Ankylosing spondylitis is a form of inflammatory arthritis which involves spine and joints of hips, heels and chest wall as well as other body parts such as eyes, heart, lungs and kidneys. Diffused pain and stiffness in the buttocks and lower back are the most common symptoms of ankylosing spondylitis. The pain may worsen after prolonged sitting or rest and it may improve with exercise and activity.

The severity of symptoms and complications may vary patient to patient. Inflammation of spine may cause stiffness and pain in low back, neck, upper buttock area and remaining area of spine. Stiffness is generally worst in the morning and may reduce after physical activity. Some people may experience fatigue as the disease progresses. There may be involvement of eyes causing iritis.

In case of severe and chronic inflammation of spine, there may be total bony fusion of spine which is known as ankylosis resulting in complete loss of mobility of spine. There may be difficulty in walking or standing as the spine loses its natural curve. These fused spines are brittle and susceptible for fractures. Sometimes, patients with ankylosing spondylitis can develop Achilles tendinitis which may cause stiffness and pain in the back of heel. In addition to that, plantar fasciitis (inflammation of tissues of bottom of foot) is frequently found in people with ankylosing spondylitis.

Other symptoms of ankylosing spondylitis are associated with involvement of other organs. When the disease becomes chronic and severe, there may be cause forward curving of the upper torso (thoracic spine) which can reduce the breathing capacity. There may be inflammation and scarring of the lungs as well as enthesis of ribs due to ankylosing spondylitis which may cause coughing and shortness of breath.

Advanced ankylosing spondylitis can cause deposition of protein material known as amyloid into the kidneys leading to kidney failure. Progressive kidney disease can give rise to nausea and chronic fatigue. Besides this, if the heart is involved, there may be valve problems such as aortitis (inflammation of the largest artery, aorta). Inflammation of other body parts can give rise to some other conditions such as inflammatory bowel disease, anemia and iritis (painful and inflamed eyes).

Just like other chronic inflammatory diseases, patients with ankylosing spondylitis may have malaise and fatigue. Other symptoms of ankylosing spondylitis are low grade fever, weight loss and disturbed sleep due to joint pain. Besides this, some people may experience the bowel inflammation that is associated with ulcerative colitis or Crohn’s disease.

The symptoms of ankylosing spondylitis such as pain in lower back, inflammation and stiffness of joints, fatigue and weight loss can also be found in other forms of arthritis and other medical conditions. It may be confusing for the doctor to make correct diagnosis, especially due to involvement of other organs. Hence, some laboratory tests and imaging are very important for the diagnosis of ankylosing spondylitis and to rule out other types of arthritis and other diseases.