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Diseases > Ankylosing Spondylitis | AS > Symptoms | Ankylosing Spondylitis | AS

What are the Signs and Symptoms of AS?

As mentioned before, the common symptom among people with AS is back pain and stiffness. However, different people show different symptoms. What’s more, they can have varying discomfort and reduced mobility. Typically symptoms are worse in the morning or after periods of inactivity (like sitting for a long time). The morning pain and stiffness caused by AS can get better with certain exercises and activities. That makes AS different from most other back injuries or conditions.

People usually notice the first signs and symptoms of AS in early adulthood (in their late teens to 30s). Other times, people think they just have a stiff back. In other words, some people can live for years without knowing they have AS. With time the inflammation caused by AS can eventually evolve to the rest of the spine. It can also evolve to other areas of the body like the hips, shoulders, and sometimes the knees. In some people, the tendons surrounding the joints at the back of the heels or under the bottom of the feet may become inflamed. People with AS can also have inflammation in one or both eyes, called “iritis.”

One thing to remember about AS and other types of inflammatory arthritis is that chronic (long-term) inflammation is not good for the body. We now know that having AS or other types of inflammatory arthritis is linked to heart disease. That means people with AS have a higher chance of developing heart disease than people without AS. So if you have AS, make sure you do everything you can to reduce your risk of heart disease. The first thing you should do is to make sure your arthritis is treated. Other things include keeping your blood pressure and cholesterol at healthy levels. If you have diabetes, keep your blood sugar under control. And if you are a smoker, quitting can be one of the best things you can do for your overall health.

Work and Ankylosing Spondylitis

The pain and stiffness caused by AS can sometimes limit people’s normal activities, including work. But there are things you can do to lessen the impact of AS on your work and daily routine. If you find out you have AS when you’re still young, consider choosing a career that won’t be physically demanding on your joints, especially your spine.

If you have a job where you sit for much of the day, adjusting features of your workplace can help make working with AS easier. For example, adjusting the position of chairs and desks for proper posture can help. You can also make adjustments to the seat of your vehicle to make driving more comfortable and reduce the stress on your spine.

Travel and Ankylosing Spondylitis

Traveling is still possible when you have AS. It is best to be organized prior to your trip to ensure a smooth, comfortable, and enjoyable time. See our travel check list.

Sex and Ankylosing Spondylitis

Although AS does not particularly cause a loss of sex drive, it can cause pain, fatigue and emotional hardships. These hardships can create barriers to sexual needs, ability and satisfaction. Take comfort knowing that sex and intimacy can be maintained in people with AS … it can even draw partners closer together, especially through improved communication between mates.

For more information on intimacy and arthritis, a great book is Rheumatoid Arthritis: Plan to Win by Cheryl Koehn, Taysha Palmer and John Esdaile.

Pregnancy and Ankylosing Spondylitis

Ankylosing spondylitis (AS) has no effect on fertility. Your chances of getting pregnant are the same as if you didn’t have AS. Ankylosing spondylitis also has no known effects on the developing fetus or the newborn.

The two main issues we worry about with AS and pregnancy are: (1) Medications and (2) Delivery.

Patients with AS can be treated with a number of medications including NSAIDs, anti-TNF biologics, and occasionally DMARDs. It is important to discuss your medications with your doctor and have a pre-pregnancy plan. For example, if a medication needs to be discontinued, and your disease flares, how will this be handled?

Any type of arthritis that affects the pelvis or the hips can make vaginal delivery difficult. It is important to discuss delivery options with your obstetrician. Women with AS are more likely to have caesarean sections than women without. The presence of significant spinal fusion may make an epidural difficult or impossible. If an epidural is not an option then other methods of pain control during delivery need to be discussed. The inability to administer an epidural would likely result in general anaesthesia for c-section.

Read more – Treatment of Ankylosing Spondylitis (AS)