Ankylosing Spondylitis Questionnaire:

This questionnaire is not a diagnosis for AS and should not be substituted as one. Only a rheumatologist can effectively diagnose AS with a physical exam, x-rays and HLA-B27 test. EraseAS.com does not advise anyone to use this quiz as a form of AS diagnosis. This is purely a list of symptoms associated with AS. EraseAS.com offers this survey strictly for informational purpose. By using this questionnaire, you agree to the above stipulations.

1. Are you experiencing pain and/or stiffness in your spine or pelvic area?
Yes     No


2. Did the pain/stiffness first appear in your lower back?
Yes     No


3. Did the pain/stiffness develop slowly in the spine and exponentially grow worse?
Yes     No


4. Have you been experiencing lower back pain/stiffness chronically (over three months)?
Yes     No


5. Has the pain/stiffness gradually spread from the spine to other joints?
Yes     No


6. Are you currently experiencing pain/stiffness in other joints like your neck, shoulders, hips, knees and heels?
Yes     No


7. Did the pain/stiffness first appear before or after the age of 35?
Before     After


8. Does the pain/stiffness flare up intermittently?
Yes     No


9. Does the pain/stiffness increase after long bouts of inactivity?
Yes     No


10. Does the pain/stiffness decrease after mild exercise or physical activity?
Yes     No


11. Are you experiencing a decreased range of motion in your back?
Yes     No


12. Are you losing some mobility in your neck and back?
Yes     No


13. Is the pain/stiffness worse in the morning, daytime or evening?
Yes     No


14. Does heat or cold (hot shower/ice pack) ease the pain/stiffness?
Yes     No


15. Is your posture worsening?
Yes     No


16. Do you have a family history of AS?
Yes     No


17. Have you had a bacterial infection lately?
Yes     No


18. Do you have frequent gastrointestinal infections?
Yes     No


19. Have you tested positive or negative for the HLA-B27 gene? (does not determine AS diagnosis)
Positive     Negative


20. Are you having difficulty with deep breathing?
Yes     No


21. Are you experiencing chest pain or chest constriction?
Yes     No


22. Are you experiencing inflammation of the eye (iritis)?
Yes     No


23. Are you feeling fatigue more often?
Yes     No


24. Are you male or female?
Male     Female


25. How old are you?