Living with spondylitis means managing some of its most common symptoms, including back pain, joint pain, reduced range of motion, and fatigue. But you may not realize that spondylitis may also be linked to talking issues, including slurred speech and trouble finding the right words.

“My speech some days sounds like I am drunk — sluggish and slurred,” one MySpondylitisTeam member wrote. “I didn’t realize I slur sometimes until I watched and heard a video of me interacting with one of my grandchildren.”

Spondylitis, which is also referred to as spondyloarthritis, is a group of diseases characterized by inflammatory arthritis in the spine and other joints. Although not a common symptom, speech problems in spondylitis can have many causes. Read on to discover six reasons you may be experiencing slurred speech and other speaking difficulties, as well as how you can manage these issues.

1. Nerve Compression and Pinched Nerve

Spondylitis inflammation can press on the back part of the cervical spinal cord (the neck), affecting your ability to feel things like touch, pain, and temperature. Compression of the front part of the cervical spinal cord can cause motor (movement) dysfunction. Sometimes, both the front and back of the cervical spine can be compressed at the same time.

Some people with spondylitis feel that they simply can’t make the right words come out. As one member described, “I find it hard to get my words out at times, and sometimes when speaking easily, my words don’t make sense but do in my mind,” shared one member of MySpondylitisTeam, describing a condition known as dysarthria.

Dysarthria is caused by muscle weakness of the tongue and throat. In spondylitis, dysarthria may result from nerve compression and can cause slurred speech.

Nerve compression can also lead to a pinched nerve, which can cause numbness, tingling, and muscle weakness. This has led many members to ask, “Can a pinched nerve cause slurred speech?” In some cases, the answer is yes. Slurred speech is among the more serious symptoms of a pinched nerve, and you should call a doctor right away if it occurs.

2. Bone Changes

As the bones in the upper section of the spine begin to change in people with spondylitis, they can compress the nerves and lead to slurred speech. Ankylosing spondylitis (a subtype of spondyloarthritis), in particular, can result in changes to the bones in the neck.

When the bones of the spine begin to fuse together, the spine becomes less flexible. The new bone that forms is thinner and weaker than regular bone, so it’s more prone to fractures or breaks. People living with ankylosing spondylitis are therefore at a much greater risk of spinal fractures.

“Long ago, my ankylosing spondylitis went into my jaw and fused the joints,” wrote one MySpondylitisTeam member.

Other spondylitis-related spine changes that can compress the nerves include:

• Syndesmophytes (bony growths)
• Osteophytes (bone spurs)
• Sclerosis (thickening of ligaments or tissue)

Any of these side effects of bone changes can lead to nerve compression that causes your jaw to tighten and be less flexible, which can make your speech sound slurred.

3. Cervical Stenosis

Cervical fractures can cause neurological problems and spinal stenosis, a narrowing of the vertebrae in the spine. Cervical stenosis causes discomfort when the spinal cord has been compressed by 30 percent or more.

Severe nerve compression in the cervical spine can lead to cervical myelopathy, a condition that may cause neurological symptoms such as difficulty speaking. Other symptoms of cervical myelopathy can include:

• Tingling
• Weakness
• Difficulty walking
• Neck pain, stiffness, and reduced range of motion
• Clumsiness
• Issues with balance
• Numbness
• Dysphagia (swallowing problems)

“I’ve got chronic pain in my neck, jaw, behind the eyes, and ear pain,” one MySpondylitisTeam member wrote. “I have trouble hearing and talking.”

4. Neck Instability

The changes that spondylitis causes in the cervical spine can sometimes lead to instability in the neck. This instability can result in the compression of nerves in the brainstem that control movements between the head and the neck.

The hypoglossal nerve, in particular, controls the muscles in the throat and helps move food between the mouth and the esophagus. The glossopharyngeal nerve is responsible for the movement of the tongue and throat muscles. Compression of either of these nerves can affect speech and swallowing.

“I suffer pain in my neck and legs,” one member wrote. “I’m on strong medication, having falls and trouble with speech.”

5. Jaw Problems

About 15 percent of people with ankylosing spondylitis will experience jaw problems. Inflammation of — and resulting damage to — the jaw’s temporomandibular joints (TMJs) can lead to difficulties with speaking and eating. This makes it challenging to open your jaw all the way, which can lead to slurred speech.

“I have TMJ so severe that I have a headache almost all the time,” wrote a MySpondylitisTeam member with TMJ disorder. “I can’t open my mouth very far.”

