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Spondylitis and Numbness or Weakness in Legs

Posted on June 09, 2021
Medically reviewed by
Ariel D. Teitel, M.D., M.B.A.
Article written by
Elizabeth Wartella, M.P.H.

Spondylitis is a condition that may cause symptoms such as numbness or weakness in the legs.

As a rheumatic and autoimmune disease, symptoms of spondylitis occur when the immune system attacks its own tissue and joints, mainly in the spine, leading to inflammation. The most common symptom of spondylitis is lower back pain. However, symptoms like neck pain, hip pain, leg pain, numbness, and weakness in the legs may occur. Experiencing numbness, tingling, and weakness accompanied by severe head, neck, or back pain requires immediate assessment by a physician. Other cases may be less serious.

Here’s what to know, including why you may be experiencing numbness, tingling, or weakness in your legs as well as how to manage these bothersome symptoms.

What Spondylitis-Related Numbness or Weakness in the Legs Feels Like

Sensations such as numbness and weakness in the legs or arms, which some but not all people with spondylitis experience, may be bothersome and concerning.

Numbness and weakness range in severity, from light feelings of tingling, like “pins and needles,” to complete numbness and immobility, according to MySpondylitisTeam members. These symptoms may affect just a portion of the legs or feet or may affect the entire body from the hips down.

“There are times where I can’t feel my legs … no feeling from the waist down,” said one member. Another member described the sensations like “electric shocks,” adding, “My hands and feet are throbbing and numb.”

One member talked about the progression of feelings of tingling and numbness. “My left side is mostly all numb (but I can still feel pain), and now my right side is going numb,” they said. “It starts with pins and needles, then goes numb and becomes almost totally nonfunctional.”

These symptoms affect the functionality of the limbs and might have an impact on your physical and mental health. If symptoms are severe, they may affect your ability to perform daily activities like driving or walking.

How Spondylitis Causes Numbness or Weakness in the Legs

Different types of spondylitis produce inflammation in the spine and other areas of the body. Inflammation and compression of the spine may have an impact on nerves along the spinal cord and produce feelings of numbness or weakness in the legs.

The location of inflammation or damage along the spine and spinal cord may predict the type and severity of symptoms and whether it’s in the arms or the legs, or both. For example, degeneration of soft tissue in the neck (cervical spine) may cause weakness and a reduction in fine motor skills.

Spine specialists and rheumatologists use diagnostic tools like physical exams, X-rays, magnetic resonance imaging (MRI) tests, computed tomography (CT) scans, electromyogram (EMG), nerve conduction studies (NCS), and blood tests to isolate the location of the spine damage and recommend treatments that could help alleviate symptoms like weakness and numbness.

Axial Spondyloarthritis and Leg Weakness

Axial spondyloarthritis, or axSpa, is a type of spondylitis characterized by chronic back pain. As compared to peripheral spondyloarthritis, axSpa includes types of spondylitis that mainly affect the spine and pelvis.

Inflammation due to axSpa may lead to damage or deterioration of the soft tissue between spinal columns and compression of the spine. To accommodate for the loss of soft tissue, abnormal bone growths (bone spurs) may develop. Bone spurs can create undue pressure on the spine, which may cause feelings of weakness, numbness, and tingling, with or without pain, in the limbs.

People with axSpa may also experience neuropathic pain — pain caused by damage to the nervous system. This type of pain is characterized by sudden, sometimes spontaneous sensations like stabbing and burning, and tingling or numbness. A study by the Journal of Clinical Rheumatology estimated that about one-third of people with axSpa experience some degree of neuropathic pain.

Ankylosing Spondylitis and Leg Weakness

Ankylosing spondylitis is a type of axSpa that mainly affects the spine and sacroiliac joints, where the pelvis meets the spine. Symptoms of ankylosing spondylitis are different from person to person. Some people will only experience spine damage and back pain. Other people may experience pain in any area where tendons attach to bones, like the knees and heels.

When ankylosing spondylitis is severe, it may cause weakness, numbness, or tingling in the legs. Rarely, people with ankylosing spondylitis may develop a complication called cauda equina syndrome. In this condition, weakness, tingling, or numbness in the legs and feet result from swelling and pressure on the bundle of nerve roots at the end of the spinal cord (called the cauda equina). Cauda equina syndrome is a serious condition and should be treated immediately.

How To Manage Spondylitis-Related Numbness or Weakness in the Legs

Symptoms like numbness and weakness in the legs can be distressing and interfere with daily life. Although there is no cure for spondylitis, there are non-surgical treatments and methods to help manage symptoms, including numbness or weakness.

Spondylitis treatment should help to alleviate symptoms such as numbness or weakness in the legs. Treatment options for spondylitis include medications, physical therapy, lifestyle interventions, or surgery in severe cases.

Medications

Medications won’t directly target symptoms like numbness and weakness. However, medications that aim to reduce spondylitis-related inflammation may help with weakness and numbness that result from inflammation.

