Spondylitis symptoms are caused by inflammation as the body’s immune system attacks its own tissues. The more active the disease is, the more inflammation increases, and the worse symptoms become. Spondylitis is a progressive disease. Without treatment, spondylitis symptoms tend to worsen and lead to joint damage.
The primary symptom of spondylitis is pain caused by inflammation. Spondylitis pain generally worsens when you are immobile for long periods of time – such as overnight during sleep – and improves when you are physically active.
Where and how the pain is experienced depends on where the disease is active in your body. Joint pain – especially in the spine, neck, and hips – is the most common type of pain reported, but other parts of the body may become affected by inflammation.
Spondylitis can cause inflammation and pain in many parts of the body. Spondylitis most typically involves pain in joints and eyes. Spondylitis pain most commonly affects:
Spondylitis can cause stiffness and muscle weakness or spasms. These issues can contribute to motor problems such as poor balance, trouble breathing, difficulty walking, limited range of motion, and trouble swallowing. Progressive damage to the spine can lead to ankylosing (fusing) of the vertebrae and posture changes, including kyphosis – rounding of the back.
Spondylitis also causes general symptoms that involve the whole body such as fatigue, depression, anxiety, and problems sleeping. Chronic fatigue is caused by inflammatory processes in the body. Depression and anxiety are common in spondylitis and all chronic illnesses.
Many people with spondylitis report cognitive symptoms, or “brain fog,” such as memory issues and trouble finding the right word.
Some spondylitis symptoms may depend on which type of spondylitis a person has. For instance, those with enteropathic spondyloarthritis experience bowel inflammation and other gastrointestinal problems. People with psoriatic arthritis are likely to have an inflammatory skin rash in addition to joint pain. Those who have psoriatic or reactive arthritis often experience dactylitis, or “sausage digits” — swollen fingers or toes.
Less common spondylitis symptoms include heart arrhythmias and neuropathy (numbness or tingling sensation).
Studies show that people with spondylitis have a significantly higher rate of fatal cardiovascular disease than people without spondylitis. Inflammation caused by spondylitis may increase the risk for cardiovascular diseases such as hypertension (high blood pressure), heart failure, heart attacks, and stroke.
Other studies have found that the risk for cardiovascular disease is lowered in people with spondylitis when they take statins, a class of medications that lower cholesterol and fight inflammation.
Those with spondylitis have an increased risk for osteoporosis — weak and brittle bones — that may lead to painful and debilitating fractures.
People who take high levels of nonsteroidal anti-inflammatory drugs (NSAIDs) such as meloxicam (Mobic) and ibuprofen (Advil) long-term have a higher risk of developing both heart and gastrointestinal problems.
Most people experience their first spondylitis symptoms before age 45, typically in the 20s or 30s.
The most common early symptom include chronic pain in the lower back. Others may include pain in other joints, fatigue, and skin changes.
Researchers have not yet agreed upon how to define remission in cases of spondylitis, so it is not yet possible to estimate what percentage of people achieve remission. More clinical studies are needed. However, some people treated with nonsteroidal anti-inflammatory drugs (NSAIDs) or biologic drugs are able to significantly reduce their spondylitis symptoms. Symptoms of axial spondyloarthritis — spondylitis that affects the axial skeleton (spine, neck, ribs, and hips)— generally don’t disappear spontaneously (on their own, without treatment).