Characteristics of Pain in Ankylosing Spondylitis(AS)

Back and waist pain is the most common symptom and an indicator of disease activity of Ankylosing Spondylitis(AS). The locations of pain include lumbar pain, lower back and lumbosacral part. Ankylosing Spondylitis mainly affects the axial joints, the involvement of sacroiliac joint and lumbar spine disease is found in almost all patients. In the earlier stage, sacroiliac arthritis is generally hidden, so the early manifestations of lumbosacral pain are only discomfort or pain. The disease occurs only after fatigue, intermittent or alternating sides aches, or the disease is reflected as hip discomfort.
In some other patients, there may be traumatic or other inducing factors.
The pain occurs in lumbosacral suddenly, and can become very severe, making the patients unable to move. The pains is also sometimes accompanied by fever, and will get better after a rest for a few days. The pain can be alleviated or disappear. This situation can be repeated or may be worsened gradually. In the initial stage, the pains are located in the lumbosacral area. Severe pains may radiate to the iliac crest, ischial tuberosity and rear thigh. Coughing , sneezing, bending and other movements can suddenly worsen the pains.
With the further deterioration of disease, pains or intermittent pain will become persistent. Maintaining a posture in the early morning or for a long time usually cause stiffness in the lower back, and the pains will aggravate. Some patients are afraid of wind and cold, and the pains worsen after suffering from cold or dampness. In severe cases, the patients can’t get out of the bed and have difficulty turning around. Nocturnal rest pain is one of the indicatiors of disease activity.
In general, having rests will not relieve lower back pain or stiffness, but appropriate activities can alleviate the symptoms, which is the characteristic of inflammatory back pain and can be distinguished from mechanical waist pains. In the latter, activities or labor can worsen the symptoms, while resting can aggravate symptoms. But when the pain is so severe that not the patients can not move, this characteristic of Ankylosing Spondylitis(AS) is often overshadowed. So it needs to be carefully identified.

Some patients don’t pay attention to mild pains or discomfort. The patients only show a stiff lower back pain or lumbar pain, and tenderness or paravertebral is easily mixed with polymyalgia rheumatica , muscle fasciitis, fibrositis neuralgia pain or mental confusion. Pains in Ankylosing Spondylitis seldom rediate to joints below the knees.

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