What are the symptoms of ankylosing spondylitis?

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Back pain
The main symptom is back pain. The pain usually starts in the lower back. You may think of it as just mild backache at first. It typically becomes worse over several months. You may have aching over your buttocks, and down the back of your thighs. Coughing or straining may make it worse. Rest does not make it better. Instead, exercise usually eases the pain. The pain tends to be worse first thing in the morning. Lying in bed after waking is often uncomfortable. The pain tends to ease as the day goes on. The middle (chest part) of the spine may become affected. If this occurs the joints between the ribs and the spine may also become painful.

Stiffness in the lower spine
The stiffness can be quite severe first thing each morning. It usually improves with activity and exercise, and tends to ease as the day goes on.

Other joint symptoms apart from the spine
Other joints are affected at some stage in about 4 in 10 cases. The most common are: the hips, knees, ankles, and shoulders. Affected joints can become painful, stiff, and swollen.

Inflammation of tendons and ligaments
Tendons and ligaments may become inflamed and painful where they attach to bones. Common examples (apart from the spinal ligaments) are the Achilles' tendon where it attaches to the heel, and where chest muscles attach to the ribs. However, it can occur in various parts of the body.

Inflammation of part of the eye (uveitis)
This affects about 1 in 3 people with AS from time to time. Tell a doctor urgently if you have AS and develop a painful or red eye. If you develop uveitis, treatment with eye drops is best started as soon as possible after eye symptoms begin.

Associated diseases
Some other 'inflammatory' conditions develop more commonly than normal in people who have AS. For example, people with AS have a greater than average chance of developing bowel inflammation (ulcerative colitis or Crohn's disease), and skin inflammation (psoriasis).

General symptoms
Some people with AS feel generally unwell with symptoms of tiredness or depression. Weight loss or anaemia sometimes occur.