Non-surgical Treatments for Ankylosing Spondylitis
Treatment for ankylosing spondylitis (AS) is aimed at relieving the patient's symptoms and preventing spinal deformity. Seldom is surgery required, and there are several non-surgical treatment options available.
Standard non-surgical treatments for ankylosing spondylitis include:
- Exercise: This is one of the best ways to gain long-term pain relief, especially when you exercise and take medications for inflammation (see NSAIDs below). When you exercise, it 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 allow your spine to fuse more 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): The earlier AS is diagnosed, the better it responds to medications such as NSAIDs. By reducing inflammation, these medications can help 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). It is necessary take these medications under a physician's supervision, as NSAIDs have side effects such as gastrointestinal bleeding.
- Physical therapy: Physical therapy teaches the patient exercises designed to strengthen 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.
- Self-care techniques: Activities that help to alleviate stiffness include taking a warm bath or shower, gentle stretching movements performed in bed before rising or aquatics such as swimming.
If you have a spinal fracture— a great possibility in people with ankylosing spondylitis as your spine fuses—brace therapy may be recommended. There are many different types of braces that can help support the spine and may reduce pain. There are braces available for every region of the spine—cervical (neck), thoracic (mid back), lumbar (low back), and sacral (pelvis).
- A thoracolumbar sacral orthotic (TLSO) is a jacket-like, sleeveless brace that stabilizes the thoracic-lumbar-sacral spinal regions. It may be worn for 3 months or more, depending on your condition and the severity of the spinal fracture and and potential for progressive deformity.
- A halo brace is used for cervical fractures, and it's considered a form of spinal traction. The apparatus immobilizes the cervical spine by placement of pins into the skull secured to a metal ring—a halo—around the head. Two metal rods then attach the ring to a well-fitted jacket. The halo brace may be worn for 3 months or more, depending on the severity of your spinal fracture and potential for spinal deformity.