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Ankylosing Spondylitis - Symptoms

Ankylosing spondylitis is inflammation primarily of the joints of the spine. But it can also involve inflammation of the eye, other joints—especially those in the hips, chest wall, and around the heels—and, on occasion, the shoulders, wrists, hands, knees, ankles, and feet. Although it is unusual, ankylosing spondylitis can also cause changes such as thickening of the major artery (aorta) and the valve in the heart called the aortic valve.

If the inflammation continues over time, it will lead to scarring and permanent damage. In some people the disease is mild and progresses slowly, and symptoms may never become severe. Other people may have a more aggressive disease process.

Whether ankylosing spondylitis gets worse depends on a number of things such as how old you were when the disease began, how early it was diagnosed, and what joints are involved. It's too early to tell yet, but experts hope that early treatment with newer medicines will slow or minimize the inflammation, prevent scarring, and limit the progression of the disease.

Mild or early ankylosing spondylitis

Ankylosing spondylitis usually starts with dull pain in the low back and back stiffness. Some people with ankylosing spondylitis have "flares" of increased pain and stiffness that may last for several weeks before decreasing again.

  • Affected bones of the low back, middle back, hips, or neck may become painful, stiff, and limited in motion. Pain tends to increase slowly over a period of weeks or months, and it is often hard to point to exactly where the pain is. Stiffness is usually worse in the morning and usually lasts for more than one hour. Pain is often noticeable in the early morning hours of sleep, such as between 3 a.m. and 6 a.m. Physical activity often helps decrease pain and stiffness.
  • Some people feel tired as the disease progresses. This tiredness comes from the body fighting the inflammatory process that is part of ankylosing spondylitis and also from ongoing stiffness and pain.
  • The colored part of the eye (iris) may become inflamed. Symptoms of iritis include redness and pain in the eye and sensitivity to light.
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