The first symptoms of ankylosing spondylitis are usually pain and stiffness in the lower back and buttocks. However, sometimes, the pain may start in the neck rather than the back, especially in women.
Pain and stiffness may only be felt on one side or on alternate sides. Usually symptoms appear gradually, over a few weeks or months and can come and go (or “flare up”), eventually becoming persistent, chronic pain on both sides. It’s important to note that ankylosing spondylitis varies from person to person, and the onset of symptoms does, too.
The pain AS causes lasts longer than 3 months, and you might notice the stiffness and pain are worse after you’ve been resting or sitting.
If any of these symptoms sound familiar, talk to your doctor. Over time, AS can start to worsen. It may even begin to restrict your spinal movement and, in more severe cases, cause fusing of the spine.
AS often affects the area where connective tissues, such as ligaments and tendons, attach to bone. This area is called the enthesis. Enthesitis is inflammation in those areas. Click or tap on the hot spots to show where AS can affect you.
In severe cases, ribs can fuse together, making breathing more difficult
Frequent pain and stiffness in the lower back and buttocks are the most common early symptoms
Over time, AS can include pain and stiffness in the hips
While the exact causes of ankylosing spondylitis are not understood, it is known that genetics plays a role. A protein called HLA-B27 is produced by a gene that is found in many people with ankylosing spondylitis. However, you do not have to be HLA-B27 positive to have AS; nor do the majority of people with this genetic marker have AS.
Scientists believe that other causes of ankylosing spondylitis may include:
If you have any of the following problems in addition to back pain and stiffness, make sure to tell your doctor.
This information could be helpful to your doctor when ruling out or diagnosing AS.
Diagnosing AS is important, as advanced symptoms may include hunched posture, “bamboo spine” (the appearance of a spinal column that resembles bamboo), and a fused spine (when the spine fuses together), which can happen as a result of chronic progressive disease and uncontrolled inflammation.