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AS Neurologic Symptoms

• Low back pain and stiffness gradually increase over 3 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
     
• Approximately 25% of persons with AS experience proximal joint (hips, knees) involvement. Rarely, persons with AS may complain mostly of small joint (ankles, toes [metatarsophalangeal joints]) involvement. Arm joints are rarely involved.



• Persons 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.