Ankylosing spondylitis is characterized by a continual irritation and swelling of the spine and the sacroiliac joints. This form of arthritis manifests itself in the form of chronic inflammation in the spine eventually leading to a cementing of the vertebrae, a process known as ankylosis. When ankylosis sets in, it results in a loss in mobility of the spine. The usual symptoms of the disease include fatigue associated with irritation of the spine, lower back, upper buttock, and the neck. The onset of pain and a rigor mortis kind of stiffness is gradual and worsens with time.

The onset of symptoms of ankylosing spondylitis varies from person to person. Though they are known to appear in late adolescence or early adulthood, the typical symptoms of this disease can be seen in children as well. Classically, the earliest symptoms of this form of arthritis are frequent stiffness and pain in the lower back and buttocks area. These symptoms may appear and disappear periodically over few weeks or months. Initially, a sense of discomfort may only be felt on one side, or maybe on alternate sides of the back area. The pain is usually dull and distributed over the area rather than being concentrated in its origin. The pain is known to worsen in the mornings and may ease out during the night after a warm shower or light exercise. These early symptoms maybe accompanied by mild fever, loss of appetite and a general sense of discomfort.

The typical symptom of ankylosing spondylitis is a sense of pain that is felt on both sides, and usually persists for at about three months. This pain can eventually travel up to the spine and into the neck. The stiffness may as well spread to the shoulder blades, ribs, hips, thighs and heels. The uniqueness of this arthritis is that it may present itself in a rather peculiar manner in the case of women. Women are known to show signs of the disease in a more atypical fashion making it difficult for an appropriate diagnosis. For example, women typically complain of a sense of discomfort and pain originating in the neck rather than the lower back which is regarded as an indicator of ankylosing spondylitis.

A common symptom of ankylosing spondylitis is varying levels of fatigue which is a result of the pain and inflammation in the body. The body would need to expend extra energy to deal with the pain and inflammation. This causes a sense of fatigue in the spondylitis patients. Anemia might also set in due to the inflammation. This may contribute to the general feeling of tiredness as well.