Ankylosing spondylitis rarely behaves the same way two weeks running. That is exactly why a record helps — and exactly why most people stop keeping one after a fortnight. The trick is to track a few things consistently rather than everything occasionally.
Why track at all
Ankylosing spondylitis (AS) is a long-term inflammatory condition that mainly affects the spine and the sacroiliac joints, with symptoms that come and go over months and years (NHS). Appointments are short and memory is heavily weighted toward the last few days and the worst ones. A record fills the gap between "how have you been?" and what actually happened.
A record is also the raw material for the questionnaires your rheumatology team may already use. The BASDAI, for example, asks about fatigue, spinal pain, joint pain, tenderness and morning stiffness over the past week (NASS, The Bath Indices). If you have been noting those daily, the answer is a glance rather than a guess. See understanding BASDAI.
The core set: five signals, under a minute
If you record nothing else, record these. Each takes one tap on a scale, and together they cover most of what a clinician will ask about.
| Signal | How to record it | Why it matters |
|---|---|---|
| Morning stiffness | Roughly how long it took to loosen up (none, under 30 min, 30–60, 1–2 h, 2 h+) | Stiffness that is worse in the morning and eases with movement is among the symptoms the NHS lists for AS, and it is two of the six BASDAI questions. |
| Spinal pain | 0–10, thinking of neck, back or hips | Direction over weeks matters more than any single day; a spinal pain score also appears in treatment criteria such as NICE TA383. |
| Other joint pain or swelling | 0–10, and where | AS can involve hips, knees, shoulders and other joints; noting location helps a clinician judge what is spinal and what is not. |
| Fatigue | 0–10 | Fatigue has its own BASDAI question because research at Bath identified it as a major component of AS, separate from pain; the index was developed with input from people with AS. |
| Sleep | Hours, and how disturbed | Disturbed sleep is common in axSpA — reported in 35–90% of people across studies — and often sits alongside pain and stiffness. |
Stiffness and pain are recorded as separate signals on purpose. They often move independently, and a single "how bad was today" number hides that. This is also how HAVYT’s AS Mode structures its check-in.
The context layer: what was true around the symptoms
Symptom scores on their own tell you that some days were worse. The context is what makes them readable later. Most of it can be recorded in passing rather than as a separate chore.
- Activity and training — what you did, roughly how hard, and whether you scaled a session down. See training with ankylosing spondylitis.
- Medication — what you took and when, including anything over the counter. Changes in timing matter as much as changes in dose. See medication tracking.
- Stress and mood — one word or one number is enough.
- Flare status — whether you would call today part of a flare, and when it started. See the flare tracker guide.
- Anything unusual — a long drive, a poor night, a cold, a change of mattress. Free text, one line.
What you can leave out
Detail is the enemy of consistency. A record with ten fields that you fill in for eleven days is worth less than a record with five fields kept for six months. In particular:
- You do not need to describe pain in prose every day. A number and, if it changed, a location is enough.
- You do not need to log every meal. If you want to look at food later, a short note about anything out of the ordinary is plenty. HAVYT’s food notes are deliberately simple for this reason.
- You do not need a wearable. Every signal above can be entered by hand; connected data from Apple Health adds context if you already have it.
How often, and for how long
Daily, briefly, in the morning — stiffness is easiest to judge then. If daily is not realistic, three or four fixed days a week beats a random scatter, because it keeps the gaps regular.
Give it at least six to eight weeks before expecting the record to show you anything. AS symptoms fluctuate on a scale of weeks; a fortnight is one data point, not a pattern. See how to track pain patterns for what a pattern in a record can and cannot tell you.
Turning the record into an appointment
Before a review, look back over the period since the last one and write down three things: the overall direction, the worst stretch and when it was, and anything that changed alongside. That is the summary a clinician can use in a ten-minute slot. A structured export such as HAVYT’s Doctor Report does the assembling; the rheumatology appointment guide covers what else to bring.