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Ankylosing SpondylitisAS Treatment

Let's Talk About Treatment for Ankylosing Spondylitis

Having a chronic illness can be a tough adjustment—but managing the pain doesn't have to be. With AS, you've got plenty of treatment options.

    Our Pro PanelAnkylosing Spondylitis Treatment

    We went to some of the nation's top experts on ankylosing spondylitis to bring you the most up-to-date information possible:

    Anca Askanase, M.D. headshot.

    Anca Askanase, M.D.Rheumatologist, Director of Rheumatology Clinical Trials

    Columbia University Medical Center
    New York City
    Howard Blumstein, M.D. headshot.

    Howard Blumstein, M.D.Rheumatologist, Clinical Professor of Medicine

    Stony Brook University
    Smithtown, NY
    Jonathan Greer, M.D. headshot.

    Jonathan Greer, M.D.Rheumatologist, Assistant Clinical Professor of Medicine

    University of Miami
    Palm Beach, FL

    Frequently Asked QuestionsAnkylosing Spondylitis Treatment

    Would a chiropractor be helpful?

    No! Chiropractors may provide relief for other types of backache, but their treatment is not appropriate for AS. In fact, they can make things worse. The decreased flexibility of the spine makes anyone with ankylosing spondylitis highly prone to spinal fracture, so the hands-on adjustments chiropractors make is not recommended.

    Do biologics prevent AS damage?

    The best we can say right now is maybe. Some studies suggest that they do not, while others have shown that they can reduce the progression of spinal damage seen on an X-ray by as much as 50%.

    Can I just stick to exercise if it’s helping?

    Yes! The right kinds of exercise go a long way towards both relieving pain and stiffness and maintaining flexibility in your spine and other affected joints. For many AS patients with mild to moderate symptoms, exercise and using NSAIDs as needed are effective treatments.

    What if I can’t exercise as much during a flare?

    That’s perfectly okay. You should adjust your routine, focusing on your stretching exercises to maintain your range of motion and do light aerobic activity, such as a short walk. Hold off on strength and balance exercises, as well as more intense aerobics or sports, if they worsen your symptoms.

    • AS in Women (1): BMJ Open. (2014). "Increasing Proportion of Female Patients With Ankylosing Spondylitis: A Population-based Study of Trends in the Incidence and Prevalence of AS." bmjopen.bmj.com/content/bmjopen/4/12/e006634.full.pdf
    • AS in Women (2): Current Rheumatology Reports. (2018). "Gender Differences in Axial Spondyloarthritis: Women Are Not So Lucky." doi.org/10.1007/s11926-018-0744-2
    • 2019 Axial Spondyloarthritis Treatment Recommendations: Arthritis & Rheumatology. (2019). "2019 Update of the American College of Rheumatology/ Spondylitis Association of America/Spondyloarthritis Research and Treatment Network Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis" rheumatology.org/Portals/0/Files/AxialSpA-Guideline-2019.pdf
    • The Role of Exercise: Spondylitis Association of America. (2018). "The Role of Exercise in Spondyloarthritis/" spondylitis.org/LinkClick.aspx?fileticket=fo_RrqLaNaQ%3d&portalid=0
    • Combining NSAIDs and Biologics to Treat AS: American College of Rheumatology. (2016). “Combination of NSAIDs and TNF-inhibitors shows benefit for ankylosing spondylitis.” sciencedaily.com/releases/2016/11/161113154759.htm
    • Exercise Recommendations: Seminars in Arthritis and Rheumatism. (2016). “Exercise for Ankylosing Spondylitis: An Evidence-Based Consensus Statement.” ncbi.nlm.nih.gov/pubmed/26493464
    • The Latest as Therapies and Most Recent Discoveries: F1000 Research. (2018). “Recent advances in ankylosing spondylitis: understanding the disease and management.” f1000research.com/articles/7-1512
    • Role of Methotrexate: Annals of Rheumatic Diseases. (2015). "The Effect of Comedication With Conventional Synthetic Disease Modifying Antirheumatic Drugs on TNF Inhibitor Drug Survival in Patients With Ankylosing Spondylitis and Undifferentiated Spondyloarthritis: Results From a Nationwide Prospective Study." pubmed.ncbi.nlm.nih.gov/25710471/
    Stephanie Wood

    Stephanie Wood

    Stephanie Wood is a award-winning freelance writer and former magazine editor specializing in health, nutrition, wellness, and parenting.