Can Leg Pain Be a Symptom of Ankylosing Spondylitis?

Ankylosing spondylitis (AS) is arthritis that primarily affects the spine. For some people, this disease can also cause inflammation in other joints, most commonly the hips. However, leg pain can be an indication that inflammation has spread to your knees, ankles, or joints in your feet.

This article discusses leg pain as a symptom of ankylosing spondylitis—why it happens and treatment options.

Is Leg Pain a Symptom of Ankylosing Spondylitis?

The primary symptom of ankylosing spondylitis is pain and stiffness in the lower back and/or hips. However, leg pain can be a symptom of AS if the inflammation caused by this autoimmune disease spreads to other joints.

When AS spreads to areas other than the spine, it can cause additional symptoms, including:

• Joint pain and stiffness, including prolonged morning stiffness
• Decreased range of motion
• Decreased appetite
• Skin rash
• Diarrhea
• Changes in vision
• Eye pain and redness
• Abdominal pain

Inflammation from AS can also cause swelling, redness, and warmth in the knees, ankles, and feet.

Leg pain caused by injury or other joint conditions often improves with rest. However, AS pain—in the spine or elsewhere—typically worsens when you're not moving around.

Although uncommon, AS can also cause referred symptoms—pain that is felt in the legs but is actually caused by arthritis in the lumbar spine.

Treatments and Management of Leg Pain From AS

Leg pain and other symptoms of ankylosing spondylitis are treated with a combination of medications, lifestyle habits, physical therapy, and in severe cases, surgery.

Medications

The primary treatment for pain caused by ankylosing spondylitis is the use of nonsteroidal anti-inflammatory drugs (NSAIDs). This can include over-the-counter (OTC) medications such as Advil or Motrin (ibuprofen) or Aleve (naproxen). Some people may need prescription anti-inflammatory medications, such as Celebrex (celecoxib), Indocin (indomethacin), or Zipsor, Zorvolex, Cataflam (diclofenac).

Other types of medications to treat AS symptoms can include:

• Pain relievers
• Biologics
• Disease-modifying anti-rheumatic drugs (DMARDs)
• Corticosteroids

Lifestyle Habits

Healthy lifestyle habits can help decrease leg pain and other symptoms of ankylosing spondylitis.

• Stay active: Exercise is an integral part of managing your AS symptoms. Physical activity helps increase flexibility, reduce stiffness, and improve posture. However, exercise that is too aggressive can make your symptoms worse. Try low-impact activities, such as swimming or walking.
• Quit smoking: Not only is smoking bad for your general health, but this habit can speed up damage caused by AS.
• Improve your sleep: Over 50% of people with AS also have difficulty sleeping due to pain, stiffness, and difficulty breathing. Practicing relaxation techniques, soaking in warm baths, stretching gently, and taking your medications as prescribed can all help improve your sleep.
• Eat a balanced diet: Avoid processed foods and incorporate fresh fruit and vegetables. Include healthy fats found in foods such as fish and nuts.

Physical Therapy

Physical therapy benefits people with ankylosing spondylitis, with or without leg pain. Your physical therapist can teach you helpful exercises without worsening your pain and can make positioning recommendations to improve your sleep.

If you're having difficulty with your mobility, a physical therapist can teach you to use assistive equipment, such as a cane, to improve your function.

Surgery

Surgery isn't necessary for most people with ankylosing spondylitis. However, if joint damage is severe, it might be needed.

AS causes the most damage to the spinal joints. Over time, a person can develop a deformity and become "stuck" in a bent position. In addition to causing pain, this deformity can negatively affect internal organs and make breathing difficult. Surgery is performed to stabilize the spine in an upright position.

AS can also cause severe damage in other joints, including the hips and knees. In some cases, joint replacement surgery is indicated.

Summary

Ankylosing spondylitis (AS) is an inflammatory condition that primarily causes back pain from damage to the spinal joints. AS can spread to other joints too—most commonly, the hips. However, it can also affect the knees and ankles, leading to leg pain.

Treatment includes medication, lifestyle changes, and physical therapy. In severe cases, surgery might be required.

A Word From Verywell

Managing leg pain and other symptoms of ankylosing spondylitis can be challenging. Speak with your healthcare provider about lifestyle changes, such as diet and exercise, physical therapy, or other options that may help. Know that you can find relief and live a long, healthy life.