![While there is no cure for ankylosing spondylitis, treating it early on can help prevent long-term complications and joint damage, and manage symptoms. Treatment for ankylosing spondylitis may involve exercise, physical therapy, medication, healthy lifestyle changes, and surgery (rarely).](https://images.medicinenet.com/images/article/main_image/ankylosing-spondylitis.jpg?output-quality=75)
Ankylosing spondylitis is a chronic, inflammatory autoimmune disease that is a rare form of arthritis. The main areas of the body affected include
- the sacroiliac joints (between the bones of the pelvis), and
- the axial skeleton (the spinal column, ribcage, neck, and skull bones).
There is currently no cure for ankylosing spondylitis, however, early, aggressive treatment can help prevent long-term complications and joint damage, manage the condition, and improve quality of life. Treatment may involve a combination of exercise and physical therapy, medication, healthy lifestyle changes, and in rare cases, surgery.
Medications for Ankylosing Spondylitis
Medications used to treat ankylosing spondylitis include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most commonly used medications for or pain and stiffness
- Biologics may be used if NSAIDs don’t work well
- Tumor necrosis factor-α (TNF-α) antagonists
- Infliximab (Remicade)
- Etanercept (Enbrel)
- Adalimumab (Humira)
- Certolizumab pegol (Cimzia)
- Golimumab (Simponi)
- Anti-interleukin 17 therapy
- Secukinumab (Cosentyx)
- Ixekizumab (Taltz)
- Tumor necrosis factor-α (TNF-α) antagonists
- Sulfasalazine (a DMARD) and methotrexate for arthritis symptom relief
- Corticosteroid injections are used for swollen, painful joints
- Opioids (narcotics) to treat pain
Physical Therapy and Exercise
Physical therapy and exercise used to treat ankylosing spondylitis includes:
- Exercises
- Core strengthening
- Cardiovascular
- Isometric strengthening
- Breathing exercises
- Stretching
- Dynamic movements
- Fall-prevention exercises
- Posture training to help prevent the spine from becoming “frozen”
Lifestyle Modifications
Lifestyle modifications to help manage ankylosing spondylitis include:
- Safety measures to minimize accidents caused by limited mobility
- Modify the home to decrease the risk of falls
- Always wear seatbelts in motor vehicles
- Limit alcohol
- Sleep on a thin pillow to help avoid developing deformities of the neck
- Use narcotics and sleeping pills with caution or avoid them entirely
- Avoid contact sports and high-impact activities if the spine is inflexible
- Eat a healthy diet with anti-inflammatory foods
- Consume foods such as fruits, vegetables, whole grains, fatty fish, and extra virgin olive oil
- Limit red meat, sugar, and processed foods
- Don’t smoke
- Pace yourself
- Take breaks throughout the day to manage fatigue
- Support groups to help patients cope
Surgery for Ankylosing Spondylitis
Surgery is rarely used to treat ankylosing spondylitis. When surgery is needed, it may include:
- Joint replacement to help with severe pain or joint damage
- Spinal surgery to help straighten a severely bent forward spine
- Wedge osteotomy to remove a wedge-shaped piece of bone from a vertebra, followed by a realignment of the spine which is braced to heal in a better position
- Fracture stabilization
What Are Symptoms of Ankylosing Spondylitis?
Pain and stiffness in the lower back and buttocks are hallmark symptoms of ankylosing spondylitis, which usually start in late adolescence or early adulthood.
In addition to pain and stiffness in the lower back and buttocks, early stage ankylosing spondylitis symptoms may include:
- Mild fever
- Loss of appetite
- General discomfort
Other symptoms of ankylosing spondylitis may include:
- Arthritis
- Irritation of soft tissues (muscles, ligaments, tendons) where they enter the bones (enthesitis), most often in extremities
- Fatigue
- Anemia
- Bowel inflammation
- Eye inflammation (uveitis or iritis)
- Blurred vision
- Painful, watery, and red eyes
- Sensitivity to bright light
- Stooped posture (advanced stage)
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https://www.uptodate.com/contents/axial-spondyloarthritis-including-ankylosing-spondylitis-beyond-the-basics?search=Ankylosing%20Spondylitis&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2
https://spondylitis.org/
https://www.aarda.org/diseaseinfo/ankylosing-spondylitis/
https://www.arthritis.org/diseases/ankylosing-spondylitis