Ankylosing spondylitis (AS) makes you so tired because of your body's ongoing inflammation, which releases fatigue-causing cytokines, combined with pain and stiffness disrupting sleep, leading to a cycle of exhaustion. This chronic tiredness, often described as "flu-like," can also be worsened by anemia or mental health issues like depression, making it a complex, debilitating symptom needing management beyond just rest, notes the Spondylitis Association of America.
In AS patients, fatigue is one of the main systemic symptoms, occurring in 50–70% of cases (2, 3, 12, 18). In the present study, we found that 85.8% of AS patients exhibited varying degrees of fatigue symptoms, including 32.0% patients with severe fatigue.
NSAIDs are the most commonly prescribed drugs for a disease similar to AS called nonradiographic axial spondyloarthritis (nr-axSpA). Both prescription and over-the-counter NSAIDs appear safe up to 20 weeks of pregnancy, but may cause serious kidney problems in a fetus if taken longer.
Patients experiencing chronic fatigue related to autoimmune conditions often describe their symptoms as more than just feeling tired during the day. This is significant exhaustion that impacts quality of life and makes it difficult to function on a normal basis.
Back pain and stiffness are usually the main symptoms of AS. You may find: the pain gets better with exercise, but does not improve or gets worse with rest. the pain and stiffness is worse in the morning and at night – you may wake up regularly during the night because of the pain.
Key takeaways
Keeping active can improve your posture and range of spinal movement, along with preventing your spine becoming stiff and painful. As well as keeping active, physiotherapy is a key part of treating AS. A physiotherapist can advise about the most effective exercises and draw up an exercise programme that suits you.
Eating foods such as oatmeal or nuts can give you a boost to your energy level. With some autoimmune conditions, you may need to follow certain dietary restrictions or special diets. Get regular exercise. Physical activity can keep your body in good condition, which will help boost energy.
Profound and debilitating fatigue is the most common complaint reported among individuals with autoimmune disease, such as systemic lupus erythematosus, multiple sclerosis, type 1 diabetes, celiac disease, chronic fatigue syndrome, and rheumatoid arthritis.
Despite its significant impact on quality of life, ME/CFS lacks definitive diagnostic biomarkers, complicating diagnosis and management. Recent evidence highlights potential blood tests for ME/CFS biomarkers in immunological, genetic, metabolic, and bioenergetic domains.
The vast majority of women with ankylosing spondylitis can expect to have the same rate of fertility, course of pregnancy and birth, and to give birth to normal healthy babies to the same extent as the normal female population. The chance for the offspring to contract AS later in life is somewhat increased.
Illness and death
According to his father, Biden was diagnosed with ankylosing spondylitis in 2001 after returning from service in Kosovo.
HUMIRA Dosing for Ankylosing Spondylitis
The recommended dose is 40 mg every other week. Always follow your doctor's instructions about when and how often to take HUMIRA. HUMIRA is given by an injection under the skin. Your first dose of HUMIRA must be given under the supervision of a health care professional.
Medical causes– unrelenting exhaustion may be a sign of an underlying illness or condition (such as flu, glandular fever, chronic fatigue syndrome, thyroid disorders, heart disease or diabetes). Lifestyle-related causes – alcohol or drugs or lack of regular exercise can lead to feelings of fatigue.
Given the role of vitamin D in promoting bone health and its anti-inflammatory properties, people with spondylitis might benefit from taking a vitamin D supplement.
Some types of specialists you may see include: A neurologist (brain and nervous system doctor) A rheumatologist (joint, muscle and bone doctor), or. A sleep specialist.
Most of the time fatigue can be traced to one or more lifestyle issues, such as poor sleep habits or lack of exercise. Fatigue can be caused by a medicine or linked to depression. Sometimes fatigue is a symptom of an illness that needs treatment.
Ways diet can help improve your condition
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a long-term condition marked by a major decline in activities that were tolerated beforehand, along with profound tiredness, regardless of bed rest. It can begin gradually or suddenly, and can last for years.
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Although their primary focuses are different, rheumatologists and endocrinologists both work with patients who have autoimmune conditions.
People with rheumatoid arthritis typically have several permanently inflamed joints. The inflammation can lead to weakness, drowsiness and exhaustion. This feeling of extreme tiredness is also called “fatigue.” Some people find this to be the worst symptom of the disease.
Uncontrolled pain and stiffness can disturb sleep and make it difficult to get rest. This of course contributes to fatigue. Besides causing fatigue, not sleeping well can also increase pain, creating a feedback loop of pain causing sleeplessness, which then causes more pain and fatigue, and so on.
July 18, 2025
A new peer-reviewed study published in Arthritis & Rheumatology suggests that ivarmacitinib, a new medication known as a selective JAK1 inhibitor, may be a promising treatment for people with active ankylosing spondylitis (AS). The study was a randomized, double-blind clinical trial.
After a positive test, your doctor may suggest regular monitoring, even if you feel well. According to Verywell Health, recurring inflammation in the spine and sacroiliac joints is often linked to HLA-B27 positivity. This inflammation can cause low back pain and stiffness.