What are the early clinical manifestations of ankylosing spondylitis? 1, lumbosacral pain or discomfort, is the most common symptom of the disease, occurring insidiously, often hidden pain, difficult to locate. It can also be manifested as hip and groin pain, and the symptoms can radiate to the lower limbs similar to “sciatica”. A small number of patients may have neck and chest pain as the first manifestation. The symptoms are aggravated at rest and ease after activity. The pain at night may affect sleep, and in severe cases, the patient may wake up with pain during sleep, or even need to get out of bed and move before going back to sleep, which is one of the indications of the disease activity. 2, morning stiffness: is one of the common early symptoms of ankylosing spondylitis, patients feel stiffness in the morning, relieved by activity, in addition to hot compresses, hot baths can also make morning stiffness relief. 3, tendon ligament attachment point inflammation: some patients may show pain in the thoracic rib junction, vertebral prominence, iliac crest, greater trochanter, sciatic tuberosity, as well as the heel and palm of the foot. 4, peripheral joint symptoms: about half of the patients have inflammation of large joints of the lower limbs such as hip, knee and ankle joints as the first symptom, often asymmetric, recurrent and remission, and less often persistent and destructive, as a characteristic distinguishing from rheumatoid arthritis.