Complications of Ankylosing Spondylitis That Patients Need to Know

This is why early diagnosis is *so* important.

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Catching ankylosing spondylitis (AS) early is so important. Keeping good spine health as you age can allow you to stay active, keep your range of motion strong, and enjoy a higher quality of life. By starting treatment when AS is still young, you may be able to prevent severe damage to the spine.

“Early on in ankylosing spondylitis, you might have symptoms like joint pain and stiffness, and those are the early manifestations,” says Themistocles Protopsaltis, MD, a spine surgeon at NYU Langone Hospital. (Here are more symptoms of AS.)

That pain and stiffness is a sign that the immune system is attacking the joints and tendons of the spine, mistaking them for foreign threats to the body. Even if the stiffness is tolerable, it means the spine is sustaining repeated damage—and that can be devastating over time. 

A more severe complication of AS is the fusion of the spine. “Things get to a point where pain starts to recede, and the joints start to ossify or calcify and fuse together. Then at the very end of the disease, you can have very little joint pain, but now you have a joint that doesn’t move anymore,” says Dr. Protopsaltis.

Of course, an immobile spine on its own can have a negative effect on quality of life and make activity difficult. What’s more, the fused vertebrae can bring along other problems, including posture.

“You don’t want [the spine] to fuse in a position where you’re crooked [or] bent forward where your head isn’t in a good posture,” says Dr. Protopsaltis. For this reason, part of treatment for AS is practicing good posture in case spinal fusion occurs.

Posture isn’t just an aesthetic thing. If the neck fuses in a way that bends the head forward, that can make it challenging to look straight ahead or eat without dropping food, according to Dr. Protopsaltis.

“Also, if they’re crouched, to compensate for that crouched posture, patients will often bend their hips and flex their knees, and those joints can lock into place in that position as well,” he adds.

Joint inflammation may also spread beyond the spine and neck, according to the Arthritis Foundation. The most commonly affected sites include the shoulders, hips, and knees—and even all the way down to the ankles, toes, and fingers. 

Additionally, about 40 percent of people with AS experience inflammation of the eyes, or uveitis, according to the Spondylitis Association of America. This is a common complication of many autoimmune diseases.

Luckily, starting an effective treatment regimen right away can help prevent some of these complications, and the need for surgery. This can help not only your joint mobility, but also your quality of life for years to come.