Ankylosing spondylitis (AS) is a type of inflammatory arthritis primarily affecting the spine and sacroiliac joints (the point where the spine meets the pelvis). Early detection is crucial for timely management of symptoms and prevention of long-term complications like spinal fusion, restricted mobility, and chronic pain.

Most people dismiss mild to moderate backache and joint pain as “feeling tired”, believing they may be caused by general fatigue, ageing, or bad posture. In reality, ankylosing spondylitis is an inflammatory condition that often begins with subtle symptoms. Noticing these symptoms early can help affected individuals seek appropriate medical care and manage the condition.

Spine-related Symptoms in Ankylosing Spondylitis

The most commonly affected area in the body in ankylosing spondylitis is the spine. The earliest symptoms of the condition often start here.

Chronic Lower Back Pain

Unlike a typical muscle ache or back pain caused by a strain or an injury, inflammatory backache associated with AS has distinctive features:

• Pain that gradually worsens over weeks or months
• Pain that feels worse at night or during rest
• Stiffness in the lower back (after long periods of sitting or in the morning)
• Relief through physical activity, but not long rest

It is important to detect this particular type of back pain so one can differentiate between Ankylosing spondylitis and general musculoskeletal discomfort.

Reduced Flexibility in Spine

Gradual loss of spinal flexibility can develop in the early stages of Ankylosing spondylitis. This can lead to difficulty in bending forward, twisting your back, or even performing everyday tasks like tying your shoelaces.

If left untreated, this inflammation can lead to pronounced spinal rigidity over time.

Morning Stiffness

Stiffness in the morning is another telltale sign of Ankylosing spondylitis. If the stiffness persists for 30 minutes or more when you wake up in the morning, it could point to something more than general fatigue. Affected individuals may experience difficulty in twisting, bending, or even standing up straight.

Some gentle stretching and movement can provide temporary respite, but the stiffness tends to return until the condition is given proper medical attention.

Pain During Nighttime

Many people affected by Ankylosing spondylitis report their back pain becoming more severe during the nighttime, interrupting sleep. Ankylosing spondylitis pain generally tends to start in the lower back or sacroiliac area and may radiate to the hips and buttocks. 

Unlike *mechnical pain, Ankylosing spondylitis pain improves with physical activity rather than rest. 

*Mechanical Pain: Pain caused by structural issues or physical stress in your joints, muscles, and ligaments, rather than systemic disease or nerve issues.

👉 Also read: What is Osteoarthritis?

Ankylosing Spondylitis Symptoms in the Peripheral Joints

While the spine is the primary target in Ankylosing spondylitis, other joints can also be affected: 

Knee, Hip & Shoulder Pain

Early signs can include intermittent discomfort in large joints like knees, hips, or shoulders. Peripheral arthritis may affect one or several joints and is not necessarily symmetrical. Pain and discomfort in these joints can affect everyday tasks like climbing stairs, walking, and lifting objects, etc. 

Swelling or Warmth in Joints

This is not very common in the early stages, but subtle swelling or warmth near the affected joints can be an early warning sign of inflammation caused by Ankylosing spondylitis. 

Pain in Tendons or Ligament Attachments 

Ankylosing spondylitis can lead to inflammation in the area where tendons and ligaments connect to bones. This is referred to as enthesitis. Common areas affected by enthesitis include the Achilles tendon (the heel) and plantar fascia (on the underside of the foot near the heel). This causes pain while walking, standing, jogging, or running – basically anything that requires you to put pressure on the heel.

Systemic Symptoms of Ankylosing Spondylitis

Ankylosing Spondylitis can also trigger extra-articular or systemic symptoms that may not be noticed initially: 

Fatigue 

Inflammatory diseases are often accompanied by persistent fatigue. Affected individuals may feel tired and exhausted even after performing small tasks, making routine activities feel like a challenge.

Inflammation in Eyes

Some affected individuals experience symptoms of iritis or uveitis – redness, pain, light sensitivity, and blurred vision. Eye inflammation may appear suddenly. It’s important to remember that urgent medical care can safeguard your eye(s) from any further complications.

Subtle Symptoms

Some symptoms that often go unnoticed include:

• Digestive issues associated with inflammatory bowel disease
• Back or hip stiffness and discomfort after sitting for long periods
• Chest discomfort due to rib joint inflammation
• Fatigue that doesn’t feel proportionate to exertion
• Intermittent tingling or numbness if inflammation in the spine affects nerves

Identifying and addressing these issues can lead to early medical intervention and timely ankylosing spondylitis management.

👉 Also read: Types of Rheumatoid Arthritis

When to Visit a Doctor?

Timely consultation with a rheumatology doctor can help you notice and address the AS red flags before the condition progresses to severe stages. Book an appointment with the best rheumatologists in Chandigarh at Sohana Hospital. 

Our experts specialise in treating 200+ types of rheumatic and autoimmune conditions. A round of thorough screening tests, including blood work and imaging tests, is employed for proper diagnosis. After diagnosis, our team works closely to create a fully personalised treatment plan for every patient according to their unique condition. The personalised treatment targets the symptoms and aims to provide long-term management of pain, stiffness, and inflammation, making everyday life easier for our patients.

To reiterate, early detection of Ankylosing spondylitis can lead to prevention of chronic pain, while maintaining a good overall quality of life for the patient. If you or someone you know experiences any of the above-mentioned symptoms or falls in the high-risk category, consult a professional healthcare provider for an evaluation.

Having said that, it is important to highlight that being proactive and noticing the early warning signs is the first step towards preserving your spinal health and managing chronic pain.

Frequently Asked Questions

Does ankylosing spondylitis affect sleep quality even when there is no severe pain? 

Yes, inflammation alone can disturb sleep patterns, even when the affected individual might not be experiencing severe pain. This can often lead to unrefreshing sleep or a disrupted sleep cycle.

Which lifestyle changes can help manage ankylosing spondylitis symptoms? 

Consciously maintaining good posture, staying physically active, and gentle stretching, etc., can help manage the inflammation and delay stiffness in the initial stages of Ankylosing spondylitis.

Can environmental factors have an impact on the onset of ankylosing spondylitis? 

Genetics plays the primary role in the onset of Ankylosing spondylitis, but environmental factors may also trigger certain infections, leading to inflammation and the onset of Ankylosing spondylitis. Not just that, sedentary lifestyles can influence the severity and timing of symptom onset.

Do minor digestive issues point to early ankylosing spondylitis? 

Some individuals may experience mild gastrointestinal discomfort during the initial stages of Ankylosing spondylitis. This often goes unnoticed. However, it could be a sign of underlying inflammation. Often, this may precede other obvious symptoms like back pain and stiffness.