You’re most likely to feel the effects of ankylosing spondylitis (AS) in your spine, particularly your lower back and the joints where your hip bones attach to your spine. But the disease can leave its mark all over your body.
Joints at Risk
Ankylosing spondylitis is a kind of arthritis. It causes inflammation in your joints, most often between your vertebrae, the bones in your back. But it also inflames the attachment points between bones and ligaments or bones and tendons.
That’s a condition called enthesitis. It can lead to pain and stiffness in many places, including:
- Ribs. It’s very common for AS to affect your ribcage, both in the back, where your ribs attach to your spine, and the front, where the ribs and breastbone connect. That can make it hard to take a full breath.
- Ankles and feet. Many people with AS have pain at the back or bottom of their heel.
- Shoulders and hips. About a third of people with AS have pain in their hips and shoulders. If your hips are involved, it may mean your disease will be more serious.
- Knees. Some people feel AS pain in their knees, although that’s often related to hip inflammation.
- Jaw. It’s rare, but you may have inflammation in your jaw that keeps you from opening your mouth completely.
Ankylosing spondylitis is part of a broader category of illnesses called spondyloarthropathies or spondyloarthritis. They’re inflammatory diseases, believed to be caused by a problem with your immune system. AS is often linked to these other inflammatory diseases:
- Crohn’s disease
- Ulcerative colitis
You’re more likely to get AS if you already have one of these conditions, and vice versa. Doctors don’t know the exact connection.
Inflammation throughout your body may be the cause of some of the other symptoms people with ankylosing spondylitis feel, including:
- Loss of appetite and weight loss
Beyond Your Spine
When you have ankylosing spondylitis, you should be on the lookout for symptoms in places other than your back. AS can lead to a variety of issues in different parts of your body.
Eyes. One of the complications of ankylosing spondylitis that happens most often is a kind of eye inflammation called uveitis. Symptoms include:
- Sensitivity to light
- Blurred vision
- Dry or watery eyes
You should tell your doctor right away if you have any of these symptoms, so you can get treated. At worst, uveitis can cause you to lose your sight.
Bones. Ankylosing spondylitis can weaken your bones, making you more likely to have osteoporosis and fractures in the bones of your spine. Broken vertebrae can cause you to hunch over. They can also damage your spinal cord and other nerves in your back.
Digestive tract. Some people with AS have gastrointestinal symptoms, like stomach pain or diarrhea. Researchers have found that most people with the disease have some amount of inflammation in their intestines, which could account for those symptoms. You’re also more likely to have an actual inflammatory bowel disease, like Crohn’s disease or ulcerative colitis.
Skin. A rash is sometimes a symptom of ankylosing spondylitis. And many people who have AS also get psoriasis or other inflammatory skin diseases.
Heart. The systemwide inflammation that comes with AS makes you more likely to have a heart attack or stroke. But over time, the disease may also specifically damage your aorta, the main blood vessel that takes blood from your heart to the rest of your body. Your aorta can become enlarged until it prevents the valve between it and your heart from opening and closing correctly. AS can also lead to different kinds of irregular heartbeats or weakened heart muscle.
Nerves. It’s very rare, but ankylosing spondylitis can damage a group of nerves at the base of your spine called the cauda equina. It’s a serious problem with symptoms that include:
- Trouble either holding your urine or releasing it
- Loss of bowel control
- Pain or numbness in your lower back, hips, or inner thighs
- Weakness in your legs
- Sexual dysfunction
Get help right away if you’re having these symptoms. This kind of nerve damage can become permanent.
Lungs: It’s also rare, but if AS causes parts of your ribcage to fuse, it can eventually lead to lung problems. You may not be able to take a deep breath, so your lungs don’t hold enough air and you may feel short of breath. You may have scarring or hardening in your lung tissue, and you may have trouble getting over a cold or other respiratory infection.
Talk to your doctor if you notice new symptoms, or if symptoms you already have get worse. You should also have regular checkups so that any dangerous complications can be caught early enough to be treated effectively.
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Mayo Clinic: “Ankylosing spondylitis.”
Spondylosis Association of America: “Overview of Ankylosing Spondylitis,” “Possible Complications: How Is a Person Affected?” “The Spondyloarthritis Family.”
National Institute of Arthritis and Musculoskeletal and Skin Diseases: “Ankylosing Spondylitis.”
Cleveland Clinic: “Ankylosing Spondylitis (AS),” “Cauda Equina Syndrome.”
Therapeutic Advances in Musculoskeletal Disease: “Skin manifestations in spondyloarthritis.”
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