Living with chronic ankylosing spondylitis

Symptoms often fluctuate. Back or buttock pain and morning stiffness may improve with movement yet worsen after rest, while persistent inflammation can gradually restrict spinal and chest movement.

Inflammation usually begins around the sacroiliac joints, where the spine meets the pelvis, but it can also affect hips, shoulders, heels and the rib joints. Fatigue may accompany pain and stiffness. Some people develop inflammation outside the joints, particularly in an eye.

There is no single symptom that establishes the diagnosis. Assessment can combine your history, physical examination, blood tests and imaging. Ongoing reviews help track movement, daily function, treatment effects and problems beyond the musculoskeletal system.

A tailored exercise programme can maintain spinal mobility, posture, strength and chest expansion. Regular, manageable activity is generally more useful than occasional intense sessions. A physiotherapist can adapt exercises during flares and show positions that reduce strain at work and during sleep.

Medicines may be used to control pain and inflammation, with the choice based on symptom activity and other health conditions. Take prescribed treatment as directed and report side effects. Avoid smoking because reduced chest movement and lung irritation can compound breathing difficulty.

Get urgent eye assessment for a painful red eye, light sensitivity or sudden blurred vision, as these can signal eye inflammation. Seek emergency help after an injury if severe neck or back pain begins, or if weakness, numbness, loss of bladder or bowel control, chest pain or major breathing difficulty occurs.

Contact your treating clinician when stiffness or night pain is increasing, usual activities become harder, or treatment no longer controls symptoms. These changes may prompt a review of disease activity, technique, medicine or rehabilitation goals.

Discuss how disease activity is being monitored, which exercises suit your current mobility, what side effects require a call, whether eye or bowel symptoms could be related, and how to modify activity during a flare.