Ankylosing Spondylitis and Posture

Posture training tips to benefit healthy spinal alignment

Arguably, one of the most serious complications of ankylosing spondylitis (AS) is the development of a “hunchback” posture. If your spine becomes stiff or rigid into a head-forward position, it can take a huge toll on your quality of life—it can impact everything from your ability to look someone in the eyes to how you get dressed in the morning.

lateral x-ray shows ankylosing spondylitis, hunchbackIf your spine becomes stiff or rigid into a head-forward position, it can take a huge toll on your quality of life. Image Courtesy of, many patients with AS benefit from posture training. Consider the detrimental affects of modern socity that work against having good posture even in people without AS. Hours spent on the couch watching TV or stretching toward a computer screen can have major consequences for someone with AS. Posture training is designed to teach you how to combat these effects and help you maintain good spinal alignment or posture.

Ways to Maintain Proper Spinal Alignment

If you have AS, maintaining good spinal alignment should be a top priority. Square your shoulders, and keep your head relaxed and facing straight ahead (eg, don’t look down when you’re walking). When standing, imagine your ears, shoulders, hips, knees, and ankles falling in a straight line.

Below are other tips to help you maintain good spinal posture and reduce the risk of developing abnormal posture.

While sleeping
You can maintain proper spinal alignment at night by sleeping on a firm mattress that supports your full body. Sleeping on your back with a thin pillow under your neck is best. You should also keep your legs straight—avoid a curled position and don’t use a pillow under your knees—as extending your legs will preserve flexibility.

Furniture basics
Soft, cushy chairs and couches might be enticing, but they make it easy to lose good posture. Instead, seek out straight- and hard-back chairs that don’t recline. You can add a small cushion or pillow at the small of your back to add a bit of extra support and comfort.

Additional tips
If you work at a computer all day, make sure your work area is ergonomically sound, and take frequent breaks to get up and move. You can read more about keeping good posture at work in our article Workstation Ergonomic Tips: Computer Monitors and Posture.

If you’ve been sitting, occasionally get up and walk to stretch your spine. Another good way to revive your spine is to lie on the floor on your back for a bit each day. This position will help stretch your hips and promote good posture.

How to Check for Posture Problems

If you have AS and suspect you’re developing a hunchback posture, there are some simple methods to test it.

One common way is a simple wall test. Stand with your back against the wall. If your spine is straight, the back of your head should be able to touch the wall while your chin is parallel to the floor.

Another option is a mirror test. Stand to the side next to a full-length mirror, turning your head to view yourself. Imagine dropping a string from the top of your head down to your toes. If you have good posture, the invisible string should fall through your ears, the front of your shoulder, down to the center of your hip, then further down behind your kneecap, and finally to the front of your ankle.

More Posture Tips for Ankylosing Spondylitis

Practicing good posture is one of the most important things you can do to promote spinal health and quality of life when you have ankylosing spondylitis. If you are concerned about your posture, talk to your spine specialist or physical therapist about how to incorporate simple posture strategies into your daily life. If you’d like to read more about how to improve your posture, click here.

Updated on: 05/16/19
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Ankylosing Spondylitis: Treatment and Recovery
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Ankylosing Spondylitis: Treatment and Recovery

Treatment for ankylosing spondylitis (AS) is aimed at relieving the patient's symptoms and preventing spinal deformity.
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