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Does Ankylosing Spondylitis Cause Fatigue

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Why does ankylosing spondylitis cause fatigue? How to overcome it?

MySpondylitisTeam is the social network for people with spondylitis and their loved ones. On MySpondylitisTeam, more than 64,000 members come together to ask questions, give advice, and share their stories with others who understand life with spondylitis.

Do you have spondylitis and numbness or weakness in your legs? Share your experience in the comments below, or start a conversation by posting on MySpondylitisTeam.

How Spondylitis Causes Numbness Or Weakness In The Legs

Different types of spondylitis produce inflammation in the spine and other areas of the body. Inflammation and compression of the spine may have an impact on nerves along the spinal cord and produce feelings of numbness or weakness in the legs.

The location of inflammation or damage along the spine and spinal cord may predict the type and severity of symptoms and whether its in the arms or the legs, or both. For example, degeneration of soft tissue in the neck may cause weakness and a reduction in fine motor skills.

Spine specialists and rheumatologists use diagnostic tools like physical exams, X-rays, magnetic resonance imaging tests, computed tomography scans, electromyogram , nerve conduction studies , and blood tests to isolate the location of the spine damage and recommend treatments that could help alleviate symptoms like weakness and numbness.

Symptoms Of Spondylitis Fatigue

While lack of energy is the primary feeling, spondylitis fatigue encompasses many other symptoms, including mood-related disorders not typically associated with normal exhaustion. They include:

  • Sleep deprivation
  • Feelings of failure, lack of confidence
  • Difficulty concentrating or making decisions

A rheumatologist can diagnose whether your symptoms are a response to overexertion or an indication of underlying disease.

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Neurological Complications: Cauda Equina Syndrome

Rarely, people with advanced ankylosing spondylitis may have problems resulting from the scarring of the bundle of nerves at the base of the spine, called cauda equine syndrome. This condition can have a significant impact on a persons quality of life, and can cause urinary retention and/or incontinence, loss of bowel control, sexual dysfunction, and problems causing pain and weakness of the legs. If you have long-standing AS and are suffering with some of these symptoms, your rheumatologist will be able to refer you to a neurologist for consultation.

Not Sleeping Well At Night

Pin on Ankylosing Spondylitis

This is often caused by uncontrolled pain, stiffness, inability to get comfortable, etc. Here again it is important to identify the particular causes of sleeplessness, and treat them appropriately. When symptoms such as pain and stiffness are appropriately treated, sleep often improves, and fatigue diminishes.

Besides causing fatigue, not sleeping well can also increase pain, creating a feedback loop of pain causing sleeplessness, which then causes more pain, and so on. For this reason effective pain management is crucial in addressing fatigue. Other things to help bring about better sleep include slowly increasing physical activity which can help by tiring the body, helping with stiffness and pain, as well as reducing inflammation. Practicing good sleep hygiene is also important. This includes avoiding caffeine and other sleep disruptive foods or drinks late in the evening, establishing a regular and relaxing bedtime routine, creating a comfortable and calming sleep environment, and considering the use of items to block out light and disruptive noises if needed.

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Stay On Top Of Your Meds

You probably saw this coming: The number-one thing people with AS can do to fight fatigue is to stick with their treatment and follow up with their rheumatologist as needed. If the condition is not controlled, then symptoms are not controlled, and fatigue is one of them, says Amro Balki, M.D., a rheumatologist at Providence Saint Johns Health Center in Santa Monica, CA. The good news? When they finally find the right medication, for the most part fatigue is controlled, he says. So if youre taking your meds and youre still struggling to get off the couch, tell your doctor.

Ankylosing Spondylitis And Leg Weakness

Ankylosing spondylitis is a type of axSpa that mainly affects the spine and sacroiliac joints, where the pelvis meets the spine. Symptoms of ankylosing spondylitis are different from person to person. Some people will only experience spine damage and back pain. Other people may experience pain in any area where tendons attach to bones, like the knees and heels.

