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Ankylosing Spondylitis Symptoms

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The first sign of AS is inflammation in the areas where the lower spine joins the pelvis. This frequently occurs between the ages of 17 and 35.

The most common early symptoms of AS are:

  • Chronic pain and stiffness in the lower back, buttocks and hips (usually develops slowly over several weeks or months)
  • Pain and stiffness that worsens during periods of rest or inactivity and improves with movement and exercise

  • Back pain during the night or early morning

  • Feeling very stiff in the morning

AS Long-Term Effects

Over time, pain and stiffness may progress to the upper spine and even into the rib cage and neck. Ultimately, the inflammation can cause the sacroiliac and vertebral bones to fuse or grow together. When the bones fuse, the spine loses its normal flexibility and becomes rigid. The rib cage also may fuse, which can limit normal chest expansion and make breathing more difficult. Inflammation and pain also can occur in the hips, shoulders, knees, ankles, toes and fingers, which may limit mobility. The heels may be affected, making it uncomfortable to stand or walk on hard surfaces.

Smokers who have ankylosing spondylitis (AS) have more spinal damage than non-smokers with the same level of disease activity. Having the disease is also linked to an increased risk of heart disease and stroke.

The disease can cause fever, loss of appetite, fatigue and inflammation in the lungs, heart and eyes. Eye inflammation (called iritis or uveitis) occurs in more than one-fourth of people with AS. Iritis causes redness and pain in the eye that worsens with exposure to bright light.

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