Ankylosing spondylitis flare-up: Symptoms and management Health ConditionsHealth ConditionsAlzheimer's & DementiaAnxietyArthritisAsthma & AllergiesBreast CancerCancerCardiovascular HealthCOVID-19Dermatology & SkincareDiabetesEnvironment & SustainabilityExercise & FitnessEye HealthHeadache & MigraineHealth EquityHIV & AIDSHuman BiologyInflammatory Bowel DiseaseLeukemiaLGBTQIA+Men's HealthMental HealthMultiple Sclerosis (MS)NutritionParkinson's DiseasePsoriasisSexual HealthWomen's HealthDiscoverNewsLatest NewsOriginal SeriesMedical MythsHonest NutritionThrough My EyesNew Normal HealthPodcastsHow to understand chronic painWhat is behind vaccine hesitancy?The amazing story of hepatitis C, from discovery to cureNew directions in dementia researchCan psychedelics rewire a depressed, anxious brain?Why climate change matters for human healthToolsGeneral HealthDrugs A-ZHealth HubsHealth ToolsBMI Calculators and ChartsBlood Pressure Chart: Ranges and GuideBreast Cancer: Self-Examination GuideSleep CalculatorHealth ProductsAffordable Therapy OptionsBlood Pressure MonitorsDiabetic SuppliesFitness TrackersHome GymsGreen Cleaning ProductsHow to Shop for CBDQuizzesRA Myths vs FactsType 2 Diabetes: Managing Blood SugarAnkylosing Spondylitis Pain: Fact or FictionConnectAbout Medical News TodayWho We AreOur Editorial ProcessContent IntegrityConscious LanguageNewslettersSign UpFollow UsMedical News TodayHealth ConditionsDiscoverToolsConnectSubscribe What are the symptoms of an ankylosing spondylitis AS flare-up and how can a person treat them Medically reviewed by Stella Bard, MD — By Jenna Fletcher on March 30, 2022Symptoms of an AS flare-up can include fatigue, back stiffness, fever, depression, and joint pain. To treat an AS flare-up, a person can try medication, gentle exercise, and heat or cold therapy. They can also use a transcutaneous electrical nerve stimulation (TENS) machine. Share on PinterestErmanno Foti/EyeEm/Getty ImagesA person living with AS may experience frequent flare-ups throughout their life. Research from 2017 states that people may experience three flare-ups in 3 months, each lasting for up to 2 weeks. There are two main types of AS flare-ups: generalized and localized. Generalized AS flare-ups tend to be worse than localized AS flare-ups. They may cause burning pain in several joints of the body. In addition, a person will likely experience additional flu-like symptoms, tenderness, and muscle spasms. Localized AS flare-ups affect only one part of the body. The symptoms can include immobility, pain, and fatigue. This article reviews the common symptoms associated with AS flare-ups. It also looks at the treatment options available and how a person can help prevent flare-ups from occurring. Symptoms of an AS flare-up People living with AS may experience different symptoms during a flare-up. Some common symptoms include the following:fatigueback stiffness and painfeverdepressionjoint pain Fatigue Fatigue can be a sign of a flare-up and ongoing disease activity. Some experts believe that fatigue occurs due to systemic inflammation. The body has to use energy to reduce the inflammation, which then leaves a person feeling drained and having low energy. Other related causes of fatigue include pain, depression, and other factors that disrupt sleep. Back stiffness and pain AS flare-ups often come with an increase in back pain and stiffness. Pain can make resting and sleeping difficult or impossible for long periods of time. Uncontrolled pain can lead to fatigue when a person is unable to get enough sleep each night. Fever According to Creaky Joints, fever can be a symptom of a flare-up or the result of an infection. A person who develops a fever should speak with a doctor. People who take certain medications, such as biologics, have a higher risk of developing an infection. They should report any fever to a doctor so the doctor can check for the presence of an infection. Depression As many as 75% of people experience emotional symptoms during an AS flare-up, such as depression. This may be due to the physical and mental strain that pain and stiffness can put on a person. In addition, a 2020 review found that people living with AS have an increased risk of developing depression or anxiety. They noted that people with AS should talk with a medical professional about monitoring and care for any psychiatric conditions. Pain in other joints During a flare-up, a person may experience pain in joints beyond their lower back and pelvic region. Some people may have enthesitis, which is inflammation and stiffness where tendons meet bones. A person may experience pain in their:ankleskneesrib cageneck Long-term symptoms of a flare-up Many of the short-term symptoms of a flare-up can continue for a while after the flare-up. A person can also experience symptoms related to chronic inflammation from uncontrolled AS. Long-term symptoms of a flare-up can include:continuing back painstiffness and pain in other jointsdifficulty moving and with flexibilityuveitis, which is the inflammation of the middle layer of the eyegastrointestinal (GI) issuesdifficulty breathingfatiguejaw pain and stiffness Continuing back pain Continuing or chronic lower back pain can come and go over time. During a flare-up, the pain and stiffness can spike. After a flare-up, it