When ankylosing spondylitis is severe, it may cause weakness, numbness, or tingling in the legs. Rarely, people with ankylosing spondylitis may develop a complication called cauda equina syndrome. In this condition, weakness, tingling, or numbness in the legs and feet result from swelling and pressure on the bundle of nerve roots at the end of the spinal cord . Cauda equina syndrome is a serious condition and should be treated immediately.

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Ankylosing Spondylitis And Fatigue

Ankylosing spondylitis is known for complications related to inflammation of the spine.

While the pain and discomfort may disrupt your daily activities, you could be contending with another debilitating side effect: fatigue.

According to the National Ankylosing Spondylitis Society, fatigue is one of the most common concerns among AS patients. The inflammatory process of AS can lead to fatigue.

Keep reading to learn whats causing your fatigue and how to stop it in its tracks.

Why As Flares Happen

Ankylosing spondylitis – Low back pain in the morning, symptoms and treatment

There are many possible causes. More inflammation is partly to blame. Other things could play a role too.

You may feel worse because of conditions you might have in addition to AS. Or you might have an injury. A weather change could even be the cause. And a flare might mean that in some way, your treatment isnât working well enough.

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How Is Fatigue Assessed

Fatigue is assessed by a doctor during a physical exam and symptom history. Doctors may use a tool, such as the Bath Ankylosing Spondylitis Disease Activity Index , which measures well-being and how someone’s life is impacted by AS.2 Patients who are experiencing fatigue should tell their doctors how often they experience fatigue and what effect it has on their daily functioning and activities.

When To Seek Medical Advice

You should see your GP if you have persistent symptoms of AS.

If your GP thinks you may have the condition, they should refer you to a specialist in conditions affecting muscles and joints for further tests and any necessary treatment.

Further tests may include blood tests and imaging tests.

Read about diagnosing ankylosing spondylitis.

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Comparison Of Severe Versus Low Fatigue Patients

Comparison of patients with severe versus low fatigue states revealed that these factors were significantly higher in the severely fatigued subset: enthesitis, arthritis, acute-phase measures , ASDAS-CRP, total BASDAI, BASDAI inflammation, BASDAI spinal pain, BASDAI arthralgia, BASDAI enthesitis, BASFI, HAQ, ASQoL, and age . SF-36 mental component summary , SF-36 physical component summary , and EQ-5D indices were significantly higher in the low fatigue group . Between the groups, there were no differences in sex, disease duration, anemia, uveitis, inflammatory bowel disease, mSASSS, or TNFi use .

Other Symptoms Associated With Ankylosing Spondylitis

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Ankylosing spondylitis is a systemic diseaseit affects the whole bodyand pain is not the only symptom. Other symptoms include:

Unexplained fatigue. This body-wide fatigue can be overwhelming and last for days, regardless of how much sleep a person gets.

Fever. A persistent low-grade fever may occur as a result of the body-wide inflammation.

General feeling of illness. Some people report feeling unwell or not quite right.

Weight loss and/or loss of appetite. The inflammation may cause people to lose their appetite and lose weight, similar to when having a cold or flu.

Swollen fingers or toes. Dactylitis, the medical name for swollen fingers or toes, can be a sign of ankylosing spondylitis or another type of a spondyloarthritis.

Vascular disease. Experts estimate people with ankylosing spondylitis are 36% more likely to die from vascular disease than the general population.2 Vascular disease includes:

  • Cardiovascular disease, which affects the heart and increases the risk of heart attacks.
  • Cerebrovascular disease, which affects the brain and increases the risk of stroke.

Pulmonary disease. Anyklosing spondylitis can affect the rib cage and the lungs making breathing difficult or uncomfortable.

People with ankylosing spondylitis may experience none, one, or all of these symptoms. Symptoms may come and go and tend to lessen with treatment.

