Ankylosing spondylitis - Symptoms 

Symptoms of ankylosing spondylitis 

The symptoms of ankylosing spondylitis (AS) can vary from person to person, but usually develop slowly, over several months or years.

AS usually first starts to develop during later teenage years or early adulthood. The symptoms may come and go, and improve or get worse over many years.

Main symptoms

The main symptoms of AS are described below, although you may not develop all of these if you have the condition. 

Back pain and stiffness

Back pain and stiffness are usually the main symptoms of AS. You may find:

  • the pain gets better with exercise but doesn't improve, or gets worse, with rest
  • the pain and stiffness is worse in the morning and at night  you may wake up regularly during the night because of the pain
  • you have pain in the area around your buttocks


As well as causing symptoms in your back and spine, AS can also cause inflammation of the joints (arthritis) in other parts of your body, such as your hips and knees. The main symptoms associated with arthritis are:

  • pain on moving the affected joint
  • tenderness when the affected joint is examined
  • swelling and warmth in the affected area  


Enthesitis is painful inflammation where a bone is joined to a tendon (a tough cord of tissue that connects muscles to bones) or a ligament (a band of tissue that connects bones to bones).

Common sites for enthesitis are:

  • at the top of the shin bone
  • behind the heel (Achilles tendon)
  • under the heel
  • where the ribs join to the breast bone

If your ribs are affected, you may experience chest pain, and you may find it difficult to expand your chest when breathing deeply.


Fatigue is a common symptom of untreated AS. It can make you feel tired and lacking in energy.

When to seek medical advice

You should see your GP if you have persistent symptoms of AS.

If your GP thinks you may have the condition, they should refer you to a rheumatologist (a specialist in conditions affecting muscles and joints) for further tests and any necessary treatment.

Read more about diagnosing ankylosing spondylitis.

Page last reviewed: 26/06/2014

Next review due: 26/06/2016


How helpful is this page?

Average rating

Based on 145 ratings

All ratings

Add your rating


The 2 comments posted are personal views. Any information they give has not been checked and may not be accurate.

sav3001 said on 01 August 2014

I was diagnosed with stage 1 AS about three years ago after suffering lower back pain for some months, Shortly afterwards I read an article in the Daily Mail (I think) recommending taking powdered rose hip capsules. I have taken two capsules per day plus glucosamine and chondroitin pills. For the last three years I have been completely symptom free and do a lot of gardening including heavy digging with no problems I am 67 years old and I would urge you to give it a go!

Report this content as offensive or unsuitable

janie123 said on 03 December 2013

Please be aware that AS doesn't always present itself by pain in the spine. My child's (which took 4 years to be diagnosed) took the form of hip pain.
Also the associated eye condition is not always experienced as a 'sharp, stabbing pain in the eyes'. It can look like an allergy and be pain free. If you are unsure about anything keep perservering with the professionals - they do not always get it right first time.

Report this content as offensive or unsuitable

Back pain

Eight in 10 adults experience back pain at some point. Find out what treatments are available