What are the signs and symptoms of ankylosing spondylitis (AS)?

Updated: Sep 03, 2019
  • Author: Lawrence H Brent, MD; Chief Editor: Herbert S Diamond, MD  more...
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Key components of the patient history that suggest AS include the following:

  • Insidious onset of low back pain - The most common symptom

  • Onset of symptoms before age 40 years

  • Presence of symptoms for more than 3 months

  • Symptoms worse in the morning or with inactivity

  • Improvement of symptoms with exercise [2]

General symptoms of AS include the following:

  • Those related to inflammatory back pain - Stiffness of the spine and kyphosis resulting in a stooped posture are characteristic of advanced-stage AS.

  • Peripheral enthesitis and arthritis

  • Constitutional and organ-specific extra-articular manifestations

Fatigue is another common complaint, occurring in approximately 65% of patients with AS. Increased levels of fatigue are associated with increased pain and stiffness and decreased functional capacity. [3, 4]

Extra-articular manifestations of AS can include the following:

  • Uveitis

  • Cardiovascular disease

  • Pulmonary disease

  • Renal disease

  • Neurologic disease

  • Gastrointestinal (GI) disease

  • Metabolic bone disease

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