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Functional Integration: Whole Brain Resting

To explore the whole-brain inter-regional functional relationship, we constructed the brain network according to a set of 264-region-of-interest atlas derived from resting-state functional connectivity meta-analyses . The 264 nodes were input into the GRETNA as 10 mm diameter spheres. This atlas has been demonstrated to establish authentic network topologies . Utilizing a publicly available ROI atlas is conducive to the external validation of our results by other researchers and limits the possible bias in autonomously choosing independent components resulting from independent component analysis using different datasets. We then created undirected and weighted Fisher z-transformed 264 × 264 bivariate correlation matrices for every subject based on the mean signal from all 264 nodes in the atlas. The strength of a FC between 2 nodes was treated as an edge: the Fisher-transformed correlation between the average time series of 2 nodes. We then performed between-group FC analyses based on two-sample t-tests including age and sex as covariates. The significance threshold was defined at p> 0.05 with a multiple comparison correction of the false discovery rate .

Devastating Ankylosing Spondylitis Effects On The Body

Arthritis conditions are known to be painful and uncomfortable, but these diseases are most often associated with older people.

One particular type of arthritic condition, however, has been linked to younger children and adolescents. This arthritic condition, which is classified as a rheumatic and autoimmune disorder, is known as Ankylosing Spondylitis.

Parents need to understand what is Ankylosing Spondylitis. Knowing about the symptoms of Ankylosing Spondylitis help parents understand what to look for and when to take action.

When diagnosed at a younger age, it is usually referred to as Juvenile Ankylosing Spondylitis.

The disorder can cause many unpleasant symptoms to develop and may also lead to deformities in certain parts of the body. The physical symptoms of Ankylosing Spondylitis can soon have a patient struggle dealing with mental illness, due to the limitations that it causes.

Thus, early intervention is very important. In this post, we will look at the Ankylosing Spondylitis effects on the human body.

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Functional Separation: Nodal Properties

Graph theoretical measures can reflect not only brain network functional integration, but functional separation based on nodal indices . On the basis of FC analyses, we obtained a 264 x 264 matrix for each participant. Next, we need to set the network sparsity . Because network sparsity has a fundamental impact on topological measures, reasonable network thresholding is necessary to guarantee appropriate network comparisons among different subjects and cost thresholds . We analyzed the nodal indices across a series of cost thresholds , and the resulting area under the curve analysis was completed on node metrics across all sparsity thresholds. The AUC analysis reflects the curves of topological measure changes varied as the function of sparsity. The detailed analysis method was described using GRETNA toolbox.

Briefly, nodal degree centrality represents the number of connections to a given node and reflects a nodes accessibility, and nodal betweenness centrality embodies the important roles of nodal communication across a given node as the bridge . On the basis of the AUC value of each node, we conducted comparisons to identify the differences in nodal degree and betweenness centrality between HC and AS patients. Group differences were tested based on two-sample t-test with FDR correction . These analyses were conducted in GRETNA. Connectome figures were presented by BrainNet Viewer 1.7 .

How Does Ankylosing Spondylitis Cause Fatigue

Ankylosing spondylitis – causes, symptoms, diagnosis, treatment, pathology

There are several ways AS can cause fatigue. The chronic inflammation caused by AS not only affects the joints but also affects the whole body. Inflammation causes a release of cytokines , and cytokines may cause fatigue. In addition, the body uses energy to deal with the inflammation, leaving less available energy overall.1,3

Dealing with the chronic pain of AS can make it difficult to sleep comfortably, adding to a sense of fatigue, and living with a chronic condition like AS increases a person’s risk for depression, which also causes fatigue as a symptom. Chronic diseases like AS also increase the risk of developing anemia of chronic disease , which can lead to fatigue.1,3

Some medications used to treat AS may cause fatigue as a side effect and worsen the symptom of fatigue experienced by people with AS.

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Pay Attention To Your Mental Health

Living with a chronic condition that packs pain and fatigue can make you feel like youre missing out on life, which can leave you feeling depressed at times. And, unfortunately, depression can make it harder to fall asleep, or it can make you sleepy during the day. And those sleep problems, in turn, can make your depression worse! Seek out help if youre feeling down or depressed. Your primary healthcare provider can suggest the right type of therapy for you, which could include a support group for people with AS.

