Doctors can use several tools to assess your pain level with ankylosing spondylitis. Being as specific as possible in describing your symptoms can help doctors determine effective treatment options.

Ankylosing spondylitis (AS) is a chronic inflammatory condition primarily affecting the spine, causing discomfort and pain. This pain may vary from mild to severe, and you may feel it in the lower back, hips, and buttocks.

To diagnose and assess the disease progression, doctors may need to assess your pain level. They can use one of several pain scales to measure the intensity and nature of your pain. This helps them make informed decisions about treatment and support.

This article explores various AS pain scales, including their pros and cons. It also provides tips for effective communication with a doctor about AS pain.

An AS pain scale can help you express the intensity of your pain. By using this standardized scale, a doctor can adjust your treatment plan and improve pain management strategies.

Some pain scales doctors use in clinical settings and research include:

Bath Ankylosing Spondylitis Disease Activity Index

The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) is a widely used scale for evaluating disease activity, including pain levels, in people with AS. This questionnaire allows you to rate symptoms like pain, stiffness, and fatigue on a scale of 0–10, where 0 represents no pain and 10 represents the highest possible pain.

The BASDAI is easy to provide and effective in assessing pain levels. While research on its effectiveness in evaluating AS pain is ongoing, a 2022 study suggested that the BASDAI can guide doctors in determining treatment options.

Ankylosing Spondylitis Disease Activity Score

The Ankylosing Spondylitis Disease Activity Score (ASDAS) measures pain and other symptoms associated with AS, such as stiffness and fatigue. This score uses a combination of lab tests, physical exams, and questionnaires to assess disease activity.

The pros of this score are that it provides a comprehensive assessment of disease activity, not just pain. But it requires additional clinical data and can be more time consuming to calculate than other pain scales.

The same 2022 study above showed the usefulness of ASDAS, including pain assessment, in evaluating disease activity and treatment response in AS.

General pain scales

Doctors may also use pain scales not specific to AS pain. Research into these scales’ effectiveness in assessing AS pain is often limited. These scales include:

  • Numerical rating scale: This simple scale measures pain from 0–10 or 0–5 based on your sensory and emotional experiences. It’s easy to use, as healthcare professionals can provide it in written or verbal form. But it’s limited in its ability to show a detailed assessment of pain.
  • Visual analog scale: The visual analog scale is a self-report tool that measures pain on a line from 0–10. It involves marking a spot on a line representing pain intensity to show your pain level. The visual representation is often clearer to understand, but research on how it compares to other scales is mixed.
  • McGill Pain Questionnaire (MPQ): Developed in the 1970s, the MPQ measures the pain intensity and quality using a list of descriptive words. It can provide a detailed description of pain by identifying its specific characteristics, such as throbbing, burning, or stabbing. But some people may find it difficult to use due to the complexity of the wording.
  • painDETECT Questionnaire: Doctors primarily use the painDETECT Questionnaire for neuropathic pain, a unique type of pain resulting from nerve issues. Some people with AS develop neuropathic pain. According to a 2017 study, the painDETECT Questionnaire may help identify the cause of pain in conditions like AS.

When discussing AS pain with a doctor:

  • Be specific: Describe the location, intensity, and nature (dull, sharp, or burning) of your pain.
  • Use comparisons: Compare your pain to experiences or sensations that a doctor can relate to. For example, you might describe it as a constant ache, like a toothache.
  • Communicate the effect: Explain how the pain affects your daily activities and overall well-being.
  • Share your pain history: Describe how the pain has changed, including when it first started, any periods of worsening or improvement, and any potential triggering events.
  • Mention treatment experiences: Discuss any treatments you’ve tried and their effectiveness.

Here are some frequently asked questions about AS pain.

How painful is ankylosing spondylitis?

The pain experienced in AS can vary from person to person. However, many people experience mild episodes of back pain, while others have chronic and severe pain.

Is ankylosing spondylitis a disability?

Though severe limitations aren’t common, AS can qualify as a disability if it significantly affects your ability to perform daily activities or work. Eligibility for disability benefits varies, depending on the severity and limitations experienced.

Can people live pain-free with ankylosing spondylitis?

While it may not be possible for every person to live pain-free with AS, treatment with medication, physical therapy, and regular exercise can help manage and reduce pain.

Healthcare professionals currently use several AS pain scales, including the BASDAI and ASDAS pain scores, to monitor the severity of pain in people with AS.

Each scale has its pros and cons. Consider talking with a healthcare professional who can help select the most appropriate AS pain scale for your needs.