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What are the early symptoms of ankylosing spondylitis?

Sep 08, 2025 Source: Cainiu Health
Dr. Chen Jian
Introduction
Ankylosing spondylitis is a chronic inflammatory disease primarily affecting the spine and sacroiliac joints. Its initial symptoms mainly include pain in the sacroiliac joints, morning stiffness, discomfort in the lower back, joint swelling, and changes in symptoms after physical activity. Patients should maintain proper standing and sitting postures in daily life, avoid maintaining the same posture for prolonged periods, and appropriately engage in low-intensity exercise to maintain joint mobility.

Generally, as a chronic inflammatory disease primarily affecting the spine and sacroiliac joints, the initial symptoms of ankylosing spondylitis mainly include sacroiliac joint pain, morning stiffness, lower back discomfort, joint swelling, and symptom changes after physical activity. A detailed analysis is as follows:

1. Sacroiliac Joint Pain: Sacroiliac joint pain is a typical early symptom of ankylosing spondylitis. It often presents as a dull or aching pain in the lower back, buttocks, or groin area. The pain may occur on one side or both sides simultaneously and tends to worsen after prolonged sitting or standing.

2. Morning Stiffness: Patients experience significant morning stiffness, characterized by stiffness in the lower back, spine, and joints upon waking up, making movements difficult. Simple actions such as dressing, bending over, or turning around need to be performed slowly. Morning stiffness typically lasts more than 30 minutes, and the stiffness gradually decreases after some physical activity.

3. Lower Back Discomfort: Persistent discomfort in the lower back is common during the early stages. This discomfort may manifest as aching, heaviness, or mild stabbing pain, and the intensity of the pain may progressively increase with disease progression. Pain often becomes more noticeable at night, and some patients may even wake up from sleep due to the discomfort.

4. Joint Swelling: Some patients may experience swelling in peripheral joints during the early stages, commonly affecting the hip, knee, and ankle joints. The swollen areas are often accompanied by mild pain or tenderness, and a grinding sensation or limited range of motion may occur during joint movement. Swelling typically occurs unilaterally but may also alternate between both sides.

5. Symptom Changes After Activity: Unlike common low back conditions, symptoms in patients with ankylosing spondylitis change specifically after physical activity. Mild physical activity may alleviate pain and stiffness, but excessive activity can worsen symptoms, causing significant fatigue or joint discomfort.

Patients should maintain proper posture while standing and sitting in daily life, avoid staying in the same position for long periods, and engage in appropriate low-intensity exercises to maintain joint mobility.

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