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What are my treating options for ankylosing spondylitis?
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by AGE2B

Although there's no cure for ankylosing spondylitis — a type of arthritis that affects the spine — treatment can ease your symptoms and possibly slow the progression of the disease.

Ankylosing spondylitis usually starts with pain and stiffness in your back, after times of inactivity. Symptoms typically develop gradually, before age 45, and last more than three months. Pain and stiffness tend to ease with activity but may become ongoing and spread to the neck, ribs, shoulders, and heels. When the condition is severe, bones in the spine can fuse together. This can make those parts inflexible, which may stiffen your ribs — making it hard to breathe deeply — or cause a hunched posture.

Ankylosing spondylitis treatment is most successful when started before the disease causes irreversible damage to your joints. Before meeting with your doctor, it may help to understand the treatment options.

Initial treatments

Ankylosing spondylitis treatment typically starts with physical therapy and non-steroidal anti-inflammatory drugs (NSAIDs).

Physical therapy. A physical therapist designs specific exercises for your needs. These exercises can help improve strength. Range-of-motion and stretching exercises can help keep your joints flexible and preserve good posture. Proper sleep and walking positions and abdominal and back exercises can help maintain your upright posture, too.

NSAIDs. Non-steroidal anti-inflammatory drugs —can relieve swelling, pain, and stiffness. Often, these may be the only medications required. A potential side effect, however, is bleeding in your stomach or intestines.

If NSAIDs aren't helpful, your doctor might suggest a biological medication. These could include:

Tumor necrosis factor (TNF) blockers. TNF blockers help reduce pain, stiffness, and tender or swollen joints. The drug is given as an injection under your skin or through a vein (intravenously).

Interleukin 17 (IL-17) inhibitors. IL-17 also may help ease inflammation and is given as an injection under your skin.

Potential side effects of TNF blockers and IL-17 inhibitors are reactivation of inactive (latent) tuberculosis and an increased risk of infections.


Most people with ankylosing spondylitis don't need surgery. But if you have severe pain or joint damage, or if your hip joint is so damaged that it needs to be replaced, your doctor might recommend surgery.

Regardless of what treatments you and your doctor choose, it's important to see your doctor often and follow your treatment plan. This can help you avoid complications and worsening of your symptoms and keep your joints working as well as they can.

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