I've had A.S. and scoliosis since I was a teenager; I am in my 40's now. Pre-2012 I was on heavy NSAID use; Post-2012 I've been on Enbrel, Humira, and now Remicade. I also take steroids, Nsaids, and prednasone.
Before 2012, my symptoms were limited to spine and joint pain. Post 2012, I had almost all A.S. symptoms and visible damage.
In my personal experience, my symptoms have been modulated by physical activity, but not too much. There is a definite threshold. Usually when I wake up in the morning I immediately take a hot shower and then walk to the bus stop. 3-5 blocks. That has always really helped my symptoms. Over the years, I've frequently had significant fatigue and stiffness in the early A.M. at work. Especially from not moving at my desk. But this has almost always eased up by 10am-noon.
For whatever reason, only over the past 3 years, all of my symptoms are worse starting late afternoon through bedtime. It's also I am thinking because I am tapped out for energy after a 10-12 hr work and commute day. And when I get home after dinner I am fairly inactive. So, I also can say my symptoms are often worse in the evening as opposed to the A.M.; in all measures; pain, fatigue, stiffness.
My new years goal is to incorporate some light activity in the even as well to see if that improves things.
My only complaint about the drugs is I periodically get dizziness or nausea. Not everyone does. Enbrel worked for a while for me, Humira not at all. Remicade does somewhat half the time. When I get really bad, I've taken prednasone. I DO believe diet does wonders for people, but for me personally, I am a terrible patient and refuse to give up starches to even try. No apologies or debates, it's just how I am.
Anyway... I just wanted to say that I too, have worsening problems in the pm. Oh.. but for me a lot of that pain is from visible damage to my bones. spurring and fusing I already have.