Ankylosing spondylitis (AS) is a complex condition that can affect many parts of your body. It can cause complications in your day-to-day life, and lead to additional health conditions.
Some complications associated with ankylosing spondylitis are outlined below.
Uveitis, also known as iritis, is a condition sometimes associated with ankylosing spondylitis. Uveitis is inflammation (redness and swelling) of part of the eye. It usually only affects one eye, not both. If you have uveitis, your eye will become:
- sensitive to light (photophobia)
Because uveitis can damage your eyesight, if you have ankylosing spondylitis and you develop pain or redness in one eye, or misty vision, you should urgently visit:
- your GP
- an ophthalmologist (a medical doctor who specialises in eye disease and its treatment or surgery), or
- an optometrist (a person who examines eyes and tests sight)
Uveitis is easily treated using eye drops. If treated quickly, uveitis usually clears up within two to three weeks. However, if uveitis is not treated quickly, it can cause the loss of some or all of your vision.
Osteoporosis is a condition that causes your bones to become weak and brittle. In ankylosing spondylitis, osteoporosis can develop in the spine.
Read more information about osteoporosis.
Having ankylosing spondylitis increases your risk of developing fractures (breaks) in the vertebrae of your spine. This risk increases with the duration of your condition.
If you have ankylosing spondylitis, you may also have an increased risk of developing cardiovascular disease. Cardiovascular diseases include:
- heart disease – your heart's blood supply is blocked or interrupted by a build-up of fatty substances in the coronary arteries (the blood vessels that supply blood to the heart)
- stroke – a serious medical condition that occurs when the blood supply to the brain is interrupted
- deep vein thrombosis (DVT) – where blood clots develop in one of the deep veins in your body, usually in your legs
Due to the increased risk, it is important to take steps to minimise your chances of developing cardiovascular disease.
Your rheumatologist (specialist in treating muscle and joint conditions) will be able to advise about lifestyle changes you should make to minimise your risk of developing a cardiovascular disease. These changes may include:
- giving up smoking (if you smoke)
- losing weight (if you are overweight or obese)
- taking more regular exercise – 150 minutes of exercise per week can greatly increase your health
- keeping other conditions you may have under control, such as diabetes (a long-term condition caused by too much glucose in the blood) or high blood pressure (hypertension)
It is estimated that four in 10 people with ankylosing spondylitis will eventually have severely restricted spinal flexibility. Spinal deformities are likely to take at least 10 years to develop.
In very severe cases of ankylosing spondylitis, pain and stiffness in your lower back can also spread to the upper parts of your spine. This can decrease the mobility of your spine, making it difficult to move. As a result, your posture can become fixed in one position. This may:
- make it difficult to look people in the eye
- reduce your self-confidence
However, it is unlikely this will cause severe disability unless you also have severe arthritis (inflammation of the joints) in your hips or sometimes your knees.
Two types of surgical treatment are sometimes needed by people with ankylosing spondylitis:
- joint replacement surgery
- spinal corrective surgery
These are described in more detail below.
Joint replacement surgery
In some cases, it may be necessary to have surgery to replace a joint that has become severely damaged as a result of ankylosing spondylitis. For example, if hip joints are affected, a hip replacement may help to:
- relieve pain
- improve mobility
Read about hip replacement for more information about the procedure.
Spinal corrective surgery
It is now rare for people with ankylosing spondylitis to need their spine straightened, but if the spine becomes badly bent this can often be corrected by an operation.
Cauda equina syndrome
Cauda equina syndrome is a very rare complication of ankylosing spondylitis that occurs when nerves at the bottom of your spine become compressed (compacted).
Cauda equina syndrome causes:
- pain or numbness in your lower back and buttocks
- weakness in your legs, which can affect your ability to walk
- urinary incontinence or bowel incontinence (when you cannot control your bladder or bowels)
See your GP as soon as possible if you have ankylosing spondylitis and you develop any of these symptoms.
In very rare cases, it is possible to develop amyloidosis as a complication of ankylosing spondylitis.
Amyloid is a protein produced by cells in your bone marrow (the spongy material found in the centres of some hollow bones). Amyloidosis is a condition where amyloid builds up in organs, such as your:
- heart – a muscular organ that pumps blood around the body
- kidneys – two bean-shaped organs that filter out waste products from the blood
- liver – the largest organ in the body; it performs many important functions, such as turning food into energy
Symptoms of amylodosis vary because the condition can affect different areas of your body. In some cases, there may be no symptoms at all.
Read more about amyloidosis.
As ankylosing spondylitis advances, it can affect your ability to work. It is estimated that a third of people with ankylosing spondylitis may be unable to work at all. Around one in six people may need changes to their working life in order to continue working, such as:
- working part-time
- working from home
- not taking up physically demanding occupations
When at work, it is important to maintain a good posture when sitting or standing for long periods of time. You should get up, stretch and move around regularly. This could mean adjusting your work station, or ensuring you take regular breaks.
Read more information about how to sit correctly.