Ankylosing Spondylitis

Your Options for Ankylosing Spondylitis Treatment

  • Overview

    Ankylosing spondylitis is an inflammatory condition that can cause the ligaments, joint capsule, and tendons that attach to the spine to swell (enthesis), which over time can lead to bone formation and possibly fusing of vertebrae as well. This type of arthritis can result in a loss of flexibility and, over time, you may develop a hunched-forward posture. In severe cases, it may be difficult or impossible to lift your head into a normal position. There is no cure, but treatment can minimize pain and swelling associated with ankylosing spondylitis. 

  • Massage

    Massage therapy can reduce stress, provide short-term relief from pain and stiffness, and increase flexibility. Make sure your massage therapist is aware of and understands your condition. However, some people with ankylosing spondylitis find that massage increases their pain and discomfort. If this happens to you, discontinue massage therapy and discuss other options with your doctor.

  • Stretching and Exercise

    Stretching and range-of-motion exercise can help with flexibility and may relieve painful joints. Even when your joints are inflamed, you can perform mild stretching without moving your joints. Building stronger muscles around joints will help to support them.

    Exercises that stretch the back can decrease your chances of disability in the long term. You may find it easier to exercise in water. Get approval from your doctor or a physical therapist who understands your condition before beginning a new exercise routine.

  • Work on Posture

    Good posture can decrease your chances of complications, but it takes practice. To start, check your posture in a full-length mirror and think tall! Hold your head over your body. Your chin should be horizontal and parallel to the floor, centered and slightly drawn back. Sleep on a firm—but not too hard—bed to reinforce good posture.

  • Apply Cold/Heat

    Apply an ice pack to inflamed joints to help ease swelling. Cold can help to numb pain, while hot showers and relaxing, warm baths can soothe tight, aching muscles. You can also apply a hot towel, a heating pad, or other hot pack to relieve stiffness and help get you through flare-ups.

  • Physical Therapy

    Ask your doctor to recommend a physical therapist who is familiar with ankylosing spondylitis. Your physical therapist can tailor a program suited to your specific needs. They can also provide instruction on:

    • the proper way to perform range of motion exercises
    • good stretching techniques
    • deep breathing exercises
    • proper sleep positions
    • the correct way to walk
    • how to work on your posture

  • Acupuncture

    The Chinese practice of acupuncture has been used for thousands of years. It involves the use of thin needles to puncture the skin at particular points. According to the National Institutes of Health (NIH), studies show that acupuncture can reduce pain, possibly by causing the brain and spinal cord to release opium-like molecules that may relieve pain.

    In most states, acupuncturists must pass a national board certification examination. Some states require a doctorate degree from an approved college. You can learn more about the requirements through your state's medical board.

  • Chiropractic Treatment

    Many chiropractors treat people with ankylosing spondylitis, and many patients report relief from pain with this method. However, this form of treatment should be considered on a case-by-case basis, as chiropractic treatment could inadvertently lead to complications. Discuss with your doctor whether chiropractic treatment is right for you before you begin. Be sure to choose a chiropractor who is familiar with ankylosing spondylitis. 

  • Yoga

    Yoga is known to increase flexibility and range of motion. It also helps to ease stress and tension, leading to increased relaxation and more restful sleep. If you haven't practiced yoga before, start with a beginner's class. Gentle poses will slowly increase your flexibility. You can increase your activity level gradually and at your own pace.

  • Diet

    Added weight can stress your joints, so eating right is vital to managing your condition. Include sources of omega-3 fatty acids in your diet. Omega-3 fatty acids have been found to reduce joint inflammation in some people with rheumatoid arthritis, an inflammatory joint disease. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, some evidence suggests that omega-3 supplements may reduce disease activity in people with ankylosing spondylitis.

    Foods that contain omega-3 fatty acids include:

    • flax seeds
    • walnuts
    • cold water fish

  • Medications

    Over-the-counter (OTC) medications that can ease pain and inflammation include:

    • aspirin
    • ibuprofen
    • naproxen

    Disease-modifying anti-rheumatic drugs include:

    • sulfasalazine

    Genetically engineered medications block proteins that can promote inflammation. These drugs are given intravenously or by injection and include:

    • adalimumab
    • etanercept
    • golimumab
    • infliximab

  • Surgery

    Most people who have ankylosing spondylitis will never require surgery. However, surgery may be recommended for people who have severe disability or pain. Osteotomy is a procedure that straightens a curved-forward (kyphotic) spine. 

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