spinal deformity: kyphosis (humpback), lordosis (swayback)

lordosis, kyphosis, scoliosis

Updated on: 03/13/17
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Exams and Tests for Ankylosing Spondylitis
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Exams and Tests for Ankylosing Spondylitis

The diagnosis of ankylosing spondylitis (AS) requires an in-depth review of your medical and family history, physical and neurological examinations, blood tests, and imaging studies, such as x-ray or MRI.
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