Can Neck Pain Be a Symptom of Ankylosing Spondylitis?

Ankylosing spondylitis is a form of arthritis that causes joint inflammation, pain, and stiffness. Though ankylosing spondylitis most often affects the lower back, it can sometimes also affect the neck. This causes deep, achy pain that worsens with a lack of movement.

This article will discuss how ankylosing spondylitis causes neck pain and ways to treat your symptoms.

Man with neck pain

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What Is Neck Pain?

Neck pain is any type of discomfort that comes from the structures within your neck, which include muscles, tendons, ligaments, nerves, and the vertebrae bones of the cervical spine. Symptoms of neck pain can vary in intensity from sharp, shooting pain to a dull ache. 

Other symptoms that often occur alongside neck pain include neck tightness and stiffness. Sometimes numbness and tingling can also occur and radiate down into the shoulders and arms. 

If you are experiencing severe neck pain, headache, dizziness, nausea, chest pain, difficulty breathing, neck swelling, or paralysis, seek emergency medical help or call 911 immediately.

Is Neck Pain a Symptom of Ankylosing Spondylitis?

Though ankylosing spondylitis most often affects the low back, joint inflammation, pain, and stiffness can travel higher up the spine to also affect the neck. This includes the craniocervical junction, the area where the first and second vertebrae of the neck connect to the skull.

Because this area of the neck is capable of the most movement and provides stability to the head and neck, inflammation can cause significant neck stiffness, decreased range of motion, instability, and nerve compression.

As an autoimmune condition, ankylosing spondylitis causes inflammation throughout the body when the body produces antibodies that attack its own joints. Though the exact cause is not fully understood, genetics and environmental triggers influence the development of ankylosing spondylitis. Specifically, ankylosing spondylitis can cause neck pain from:

  • Joint inflammation that affects the cervical vertebrae of the neck, resulting in pain and stiffness
  • The hardening of ligaments that connect the cervical vertebrae of the neck
  • An increased risk of fracturing the cervical vertebrae of the neck due to a decrease in bone density from persistent inflammation

Treatments and Management of Neck Pain

Medication is one of the most important treatment options for managing neck pain caused by ankylosing spondylitis. Biological disease-modifying anti-rheumatic drugs (DMARDs) and tumor necrosis factor (TNF) inhibitors are medications often prescribed for patients with ankylosing spondylitis and other autoimmune conditions to reduce joint pain and inflammation throughout the body. These medications reduce the activity of your immune system, which helps prevent your body from attacking its joints, including the cervical vertebrae of your neck.

You can perform additional treatment options at home to help manage your symptoms, including:

  • Heat to loosen and relax tight muscles and stiff joints
  • Cold therapy to decrease inflammation, swelling, and pain 
  • Gentle stretching of your neck muscles to improve your flexibility, decrease joint stiffness, and improve your ability to move your neck
  • Using a supportive pillow to sleep to keep your head and neck in good alignment

Because ankylosing spondylitis weakens bone density, fractures may occur, especially in the lower cervical spine. Rounding of the back and rigidity can also contribute to fracture risk. This can be especially dangerous if a fracture causes the vertebrae bones to shift and contact the spinal cord or nerves of the neck.

Fractures of the vertebrae of the cervical spine necessitate surgery to insert metal rods and screws to stabilize your neck. You will typically also need a neck brace to provide further stability as your neck heals from surgery.

When to See Your Healthcare Provider

If you have been experiencing ongoing neck pain, stiffness, and a decreased range of motion that has worsened over time or has not gone away, contact your healthcare provider. Joint pain and inflammation from ankylosing spondylitis that affects the neck may indicate condition progression requiring a change to your treatment regimen to decrease your body’s autoimmune response.

If you experience any of the following symptoms, call 911 because these issues require emergency care:

  • Severe neck pain
  • Headache
  • Dizziness
  • Nausea
  • Chest pain
  • Difficulty breathing
  • Neck swelling
  • Radiating pain in the arms
  • Paralysis


Joint pain, inflammation, and stiffness most commonly affect the spine of the lower back in people with ankylosing spondylitis. Sometimes the cervical spine of the neck can also be affected, resulting in neck pain and other symptoms like joint stiffness and muscle tightness. Treatment for neck pain from ankylosing spondylitis involves disease-modifying anti-rheumatic drugs (DMARDs) and tumor necrosis factor (TNF) inhibitors as well as at-home methods like heat, ice, and stretching. For cervical spine fractures that can occur with ankylosing spondylitis, emergency surgery and bracing will be necessary to stabilize your neck as your fracture heals to prevent damage to your nerves and spinal cord. 

A Word From Verywell

Joint pain from ankylosing spondylitis often worsens with inactivity, so regular movement and exercise can help alleviate some of your pain by reducing joint stiffness and muscle tightness. Maintaining good posture can also help reduce the strain on your neck. Consider consulting a physical therapist to help guide you with exercises to reduce your neck pain and improve your posture and the alignment of your neck and shoulders.

4 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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  2. Korb C, Awisat A, Rimar D, et al. Ankylosing spondylitis and neck pain: MRI evidence for joint and entheses inflammation at the craniocervial junction. Isr Med Assoc J. 2017 Nov;19(11):682-684

  3. Mehkri Y, Lara-Velazquez M, Fiester P, Rahmathulla G. Ankylosing spondylitis traumatic subaxial cervical fractures - An updated treatment algorithm. J Craniovertebr Junction Spine. 2021 Oct-Dec;12(4):329-335. doi:10.4103/jcvjs.jcvjs_131_21

  4. Lazennec JY, d'Astorg H, Rousseau MA. Cervical spine surgery in ankylosing spondylitis: Review and current concept. Orthop Traumatol Surg Res. 2015 Jun;101(4):507-13. doi:10.1016/j.otsr.2015.02.005

By Kristen Gasnick, PT, DPT
Kristen Gasnick, PT, DPT, is a medical writer and a physical therapist at Holy Name Medical Center in New Jersey.