Ankylosing spondylitis clinical features

Pain may be felt around the lower back or buttocks and can disturb sleep. Some people also develop reduced spinal movement, pain where tendons attach to bone, swelling in larger limb joints, fatigue, or episodes of a painful inflamed eye. Features vary between people and can change over time.

Inflammation often involves the sacroiliac joints, where the pelvis meets the spine, before affecting other parts of the back. Persistent inflammation can make bending, turning, posture and deep breathing feel restricted. Tenderness at the heel, sole, ribs or other tendon and ligament attachments is called enthesitis. Hip, shoulder or knee symptoms may occur alongside spinal symptoms.

Clinicians look at the pattern rather than relying on one symptom. They ask when pain began, whether stiffness is worse after inactivity, what improves it, and whether eye inflammation, psoriasis or bowel inflammation has occurred. Examination may include spinal movement, chest expansion, posture, joint swelling and tender attachment points. Blood tests and imaging can support assessment, but findings are interpreted together with the history and examination.

Arrange a clinical assessment if back pain and stiffness persist, recur, wake you at night or limit normal movement. Note where symptoms occur, their relationship to rest and activity, any swollen joints, and any eye, skin or bowel symptoms. This record can help the clinician recognise a connected pattern.

Management is tailored to disease activity and function. Regular movement, posture work, breathing exercises and an individual physiotherapy programme can help maintain mobility. Medication may be considered to control inflammation. Avoid forcing a painful joint or starting intense exercise during a flare without guidance.

Seek urgent same-day eye assessment for a suddenly painful red eye, marked sensitivity to light or blurred vision, because eye inflammation needs prompt treatment. Seek emergency care for new leg weakness, loss of sensation around the groin, or loss of bladder or bowel control. After a significant fall or impact, severe new spinal pain also warrants urgent assessment.

You might ask which findings support the diagnosis, whether imaging or blood tests would clarify the pattern, how disease activity will be monitored, and which movements are suitable now. Also ask what plan to follow during a flare and whom to contact if eye symptoms develop.