Vertigo, a sensation of motion or spinning, particularly when standing, may be more common in people living with ankylosing spondylitis compared to the general population.

Ankylosing spondylitis (AS) is a type of inflammatory arthritis often associated with lower back pain or stiffness and pain in the hips. The condition can cause widespread inflammation throughout the body, which can lead to other issues that can lead to vertigo.

This article reviews the relationship between AS and vertigo, other possible causes, balance issues with AS, and more.

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Vertigo is the sensation that the world is moving around the person or spinning. It can cause a person to feel unsteady, lose balance, or fall over.

Vertigo occurs when the pressure in the inner ear changes or when the brain processes sensory information incorrectly.

Some older evidence suggests that living with AS can increase a person’s chances of developing vertigo or experiencing it from time to time.

In a small study from 2011, research found an increased frequency of abnormal postural control during testing of those with AS. The study included about 100 participants, 47 of which had AS.

Another larger study from 2011 suggests that people with AS have a higher chance of developing Meniere’s disease, which can cause vertigo.

A small study from 2012 also showed a higher prevalence of vertigo among people with AS. Researchers found that 6 of 59 people with AS developed vertigo, while only 2 of 46 without AS developed the condition.

Additional and more current studies are lacking. More research is needed to fully understand the connection between vertigo and AS.

Vertigo has several potential causes.

Meniere’s disease is an inner ear condition that can cause ringing in the ears as well as vertigo. Some evidence suggests it may be more common in people with AS.

Another condition, benign paroxysmal positional vertigo (BPPV), occurs when small crystals are loose in the inner ear. They can move around when a person switches position, causing a sensation of vertigo.

Other possible causes can include:

  • certain viral infections, including shingles
  • fistulas, cysts, or bony growths in the inner ear
  • ministroke in the arterial system of the brain
  • certain neurological conditions, such as vestibular migraine, stroke, tumors, and multiple sclerosis (MS)
  • head trauma, whiplash, or concussion
  • psychological conditions, including anxiety or somatization disorders
  • vertebrobasilar insufficiency or poor blood flow from the back portion of the brain

Living with AS may put a person at higher risk of developing vertigo due to either inflammation in the inner ear or joint inflammation.

Inner ear inflammation

Living with AS can increase the risk that a person will develop inflammation in the inner ear. In a 2016 study, researchers tested how people with AS scored on vestibular testing, which assesses balance.

They found that people with AS score lower on the testing, indicating lower functioning that can lead to symptoms such as vertigo.

Joint inflammation

Joint inflammation can affect several aspects of a person’s health, including their gait. Gait describes a person’s balance, power, and form when walking. Issues with gait can lead to the sensation of vertigo.

AS can affect a person’s balance in several ways.

Pain and stiffness in the back can make movement and balance more difficult and negatively affect a person’s posture.

In some cases, a person may develop issues with their eyes, which can lead to issues with balance. Small changes in vision can lead to issues where a person feels a lack of balance.

It’s important that a person with AS lets a healthcare professional know if they develop vertigo. They may be able to recommend treatment for the condition.

A doctor will likely perform a physical examination and ask questions about the new symptoms, such as when they occur, their frequency, and length. They may also ask about new medications or any changes to personal health history information.

They may recommend treatments such as physical therapy or medications.

A person can take steps at home, such as:

  • learning about their triggers and taking steps to avoid them
  • incorporating exercises for vertigo into their daily routine
  • limiting activities that may cause vertigo

A person may not be able to prevent all vertigo from occurring altogether. They may be able to reduce their chances of developing the condition by following all treatment recommendations and taking their medications as prescribed. This can help keep their AS inflammation well managed, which could help limit possible complications, including vertigo.

Some evidence suggests that doctors should screen people with AS for issues with balance. This may help prevent vertigo from occurring.

The following are some questions people frequently ask about AS.

What are the neurological symptoms of ankylosing spondylitis?

Neurological symptoms associated with ankylosing spondylitis are rare. When they occur, they can include:

  • urinary retention or incontinence
  • loss of bowel control
  • sexual dysfunction
  • pain and weakness in the legs

Symptoms result due to scarring on a bundle of nerves at the base of the spine, known as cauda equine syndrome.

How does ankylosing spondylitis affect the ears?

Ankylosing spondylitis may cause inflammation in the inner ear. This can cause issues with balance and can lead to vertigo.

What is the most common complaint in ankylosing spondylitis?

The most common symptom in ankylosing spondylitis is lower back pain or pain and stiffness in the hips. Arthritis often affects joints in the spine and pelvic region, leading to pain and stiffness.

AS may increase the chances that a person will develop vertigo or other issues with balance. It may directly cause inflammation that can lead to it, or it may increase a person’s chances of, developing co-occurring conditions.

Research is generally older. Additional research is needed to fully understand how AS can increase the chances of vertigo.

A doctor may recommend a person take medications, perform exercises for vertigo, or see a physical therapist. A person can help prevent vertigo by following all their treatment recommendations and avoiding known triggers.