The first symptoms of this disease are usually a low back pain with its peak at night and in the morning and morning stiffness, which can last for hours. Both symptoms get better with exercise, back pain can worsen with inactivity. Some patients show only a partial involvement of the spine, in others the whole spine is involved. The physician always should examine the patient´s back by patting it gently with one fist, starting at the cervical spine all the way down to the sacrum, asking the patient, if and which part of the spine is painful during this.
