Is Ankylosing Spondylitis Treatment a Permanent Cure?

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).

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
  • Ibuprofen (Advil, Motrin)
  • Naproxen (Aleve)
  • Indomethacin (Indocin, Tivorbex)
  • Diclofenac (Flector, Cambia, Zorvolex)
  • Celecoxib (Celebrex) 
• 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) 
• 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