Other symptoms of TMJ disorder include:

• Pain in one or both of the temporomandibular joints
• Clicking and popping in one or both joints
• Tenderness or pain in the jaw
• Difficulty opening or closing your mouth due to jaw locking
• Pain when chewing
• Dull ache in jaw muscles that radiates to the ear
• Dull facial pain
• Associated neck, back, and shoulder pain

If your care team believes that TMJ or other jaw issues may be causing your slurred speech, they may order X-rays or other imaging to confirm a diagnosis.

6. Brain Fog

If you often forget words, have trouble remembering the right words, or feel mentally fuzzy or forgetful, you may be experiencing brain fog — mental sluggishness. Brain fog has been connected to some inflammatory conditions, including spondylitis.

Brain fog is not a medical condition but, rather, a symptom. Inflammation is thought to affect the brain and prevent it from reaching a full state of alertness. The inflammation can also lead to pain spikes that prevent signals from reaching the brain.

Spondylitis-related brain fog can also be caused by:

• Poor sleep — People living with spondylitis often struggle to achieve restorative sleep.
• Medication side effects — Certain drugs for spondylitis cause brain fog and memory issues.
• Fatigue — Battling chronic pain is often exhausting.
• Stress, anxiety, and depression — Spondylitis affects mental and emotional health.

These feelings of cognitive (thinking and memory) impairment can be difficult. Brain fog made one MySpondylitisTeam member think negatively about their intellect: “I sound like a bumbling fool — can’t think of words or articulate things most days.”

Another member wrote, “I can look at someone and call them the wrong name, even though I have known them for years.” Another said, “I can’t get the right words out or even think of words. Also, I have dizziness and vertigo.”

Learn more about spondylitis and brain fog, including ways to manage it.

Managing Slurred Speech With Spondylitis

If you develop any spondylitis complication, including slurred speech, it’s important to figure out the cause so that you can best manage it and improve your quality of life. Let your health care provider know if you have symptoms of nerve compression, a pinched nerve, jaw problems, or other complications that may lead to slurred speech.

Your doctor can refer you to health care professionals for neurology care, physical therapy, or occupational therapy. They may also suggest specific treatment options or other management approaches.

Surgery for Stenosis

It’s important to catch stenosis early so that you can manage it before it becomes too severe. In some cases, physical and occupational therapy aren’t enough. Surgery will be needed to relieve stenosis.

Surgery can prevent symptoms from worsening and remove pressure from the spinal cord. The typical surgery recommended for stenosis is called spinal decompression. If osteophytes are causing your symptoms, your surgeon will remove the bone spurs to relieve the pressure on your spinal cord.

Other procedures include:

• Laminectomy — A spine surgery that relieves pressure by removing part of a vertebra called the lamina
• Fusion — A spine surgery that permanently connects vertebrae to correct vertebral abnormalities
• Spine stabilization with implants — A spine surgery in which medical instruments like plates or rods are inserted into the spine to stabilize it
• Prolotherapy — A nonsurgical option that uses injections into tendons or ligaments to help regenerate connective tissue, stabilize the neck, and potentially reverse some symptoms

Lifestyle Approaches for Cognitive Speech Problems

If memory loss and brain fog seem to be the cause of your difficulty speaking, lifestyle remedies may help you manage it.

Assess Your Treatments

Talk to your health care provider about medications that might be affecting your memory. Your doctor may be able to adjust your dosage or recommend a new medication. It’s also important that you work with your team of doctors to manage your pain effectively.

Practice Good Sleep Hygiene

If you have difficulty falling or staying asleep, practice good sleep hygiene, such as going to bed at the same time every night. Ask your doctor about other ways to improve your sleep.

Take Care of Your Mental and Emotional Health

Anecdotal evidence suggests that depression may have an impact on memory, which could potentially contribute to or worsen speech problems in spondylitis. Ask your doctor for a referral to a mental health care professional. Your doctor can also help you find ways to manage stress and improve your mental health.

Adopt Healthy Habits

When you’re living with spondylitis, it’s important to stay hydrated and eat a diet that contributes to positive brain health — just as it is for anyone with a chronic health condition.

Recommendations From Members

MySpondylitisTeam members have discussed how they manage difficulty speaking, including medical treatment and lifestyle changes.

Removing sources of stress helped one member. “Stress creates inflammation, which in turn signals your already compromised immune system to attack,” they said.

Another member found relief from sleep difficulties by using a continuous positive airway pressure (CPAP) machine: “Sleeping with a CPAP gives the air needed to sleep better and wake feeling refreshed.”

Find Support

MySpondylitisTeam is the social network for people with spondylitis and their loved ones. Here, more than 98,000 members from around the world come together to ask questions, offer advice and support, and meet others who understand life with spondylitis.

How has your speech been affected by spondylitis? What techniques or treatments have helped you manage speech issues? Comment below, or start a conversation on your Activities page.