Non-Surgical Treatments for Ankylosing Spondylitis

Posture training, exercise, NSAIDs, physical therapy and self-care pointers

Written by Christopher I. Shaffrey, MD

The goals of ankylosing spondylitis (AS) treatment are to relieve symptoms and prevent spinal deformity. When you and your doctor discuss treatment, you may be surprised to discover that surgery is rarely recommended for AS. Many patients find that non-surgical methods, such as exercise and medications, are successful at managing their disease and keeping complications at bay.

Common non-surgical treatments for ankylosing spondylitis include:

Posture training: A serious complication of AS is the development of a “hunchback” posture. Fortunately, posture training can prevent this side effect. If you have AS, keeping your spine straight is key. Focus on squaring your shoulders, and keeping your head relaxed and facing straight ahead.

You can learn more about posture training in Ankylosing Spondylitis and Posture.

Exercise:This is one of the best ways to gain long-term pain relief, especially when you exercise and take medications for inflammation. Exercise helps maintain your range of motion, which keeps your joints mobile. Also, a lack of activity—not exercising at all for a lengthy period—may encourage your spine to fuse because the joints aren't being used as much. Exercise can also help you maintain good posture because you strengthen your muscles to better support the spine.

Non-steroidal anti-inflammatory drugs (NSAIDs): NSAIDs reduce inflammation, which helps reduce pain, stiffness, and general discomfort. Some prescription-strength NSAIDs used for AS include: ibuprofen (Advil), naproxen (Aleve), diclofenac (Cataflam), celecoxib (Celebrex), and acetaminophen (Tylenol). You’ll need to take these medications under a physician's supervision, as NSAIDs have side effects (such as gastrointestinal bleeding).

While NSAIDs are commonly prescribed to treat AS symptoms, they aren’t the only medications that help you manage the disease. To get a comprehensive look at drugs for AS, read Medications to Treat Ankylosing Spondylitis.

Physical therapy: Physical therapy teaches you exercises designed to strengthen your back muscles, improve posture, and increase flexibility and range of motion. A physical therapist can also teach you techniques to enhance breathing, since reduced lung function is a possible side effect of ankylosing spondylitis.

Physical therapy can show you how to take care of your spine for years to come. You can learn more about the benefits of physical therapy in What Can Physical Therapy Do For Me?

Self-care techniques: Activities that help to alleviate stiffness include taking a warm bath or shower, gently stretching in bed before rising, or participating in soothing aquatics therapy.

Back Pain and Stretching Exercises has ideas on good stretches to do first thing in the morning. And, you can find water-based activity inspiration in Hydrotherapy and Aquatic Therapy.

A Long-Term Treatment Outlook for Ankylosing Spondylitis
While medications may bring immediate relief to painful symptoms, most of the nonsurgical treatments for ankylosing spondylitis aren’t quick fixes—they require dedication and continued practice. With that said, they also provide long-term benefits. After your last physical therapy session, take the lessons you learned and infuse them into your daily routine. Participating in exercise, good posture, and gentle stretching for as long as you’re physically able will pay off—not just for your AS but for your overall health as well.

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Surgery for Ankylosing Spondylitis