5 Signs An Ankylosing Spondylitis Flare Is Coming

When an ankylosing spondylitis flare-up is about to happen, there are a few tell-tale signs I always experience.

I’ve had ankylosing spondylitis for about 10 years. Although, it’s been really active for the past four to five. At this point, I can tell fairly easily when a flare-up is about to occur. It is as though I am at the shoreline and the flare-up is the water, making its way — tsunami-like — toward the sand. For me, it's not gradual. It's tidal.

A note: Sometimes flare-ups are made complicated by the fact that anytime there is something wrong with me, I end up playing the game of "is this AS or is this something else?" Fun times.

5 early signs of a flare-up

Extreme fatigue

You know those mornings when you wake up and think, "Please God, let me sleep five more hours?" Yeah. Or, you know when you’re walking around as though you have a weighted blanket over your shoulders or as if you're wading through molasses?

That’s the sort of fatigue I’m talking about. It’s the kind of fatigue that tells you, "You won’t be able to do any of your chores or errands, so just give up!" It's more than just exhaustion.

Crankiness

When an ankylosing spondylitis flare-up is coming, I always get extra cranky. Almost anything could push me over the edge. I tend to lose patience quickly, and I have to keep myself in check so that I don’t snap at people.

This is probably some combination of being epically tired and annoyed from pain, but it’s also my way of setting boundaries so that I can conserve energy. It’s definitely not a great thing.

Overstimulation (or sensory overload)

This is a strange one since it's incredibly hard to describe. Although, I’ve heard from a lot of people in chronic illness communities that people experience it. I can best describe overstimulation as the feeling of exploding from the inside due to too much stimulus like light, noise, chaos, or movement.

It's the feeling of needing to turn your brain off right now. There are plenty of reasons why this may happen, but one of the core reasons could be hypersensitivity. This often occurs with conditions like fibromyalgia and chronic fatigue syndrome.

Another theory is that our bodies have a hard time processing information, perhaps due to serotonin dysfunction.¹ This might all feel like you’re about to have a panic attack or like you can’t focus on anything at all.

Whenever I get like this, it’s usually because a flare-up is on the horizon or I’m in the middle of one. My personal (not a doctor!) theory is that my body has a hard time dealing with stimuli while it’s also busy fighting off inflammation.

Random intense localized pain

Really obvious, intense pain in my hips, pelvis, back, or neck usually precedes an ankylosing spondylitis flare-up for me, but this might be different for others. For example, I’ll wake up and suddenly notice that my hips are in incredible pain. Or I'll get outside after moving perfectly fine all day and suddenly feel like I can't walk at all.

Usually, when the pain comes on that intense and quickly, it means that other pains will soon follow. For me, it’s not a gradual onset, but a horrible shocking shift from being relatively okay to suddenly being in pain. Other pain triggers? Alcohol and stress.

Brain fog

Brain fog is something that I deal with pretty much all of the damn time, but it worsens during and before flare-ups. It feels as though I can’t remember anything. It's like I am processing tasks incredibly slowly and my brain is a pile of mush.

As a writer and journalist, this can be incredibly frustrating, as I have a problem articulating myself, finding the right word, remembering tasks or follow-up phone calls, or catching errors before finishing a project. I try to give myself a lot of space to just breathe and step away when I need to since brain fog can be totally all-consuming.