7 Surprising Symptoms of Ankylosing Spondylitis

Red, watery eyes? Heel pain? If you have ankylosing spondylitis, you should know more about these and other surprising symptoms. Get the facts

Low back pain and stiffness are the hallmarks of ankylosing spondylitis (AS), but they may not be the first or only symptoms of this inflammatory type of spinal arthritis.

According to the Arthritis Foundation, almost 500,000 people in the United States have AS. The disease can be severe, causing the spine to fuse into a fixed, hunched position, but it can also be less dramatic. Some people with AS may experience only intermittent periods of mild back pain throughout their life.

“The severity of symptoms varies from person to person, and many may not realize that some symptoms are even related to AS,” says David Pisetsky, MD, PhD, chief of rheumatology at Duke University Medical Center in Durham, North Carolina, and president of the U.S. Bone and Joint Initiative. “In general, systemic inflammation is the common denominator that is responsible for most of the symptoms associated with AS.”

Seven less common, sometimes surprising signs and symptoms of AS include:

1. Eye inflammation. “If you have AS and your eye turns red, see an ophthalmologist — this may be a sign of inflammation of the eye,” Dr. Pisetsky says. According to the Spondylitis Association of America (SAA), up to 40 percent of people with AS may experience inflammation of the eye. Other eye symptoms may include painful, watery eyes, blurred vision, and sensitivity to bright light. Treatment includescorticosteroid eye drops to reduce the inflammation.

2. Bowel inflammation. Some people with AS also develop symptoms of an inflammatory bowel disease such as ulcerative colitis or Crohn’s disease, Pistesky says. This could be a result of the underlying inflammation or it could be a side effect of the nonsteroidal anti-inflammatory drugs (NSAIDs) that many people with AS take to treat pain and inflammation. “They may not realize symptoms such as diarrhea or cramping are related to AS, but it’s important to bring these symptoms to your doctor’s attention,” he says, adding that some of the same prescription drugs used to treat AS are also prescribed for inflammatory bowel disease.

3. Heart disease. Some people with AS develop heart problems due to high levels of inflammation throughout their body, says Susan Goodman, MD, associate director of the Inflammatory Arthritis Center at the Hospital for Special Surgery and associate professor of medicine at Weill Cornell Medical College, both in New York City. One possible condition is chronic inflammation around the aortic valve. “This is generally seen after years of disease,” she says. People with AS may benefit from imaging tests to catch any signs of heart involvement early, according to a study published in June 2015 in the American Journal of Medicine.

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