Key Signs and Symptoms of Ankylosing Spondylitis You Should Recognize

As part of the spondyloarthropathy family, ankylosing spondylitis shares similar symptoms and causes with conditions like psoriatic arthritis, reactive arthritis (once called Reiter's disease), and arthritis linked to Crohn's and ulcerative colitis. These illnesses impact the spine, joints, eyes, skin, mouth, and other organs.

This form of arthritis primarily targets the spine, causing inflammation that can lead to fusion of certain spinal segments. It also affects the ribs and sacroiliac joints in the lower back. More often seen in men, symptoms typically start in late adolescence or early adulthood, generally between 17 and 45 years of age.

Ankylosing spondylitis can also develop in children, called juvenile ankylosing spondylitis. The condition's primary causes are believed to be genetic and environmental factors.

What causes these symptoms?

Individuals carrying the HLA-B27 gene are more susceptible to ankylosing spondylitis. This gene is inheritable, but not everyone with it develops the disease; about 10% of carriers remain unaffected. Aside from genetics, no other definitive cause has been established.

The progression and intensity of symptoms vary from person to person, making diagnosis challenging. Medical diagnosis relies on blood tests for HLA-B27, imaging such as X-rays and MRI scans, physical assessments, and symptom evaluation. Physical exams test spinal mobility, pain reproduction in affected areas, and chest expansion during deep breathing.

Typical ankylosing spondylitis symptoms include:

Persistent dull pain and stiffness in the lower back, hips, heels, pelvis, and chest, especially in the mornings.

Early symptoms often cause significant discomfort that can disrupt sleep and daily routines, lasting for months.

Over time, pain becomes chronic and intense, hindering movement. It tends to improve with exercise but worsens with rest.

Bone overgrowth, or bony fusion, may occur, leading to abnormal joints in the neck, back, and hips, restricting mobility.

Tendonitis, especially around the Achilles tendon, caused by inflammation, is common.

Additional symptoms include fatigue, fever, and decreased appetite.

Inflammation of the iris (iritis or uveitis) can lead to eye pain, light sensitivity, redness, and blurred vision.

Severe cases may involve cauda equina syndrome, affecting bladder and bowel control, speaking, and causing numbness in limbs—urgent medical attention required.

Regarding treatment, no cure exists yet. The goal is to manage symptoms through ongoing therapy, pain relief, and maintaining quality of life, with treatment plans tailored to each individual for optimal comfort and mobility.