When you live with ankylosing spondylitis (AS), you may experience pain in your ribs or chest in addition to your back. AS is an inflammatory condition that can cause your ribs to become swollen, stiff, or even fused to your spine or breast bone as the condition progresses.

You may first experience AS symptoms as an older teenager or young adult. Pain in your ribs may develop later as the inflammation from the condition spreads to other areas of your body. The first symptoms of AS are usually pain and stiffness in your back or hips.

Rib pain near the spine occurs in 70 percent of people with AS, whereas pain in the ribs alone only occurs in 20 percent of those with the condition. This pain occurs as a result of inflammation.

While there’s no cure for AS, there are several methods you can try to soothe discomfort from rib pain. Some may involve visiting a doctor or other medical specialist to determine whether medications, physical therapy, or injections at the site of pain might help. Others options include lifestyle modifications and home remedies.

Deep breathing exercises

Practicing deep breathing exercises can help your lungs fill and empty more easily if you have rib pain caused by AS. It will also ensure that your rib cage remains flexible.

Here’s one deep breathing exercise to try:

  • Stand tall with your feet a few inches apart.
  • Stretch your arms out in front of you with your palms pointed toward the sky.
  • Breathe in and move your arms outward into a “U” shape so that they end up parallel to your body.
  • Hold this position and your breath for a few moments.
  • When you breathe out, bring your arms back in front of you, palms facing up.

There are other deep breathing exercises you can try if you have AS. Ask your doctor or another specialist like a physical therapist to show you some other methods.

Regular exercise

Keeping active helps your body stay mobile and flexible. It can also promote healthy posture, which can relieve symptoms of AS.

You may want to try exercises like swimming or biking because they are low-impact. Swimming can also help you breathe deeply, which may reduce chest or rib pain. Avoid any exercise that applies too much pressure on your back.

Physical therapy

Physical therapy techniques may help decrease your rib and chest pain by introducing helpful breathing techniques, stretches, and tailored exercises. These can help improve your breathing, posture, range-of-motion, and flexibility. A physical therapist can guide you through different cardiovascular and strength training exercises.

Over-the-counter medications

Medications can help reduce rib pain caused by AS. The first line of medication to try for AS symptoms is a nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen or naproxen. These medications target both pain and inflammation and can be purchased without a prescription.

There are some side effects to these medications, though, such as gastrointestinal bleeding. Talk to your doctor if you find yourself taking them regularly to relieve AS symptoms. Your doctor may recommend a higher dose or a prescription medication to target all of your symptoms.

Prescription medications

Your doctor may recommend a prescription NSAID or another medication to treat rib and chest pain caused by AS.

Biologics for AS include tumor necrosis factor (TNF) blockers or interleukin-17 (IL-17) inhibitors. Some may be given intravenously or by injection. These medications target specific chemicals and proteins in the body to reduce inflammation.

Hot showers or baths

A hot shower or bath may help your body and specifically your joints loosen up, reducing pain and inflammation. You may also find that they relax you and help you manage your pain levels.

Deep breathing exercises after a hot bath or shower may be more comfortable. You may also find that you remember to do the exercises more regularly if you shower or bathe daily and tie the exercises in with that routine.

Sleeping position

Your sleeping position may cause pain in your ribs and other parts of your body as a result of AS.

Make sure you sleep on a firm mattress that supports your body. Try to sleep in a straight position rather than curled up. You may also want to avoid using a pillow if you’re a stomach sleeper or try a very thin one if you sleep on your back.


Using good posture can reduce AS symptoms. Make sure you align yourself straight when you stand, walk, or sit. Regular exercise and good sleep positions will also contribute to healthy posture.

Ice packs

Ice packs are another remedy you can use at home for rib pain. Try applying ice to the painful area for a short period of time. This may reduce your pain and inflammation.

Avoid smoking

Smoking can impact your breathing, which may worsen your rib pain from AS. Quitting smoking will help you to avoid unwanted symptoms and breathing difficulties. Ask your doctor for tips to avoid smoking if you’re having difficulty.

Mild to severe inflammation in the ribs as a result of AS may appear as breathing difficulties or chest pain.

The inflammation, stiffness, and fusion affecting your ribs can make it difficult for you to take deep breaths. Instead, you may breathe from only your diaphragm, located below your ribs. Breathing may become especially difficult if you wear restrictive clothing around your midsection.

You may experience chest pain if the inflammation from AS affects your ribs, breastbone, and spine. Keep in mind that chest pain can be the sign of a serious, life threatening health condition, so do not brush it aside if you notice it for the first time. See your doctor as soon as possible.

There are many ways to reduce rib pain and discomfort if you have AS. Talk to your doctor about medications and other ways to reduce or eliminate painful symptoms that interfere or limit with your daily activities.

Seek immediate medical attention if you suspect the pain in your ribs or chest is something more than AS symptoms. These symptoms may be the sign of a serious health condition that requires medical attention right away.