may ease or go away entirely. However, it will eventually return. Stiffness and pain in other joints Though AS typically affects the spine in the lower back and the pelvic region, it can also affect other joints. The pain often gets worse during periods of inactivity, such as overnight or during a long stretch of sitting. Trouble moving and with flexibility The chronic inflammation associated with AS can cause damage to joints throughout the body. This can limit a person’s ability to move and their overall flexibility. Some people may also develop new bone growth in their spine that fuses portions together, further limiting their movement and flexibility. Inflammation in the eyes Up to 30% of people living with AS develop uveitis, a condition that affects the middle layer of the eye. The condition can cause pain, sensitivity to light, and redness in the eyes. GI issues About 10% of people living with AS develop inflammatory bowel disease (IBD). The two conditions share some genetic links. However, even people who do not develop IBD have a chance of developing GI symptoms such as diarrhea, bloating, and other symptoms. Trouble breathing People living with AS may develop chest pain and trouble breathing. The inflammation can affect the rib cage and make it stiffer. When this occurs, it can make breathing deeply painful or uncomfortable. Fatigue Inflammation can cause fatigue over time. The body needs to use energy to manage excess inflammation. This means a person has less energy overall and will not feel regenerated even if they get the recommended hours of sleep each night. Jaw pain and stiffness About 15% of people living with AS develop inflammation in the mouth and jaw. When it affects the jaw, a person may have trouble fully opening their mouth during activities such as eating. How long will an AS flare-up last Just as symptoms a person experiences during an AS flare-up can differ, so can the time they last. Some estimate that people living with AS experience approximately three flare-ups in 3 months. These can last up to 2 weeks at a time. Treatment and management A person should work with a healthcare professional to determine the best treatment for them. They should also consider contacting a doctor if they experience symptoms such as fever that could indicate an underlying illness. Medications, including nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are the first-line treatment. A doctor may prescribe biologics if NSAIDs do not work. Other common treatment methods for a flare-up include:cold or heat therapygentle exercisetranscutaneous electrical nerve stimulation (TENS) TENS help to block nerves from transmitting pain signals to the brain. Learn more about the effects of ankylosing spondylitis on the body and how to treat them. What causes AS flare-ups Experts do not fully understand the exact causes of AS flare-ups. Some anecdotal information suggests that possible causes could include stress, both physical and emotional, and overexertion. Excessive fatigue can also trigger AS flare-ups. Prevention A person living with AS may not be able to prevent all flare-ups. Some steps they can take to help prevent flare-ups, or to cope with them, include:taking steps to manage mental health, such as anxiety and depressionmaking plans for how to cope with a flare-up when they arisetaking time to rest during daily routinesfollowing all treatment recommendationsgetting regular exercise and eating a balanced, nutritious diet Summary AS flare-ups can cause a variety of symptoms when they first occur. They can also persist for a period of time after. Flare-ups can involve both physical symptoms, such as pain in the lower back and fatigue, as well as mental health symptoms, such as depression or anxiety. Doctors may recommend a combination of medication and therapies to help a person treat a flare-up. A person may be able to reduce their chance of having a flare-up by taking steps to manage their condition, stress levels, and fatigue. Last medically reviewed on March 30, 2022Back PainRheumatologyBones / Orthopedics 6 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Donvito, T. (2019). Ankylosing spondylitis flares: Exactly what to do when you have one.https://creakyjoints.org/about-arthritis/axial-spondyloarthritis/axspa-symptoms/ankylosing-spondylitis-flare-ups/Fatigue in spondylitis. (n.d.).https://spondylitis.org/about-spondylitis/possible-complications/fatigue-in-spondylitis/Gelman, L. (2018). 12 ankylosing spondylitis symptoms you can't afford to ignore.https://creakyjoints.org/about-arthritis/axial-spondyloarthritis/axspa-symptoms/ankylosing-spondylitis-symptoms/Jacquemin, C., et al. (2017). Patient-reported flares in ankylosing spondylitis: A cross-sectional analysis of 234 patients.https://www.jrheum.org/content/44/4/425Park, J. Y., et al. (2020). The incidence of depression and anxiety in patients with ankylosing spondylitis: A systematic review and meta-analysis. [Abstract]. https://pubmed.ncbi.nlm.nih.gov/32159073/Possible complications: How is a person affected? (n.d.).https://spondylitis.org/about-spondylitis/possible-complications/FEEDBACK:Medically reviewed by Stella Bard, MD — By Jenna Fletcher on March 30, 2022 Latest newsWhat sets 'SuperAgers' apart? 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