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Ankylosing Spondylitis, Neurologic Perspective (cont.)

Ankylosing Spondylitis Neurologic Symptoms

  • Low back pain and stiffness gradually increase over three or more months. The pain is usually described as follows:
    • Worse in the morning with improvement during the day
    • Better with activity and worse with inactivity (This finding helps in distinguishing AS from mechanical low back pain.)
    • Gradual ascending pattern from the lumbar region to the thoracic spine and then the cervical spine
    • Improves in response to anti-inflammatory medications
  • Approximately 25% of people with AS experience proximal joint (hips, knees) involvement. Rarely, people with AS may complain mostly of small joint (ankles, toes [metatarsophalangeal joints]) involvement. Arm joints are rarely involved.
  • People with AS may describe pain and stiffness of the rib cage. Breathlessness on exertion may be experienced. In long-standing disease, a small percentage of patients may develop fibrosis (scarring) in the upper lobes of the lungs.

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