Social And Employment Problems

While having AS should not have any direct impact on employment, being unable to work for long periods may make gaining or keeping a job more difficult. The disorder can also affect a persons social and public life as it progresses.

Over time, AS can affect the type of work a person can do, especially physical labor. Some may be unable to work for long period, while others may not be able to work at all.

It is important for people with AS to learn to sit correctly and keep good posture. As the symptoms often improve with movement, people should take regular stretch breaks.

A persons social life can also be affected by AS. People experiencing chronic pain may be less likely to visit friends, and may find that they are facing symptoms of isolation and depression.

It is important for people to stay active and keep up with a regular treatment plan to help reduce symptoms and promote feelings of well-being as much as possible.

Most of the common complications caused by AS are treatable. There are, however, some very rare complications of AS. These include:

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Secondary Analysis: Association With Other Clinical Indices

We also explored the association between the significant FC or nodes found in our primary analysis and the other clinic indices collected . Our results were as follows: the FC between nodes 208 and 115 was moderately correlated to BASDAI the GMV of putamen was weakly associated with BASDAI, which did not pass the multiple correction and the GMV decrease of node 115 was weakly associated with ESR, and also did not pass multiple correction .

Table 4. Secondary analysis: association with other clinic indices.

Increased Risk For Spinal Fractures


For a patient with advanced ankylosing spondylitis, autofusion of the spines motion segments can lead to long levers of fused spinal segments that increase stress in the spine. This is especially important with traumatic events or falls. Stress concentrates through the stiff segments and fractures can occur. In particular, the disc space is the weakest area and most vulnerable to fractures.

Even after a minor trauma, an ankylosing spondylitis patient in pain must be thoroughly evaluated to avoid missing fractures. CT scans are indicated to identify the fractures and surgical stabilization is often required to prevent neurologic injury.

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Coping With Fatigue Associated With Autoimmune Disease

The inflammatory response associated with autoimmune conditions and arthritis is systemicmeaning it affects the whole body. These conditions can cause a variety of symptoms, including pain, swelling, stiffness, loss of joint functionand fatigue. In fact, fatigue is one of the most commonand frustratingsymptoms.

General Condition Of The Patients

According to , among the 120 AS patients, 104 were male, and 16 were female. The patients ages ranged from 18 to 66 years old, with a mean age of 36.4 ± 10.5 years. Overall, the MAF-degree, MAF-severity, and MAF-timing fatigue scores in AS patients in the previous week were significantly higher than those in healthy controls .

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Inflammation Where The Ligaments Attach To The Bone

Inflammation of the entheses, where joint capsules, ligaments, or tendons attach to bone, is a hallmark of spondyloarthritis . This can be felt in multiple areas of the body, where doctors can check for pain and tenderness.

The sites are sometimes referred to as hot spots. They can lead to swelling and tenderness along the back, pelvic bones, sacroiliac joints, the chest, and the heel. The heel can be significantly affected, and the pain and tenderness can have a serious impact on a persons mobility. The two areas of the foot that can be affected are the Achilles tendon, at the back of the heel and the plantar fascia, at the base of the heel.

Neck Pain From Ankylosing Spondylitis

How to conquer the fatigue of ankylosing spondylitis?

Ankylosing spondylitis is a form of arthritis that can cause flares of burning pain in the spine. It typically develops in the lower back and hips but gradually progresses up toward the neck over time. Some people may go years and only deal with occasional episodes of intense spinal pain. Others might have frequent flare-ups as the disease continues to spread and get worse.

Enthesitis, the inflammation of ligaments or tendons where they attach to bone, can occur in the cervical spine at the facet joints and intervertebral discs. ReadAnkylosing Spondylitis

While neck pain is not the first symptom to appear with ankylosing spondylitisand sometimes never developsit can be a troubling symptom, as it typically appears when the disease has become more advanced.

This article examines how to tell when neck pain may be caused by ankylosing spondylitis and how it can be treated.

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