The Effects of Ankylosing Spondylitis on the Body

Ankylosing spondylitis (AS) mainly impacts the spine, but it can affect other joints, the eyes, heart, and lungs, too.

Many people with AS experience trouble breathing, vision changes, fatigue, skin rashes, and loss of appetite.

This article discusses ankylosing spondylitis and how it affects the body's different systems.

A woman holding her wrist at work

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Spine and Skeletal System

The most common symptoms of ankylosing spondylitis are back pain and stiffness. As the inflammation in the spine worsens, the spine tends to curve forward. In addition to back pain, people with AS may experience pain in their hips, ribs, shoulders, knees, ankles, and feet. 

The earliest symptoms usually start in the low back at the sacroiliac (SI) joints. These joints are located at the base of the spine, where it meets the pelvis. Over time, the pain travels up the spine to other areas of the body. People with AS have axial disease, which includes spine, shoulders, and hips. They also have enthesitis (inflammation of the entheses, where tendons and ligaments attach to bone), such as Achilles tendinitis.

Nervous System

AS can cause nervous system problems. In severe cases, scar formation can occur in the spine and affect the nerves at the base of the spine. This leads to changes in urinary and bowel control. It may also lead to sexual dysfunction as well. 

AS Eye Inflammation

Inflammation in the body due to AS can put pressure on the optic nerve, a nerve in the back of the eye that sends messages from the retina to the brain. This can lead to eye and vision problems like glaucoma. Glaucoma can cause a loss of peripheral (side) vision over time.

People with ankylosing spondylitis are also at risk of cataracts. Cataracts cause the lens of the eye to become cloudy. People with an inflammatory condition are at an increased risk of cataracts. Uveitis and iritis are common ocular manifestations of AS.

Respiratory System

While it is not common, some people with AS may notice trouble breathing. This can occur as the spine curves forward, putting pressure on the lungs. 

People with AS may also experience stiffening of the chest wall, which makes taking a deep breath difficult. Those with severe disease may also have lung scarring that leads to shortness of breath and an increased risk of respiratory infections.

Circulatory System

People with AS are at an increased risk of heart disease. A study found that 14.1% of people with ankylosing spondylitis had ischemic heart disease, compared to 6.36% without AS. 

The increased risk of heart disease has several factors, such as high blood pressure (hypertension), high cholesterol, high triglycerides, diabetes, and smoking. Most inflammatory diseases like AS raise the risk of heart disease from the inflammation that develops. 

In addition, people with AS often have trouble sticking with an exercise plan due to pain and stiffness. Physical activity has been proven to lower the risk of heart disease.

Hair, Skin, and Nails

Ankylosing spondylitis often causes hair, skin, and nail changes because of inflammation. Rashes are common in people with ankylosing spondylitis.

One of the most common skin problems in people with AS is psoriasis. Psoriatic arthritis and AS are forms of inflammatory arthritis. People with psoriasis often experience scaly, red patches of skin on the elbows, knees, palms, and scalp. The patches are often itchy and painful. 

Mental Health

AS causes chronic pain, and being in pain can lower your quality of life. One study found that having a high level of pain can impair a person’s daily functioning by more than 50%. It also found that chronic pain can lead to severe psychological distress, leading to depression and anxiety.

The more severe your disease is, the more your mental health is affected. A study found that people with ankylosing spondylitis had a 2.21 times greater risk of depression than those without the disease. 


Ankylosing spondylitis is arthritis that causes inflammation in the joints and ligaments in the spine. This inflammation leads to stiffness and pain in the back, hips, ribs, shoulders, knees, ankles, and feet. In addition to pain, AS can cause symptoms in several other body systems. Many people with ankylosing spondylitis experience trouble breathing, vision changes, fatigue, skin rashes, and loss of appetite.

A Word From Verywell 

Being diagnosed with ankylosing spondylitis is a life-changing experience, and you may feel overwhelmed by all the developments. The most common symptoms of ankylosing spondylitis are pain and stiffness. If you notice other body changes, talk with your healthcare provider. Even though your symptoms may not seem related to your disease, AS affects almost every area of the body. 

Frequently Asked Questions

  • Where does ankylosing spondylitis start?

    Pain and stiffness from ankylosing spondylitis often start in the lower back at the sacroiliac (SI) joints where the spine meets the pelvis. From there, pain and stiffness can travel up the spine and to other body areas.

  • What causes ankylosing spondylitis?

    The exact cause of ankylosing spondylitis in individuals is unknown. Researchers believe that genetics and environmental factors can raise the risk of the disease. Research has shown that mutations in the gene HLA-B27 are associated with ankylosing spondylitis. 

  • How is AS diagnosed?

    Ankylosing spondylitis is a complicated condition that requires a thorough workup with your healthcare team. A diagnosis usually requires a medical history, physical exam, imaging studies, and lab tests to look for inflammation and other signs of this type of arthritis. 

11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Carrie Madormo, RN, MPH
Carrie Madormo, RN, MPH, is a health writer with over a decade of experience working as a registered nurse. She has practiced in a variety of settings including pediatrics, oncology, chronic pain, and public health.