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen are used to treat spondylitis-related inflammation, and they help with pain relief.

If NSAIDs don’t work to address inflammation and its symptoms, drugs called biologics may be used. Tumor necrosis factor (TNF) blockers, a type of biologic, are recommended for first-line treatment. Biologic drugs called interleukin-17 (IL-17) inhibitors like Cosentyx (secukinumab) or Taltz (ixekizumab) may also be used.

Severe pain is sometimes addressed with steroid injections such as prednisone.

Exercise and Stretching

The Spondylitis Association of America (SAA) notes that exercise is an important part of treating and managing symptoms of spondylitis. Exercise can help alleviate spine and joint stiffness and help people with spondylitis maintain their flexibility, coordination, and mobility.

Exercise may be difficult when experiencing symptoms like weakness and numbness in the legs, but periods of inactivity could make inflammation, swelling, and pain even worse. Exercise will likely help alleviate symptoms.

The four types of exercise recommended for people with spondylitis, as noted by the SAA, include:

  • Range-of-motion exercises or stretching
  • Cardiovascular (aerobic) exercise
  • Strength exercises
  • Balance-promoting exercise

Range-of-motion and stretching exercises are performed without weights and encourage the body to express its full range of motion. This type of exercise improves mobility and flexibility and can help reduce pain in inflamed joints and bones. It also serves as a good method for preserving mobility and reducing the risk of joint fusion.

“I find that stretching and exercise help me to feel ‘normal’ again,” wrote one MySpondylitisTeam member.

Cardiovascular exercises increase blood flow through the body and the heart, and help people with spondylitis to have better breathing, improved mood, and less pain and fatigue.

Strength exercises can be performed with body weight or other weights as resistance, and they aim to strengthen muscles. People with spondylitis may focus on strengthening affected areas like their core and back to help cope with back pain. Strengthening the core muscles can also improve posture, which helps avoid related weakness in the legs.

Finally, balance exercises help improve stability and prevent injuries for people with spondylitis who are less active. Balance exercises can also help prevent muscle fatigue.

When starting a new exercise program, consult your doctor or work with a physical therapist to help find a routine that works for you and will help you reach your goals. As exercise can help address the effects of spondylitis inflammation, it may help to reduce leg numbness and weakness in combination with medical treatment.

Heat and Cold Therapy

Treating the inflamed areas affected by spondylitis with heat and cold therapy may help to reduce inflammation and symptoms such as numbness or weakness. You can put ice packs on the inflamed area, followed by applying heat from a source like a heating pad.

“As long as I use the heating pad, stay warm, get up and move around, use activities to keep my mind exercised, and take anti-inflammatory meds … I stay ahead of the discomfort,” wrote one MySpondylitisTeam member.

Stress Management

Stress, anxiety, and other mental health conditions can worsen spondylitis pain. Reducing and managing stress levels could help address spondylitis symptoms. There are many different ways to manage stress, like meditation, yoga, tai chi, and relaxation exercises, for pain relief.

Talk With Others Who Understand

MySpondylitisTeam is the social network for people with spondylitis and their loved ones. On MySpondylitisTeam, more than 64,000 members come together to ask questions, give advice, and share their stories with others who understand life with spondylitis.

Do you have spondylitis and numbness or weakness in your legs? Share your experience in the comments below, or start a conversation by posting on MySpondylitisTeam.

References

  1. Red Flags and Spine Emergencies — Denver Back Pain Specialists
  2. Overview of Types of Spondylitis — Spondylitis Association of America
  3. Ongoing Numbness, Tingling, or Weakness Could Mean a Spinal Compression in Your Neck — Norton Neuroscience Institute
  4. Neuropathic Pain in Axial Spondyloarthritis — Spondylitis Association of America
  5. Neuropathic Pain Component in Axial Spondyloarthritis and the Influence on Disease Burden — Journal of Clinical Rheumatology
  6. Overview of Ankylosing Spondylitis - Spondylitis Association of America
  7. Most Common Symptoms — Spondylitis Association of America
  8. Ankylosing Spondylitis — Mayo Clinic
  9. Complications of Severe Ankylosing Spondylitis — Arthritis-Health
  10. Cauda Equina Syndrome — American Academy of Orthopedic Surgeons
  11. Treatment of Spondyloarthritis — Spondylitis Association of America
  12. 2019 Update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis — Journal of Arthritis and Rheumatology
  13. Medications Used to Treat Ankylosing Spondylitis — Spondylitis Association of America
  14. Anxiety and Pain — Spondylitis Plus Newsletter — Spondylitis Association of America
Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Elizabeth Wartella, M.P.H. holds a masters in public health from Columbia University and is passionate about spreading accurate, evidence-based health information. Learn more about her here.

A MySpondylitisTeam Member said:

This is the most comprehensive article on AS that I have read. I'm saving it for reference. Like many AS sufferers, I have not gotten any appreciable relief from doctors that I have gone to. I get… read more

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