Treatment for Ankylosing Spondylitis

In recent years, advances have been made in the treatment of ankylosing spondylitis and related diseases. There is a lot that can be done to relieve the pain and stiffness of AS. Recent studies show that the new biologic medications (TNF-α Inhibitors) can potentially slow or halt the disease progression in some people.

A common treatment regimen involves medication, exercise and possibly physical therapy, good posture practices, and other treatment options such as applying heat/cold to help relax muscles and reduce joint pain. In severe cases of AS, surgery may also be an option. Very often, a rheumatologist will outline a treatment plan, but other professional may also be able to help.

Medication

You and your doctor can decide which of the following medications, if any, are best for you.

NSAIDs (nonsteroidal anti-inflammatory drugs) are still the cornerstone of treatment and the first stage of medication in treating the pain and stiffness associated with AS. However, NSAIDs can cause significant side effects, in particular, damage to the gastrointestinal tract.

When NSAIDs are not enough, the next stage of medications, (also known as second line medications), are sometimes called disease modifying anti-rheumatic drugs. This group of medications include: Sulfasalazine, Methotrexate and Corticosteroids.

The most recent and most promising medications for treating ankylosing spondylitis are the biologics, or TNF Blockers. These drugs have been shown to be highly effective in treating not only the arthritis of the joints, but also the spinal arthritis. Included in this group are Enbrel, Remicade and Humira.

Exercise

Exercise in an integral part of any spondylitis management program. Regular daily exercises can help create better posture and flexibility as well as help lessen pain.

A properly trained physical therapist with experience in helping those with ankylosing spondylitis can be a valuable guide in regard to exercise.

Posture

Practicing good posture techniques will also help avoid some of the complications of spondylitis including stiffness and flexion deformities / kyphosis (downward curvature) of the spine.

Heat/Cold

Applying heat to stiff joints and tight muscles can help reduce pain and soreness. Applying cold to inflamed areas can help reduce swelling. Hot baths and showers can also help provide relief.

Surgery

In severe cases of ankylosing spondylitis, surgery can be an option in the form of joint replacements, particularly in the knees and hips. Surgical correction is also possible for those with severe flexion deformities (severe downward curvature) of the spine, particularly in the neck, although this procedure is considered risky.

Other Symptom Management Tools

Alternative treatments such as massage and using a TENS unit (electrical stimulators for pain) can also aide in pain relief. Maintaining a healthy body weight and balanced diet can also aide in treatment.