When ankylosing spondylitis — a type of arthritis that affects the spine — is causing your back to feel painful and stiff, exercise might seem impossible. But exercise plays an important part in preserving your range of motion and managing your symptoms — even when your medications are already working well. Exercise helps strengthen your muscles, increase your flexibility, improve your posture and, eventually, lessen your pain.

The key to achieving the benefits of exercise is to do ankylosing spondylitis-specific exercises that are approved and supervised by your doctor or physical therapist.

Types of exercises:

Exercising on your own can be good for you, but when you have ankylosing spondylitis, research shows that working with a physical therapist or guided exercise program is most beneficial. To get the most out of your exercises, and to ensure you're doing them correctly and safely, start by talking to your doctor or a physical therapist. Ask them to help you design an exercise program appropriate for your specific situation.

Examples of exercises your doctor might suggest include:

• Deep breathing and aerobic exercises to improve your overall health and keep your chest and ribs flexible;
• Strength-building exercises to help maintain function;
• Range-of-motion and stretching exercises to help keep your joints and spine flexible;
• Water exercises (hydrotherapy) to help keep your back, neck, shoulders and hips flexible;
• Abdominal and back exercises to improve and maintain your posture, which can be affected by a stiffening neck and spine.

According to the Spondylitis Association of America, one example of a posture exercise involves lying face down on a firm surface, if you're able to. If you can't lie flat, you may need to support your chest with a pillow and your forehead with a towel. Start slowly, warming up your muscles beforehand with a hot shower and holding the position for just a minute or two. You may gradually work your way up to holding this position for 20 minutes.

Useful tips:

• Talk to your doctor or a physical therapist before you start an exercise program.
• Warm up before you start exercising.
• Choose a time that works for you — if you're stiff in the morning, exercise may help loosen you up, or you can do shorter rounds of exercises throughout the day.
• Choose a comfortable spot to exercise, such as a carpeted surface or an exercise mat.
• Exercise every day.
• Don't overdo it — ease yourself into exercise, gradually increasing your efforts over time.

By choosing the right exercises and taking steps to ensure you're doing them safely and correctly, you'll be on your way to managing your ankylosing spondylitis symptoms.