Ankylosing spondylitis (AS) commonly affects the shoulders, which may lead to shoulder pain and stiffness.
AS is a systemic disease, which means it affects more than one body system or the entire body in some people. According to the Spondylitis Association of America, it is a relatively rare condition, affecting about 1.3% of the adult population in the United States.
The condition primarily causes inflammation in the spine and sacroiliac joint, which connects the bottom of the spine to the pelvis. However, it may also cause symptoms in other areas, such as the hips, shoulders, and fingers.
This article explores shoulder pain in AS, other symptoms of AS, how to manage shoulder pain from AS, and when to speak with a doctor.
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AS primarily affects the joints in the spine and the nearby soft tissues, such as ligaments and tendons.
AS may cause pain, stiffness, inflammation, and loss of range of motion in the shoulders. Typically, only
According to a 2016 study, shoulder involvement is present in about 15% of people with AS at initial presentation, but this may reach 35% as the condition progresses. The researchers found that shoulder pain in people with AS may result from:
- bone marrow edema
- synovitis, which refers to inflammation within the layer of connective tissue that lines a joint (synovial membrane)
They also suggested that it may be possible for a person with AS to have shoulder involvement without any noticeable clinical signs.
- The age of onset is below 40 years old.
- The pain eases with exercise.
- Development is gradual.
- A person experiences stiffness in the mornings.
- The pain has been ongoing for more than 3 months.
Symptoms vary from person to person, and the condition may affect other areas of the body. Other symptoms may
- difficulty breathing deeply
- uveitis, which can lead to vision changes and eye pain
- unintentional weight loss
- loss of appetite
- psoriasis and skin rash
- inflammatory bowel disease (IBD)
- pain in the abdomen
- loose bowel movements
Learn more about the different effects of AS in the body.
Corticosteroid injections directly into the tendon sheath or joint may provide fast relief for localized joint swelling.
If NSAIDs are ineffective, doctors may prescribe disease-modifying antirheumatic drugs (DMARDs) to help relieve symptoms and prevent joint damage. Healthcare professionals may also recommend certain types of biologic drugs, which may help treat both spinal and peripheral joint symptoms.
Other treatment options for AS may include:
- physical therapy
- surgical procedures
- regular joint-directed exercises
- complementary treatments for pain, such as massage, yoga, and acupuncture
- lifestyle modifications, such as eating a balanced diet, quitting smoking, and managing stress
A person should speak with a healthcare professional for individual advice about treating AS and managing shoulder pain.
Learn more about the diagnosis and treatment of AS.
If a person experiences shoulder pain that does not go away, they should speak with a doctor. A healthcare professional can work out the underlying cause of the pain and
People should seek the advice of a doctor because another condition may be causing their shoulder pain. Healthcare professionals may ask about a person’s medical history, perform a physical exam, and order imaging and laboratory tests to help diagnose the underlying cause.
AS primarily affects the spine and lower back but may also affect other areas, such as the shoulders and hips. A person with AS may experience pain, stiffness, inflammation, and loss of range of motion in the shoulders.
The primary treatments for AS pain and inflammation are medications such as NSAIDs and DMARDs. Other treatments may include physical therapy, surgery, regular exercise, and lifestyle modifications.
A person should speak with a healthcare professional if they experience any shoulder pain that does not go away, regardless of whether they have received an AS diagnosis. A doctor can help identify the underlying cause of the pain.