Ankylosing spondylitis typically affects the lower back, but as the disease progresses, it can cause pain in the upper back or neck.

Ankylosing spondylitis is a form of arthritis that can cause inflammation and pain in your spine and other joints.

In addition to the condition directly affecting your upper spine, neck pain can also develop indirectly from changes in your posture caused by stiffness or pain lower in your spine.

Ankylosing spondylitis and other degenerative conditions, like osteoarthritis, are sometimes called cervical spondylosis when they affect the neck.

Read on to learn how ankylosing spondylitis can affect your neck and what you can do to manage your symptoms.

Ankylosing spondylitis is an autoimmune condition where immune cells attack healthy cells in your spine and other parts of your body. This autoimmune reaction can cause inflammation and pain.

Inflammation usually starts in your lower back, but it can progress to your upper back or neck over time.

Severe chronic inflammation can cause your vertebrae to fuse together. Loss of mobility lower in your spine can alter your posture and put more stress on your neck. This extra stress on your neck might also lead to neck pain over time.

Ankylosing spondylitis symptoms generally alternate through flare-ups and periods when they go away or are greatly reduced.

Inflammation in your neck can cause symptoms such as:

  • pain that wakes you up from your sleep
  • pain that improves when you exercise
  • loss of range of motion

People also usually have lower back pain or stiffness.

Ankylosing spondylitis can also cause symptoms that affect other joints or body parts. You might experience:

Neck pain is common in people with ankylosing spondylitis due to chronic inflammation.

In females, neck pain may be the first symptom. Neck pain is usually not the first symptom in males, but it may develop as the disease progresses.

Learn more about ankylosing spondylitis in males vs. females.

A doctor will likely start the diagnostic process by considering your medical history and performing a physical exam. They may suspect ankylosing spondylitis is causing your neck pain if you’ve previously received a diagnosis of ankylosing spondylitis.

Imaging can reveal inflammatory changes in your joints characteristic of the disease. A doctor may order:

MRI is the most accurate imaging test for detecting inflammation, but it’s more expensive and less readily available than the alternatives.

Blood tests can reveal markers of inflammation that may suggest ankylosing spondylitis. A doctor may order blood tests if you haven’t previously received a diagnosis of the condition.

You may be able to manage ankylosing spondylitis pain at home with certain remedies and changes to your habits.

Ankylosing spondylitis neck exercises

Exercise may help reduce pain and improve function. Doctors usually recommend low impact activities, like swimming or walking.

Neck exercises like neck rotations or head tilts may help reduce stiffness and reduce pain in your neck.

Learn more about exercises for ankylosing spondylitis.

Get enough sleep

Research suggests that poor sleep quality is associated with greater disease activity in people with ankylosing spondylitis. Improving your sleep may help reduce flare-ups.

Improve your posture

Improving your posture may help take the stress off your neck by helping keep your spine in proper alignment. A few general ways you can improve your posture include:

  • avoid slouching
  • stand with your shoulders square and head up
  • raise your phone in front of your face when texting
  • take frequent breaks when sitting
  • sleep on a firm mattress that allows you to keep your spine straight

Learn more about how to improve your posture with ankylosing spondylitis.

Cervical contour pillow

A cervical contour pillow supports your neck while you’re sleeping to take the stress off your neck. You may find that using a cervical contour pillow alleviates your symptoms while you’re sleeping and improves your sleep quality.

Find the best cervical contour pillows here.

Heat and ice therapy

Applying heat to your neck for at least 15 to 20 minutes at a time might help alleviate stiffness. You may also find applying a cold pack to your neck for 10 to 15 minutes at a time helps reduce swelling and pain.

Learn more about heat and ice therapy.

Medical treatments may be needed for ankylosing spondylitis if home remedies aren’t working. A doctor may recommend the following:

Pain medications

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most common class of drugs used to manage ankylosing spondylitis pain. Your doctor may recommend or prescribe:

Physical therapy

Physical therapy for ankylosing spondylitis might include:

  • posture training
  • strengthening exercises
  • flexibility and stretching
  • deep breathing exercises
  • a personalized exercise program

Biologic drugs

Biologics stop the immune reaction that causes inflammation. Biologics used to treat ankylosing spondylitis include:

  • TNF-alpha inhibitors, such as infliximab
  • interleukin-17 inhibitors, such as secukinumab or ixekizumab
  • interleukin 12/23 inhibitors, such as ustekinumab

Learn more about biologics for ankylosing spondylitis.

Other medications

Other medications used to reduce symptoms of ankylosis spondylitis include:

Ankylosing spondylitis neck surgery

Your doctor may recommend a type of neck surgery called a laminectomy if more conservative treatments aren’t relieving any neurological symptoms. This procedure involves removing part of the back of your affected vertebrae to take the pressure off your nerves.

Spinal fusion is usually reserved as a last-resort option. It involves permanently fusing two vertebrae together so you can no longer move them.

Learn more about ankylosing spondylitis surgery options.

Contact a doctor if you have unexplained back pain or other symptoms that could be caused by ankylosing spondylitis. Starting treatment before you have extensive damage to your joints gives the treatment the best chance of being effective.

It’s also important to talk with a doctor if you’ve previously received a diagnosis of ankylosing spondylosis and your symptoms progress, or if you develop new symptoms, like changes in your vision.

Ankylosing spondylitis can lead to stiffness, pain, or loss of range of motion in your neck. Neck pain is common in people with ankylosing spondylitis. It becomes more likely as the disease progresses.

Most people can manage their symptoms with home remedies or medications. Your doctor may recommend surgery as a last resort if more conservative treatment options aren’t relieving your symptoms.