Various treatments can help reduce the pain and stiffness associated with ankylosing spondylitis (AS). For example, exercise and movement help maintain the flexibility of the spine. Swimming is a preferred exercise for AS patients, according to the American Academy of Orthopaedic Surgeons.

The earlier treatment begins, the more effective it is likely to be. It is important that patients seek medical care before AS may cause irreversible damage to the joints.

Treatments used for AS include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs can help relieve inflammation, pain and stiffness.
  
  
• Disease-modifying antirheumatic drugs (DMARDs). These drugs are used to treat inflamed joints and other tissues. Potential side effects include stomach pain and increased risk of infections.
  
  
• Corticosteroids. These medications may suppress inflammation and slow joint damage in advanced cases of ankylosing spondylitis. These drugs are usually taken orally but can also be injected. They should be taken for only a short time under close supervision of a physician, as potential side effects of long-term use include osteoporosis, fractures and diabetes.
  
  
• Tumor necrosis factor (TNF) inhibitors. Originally used to treat rheumatoid arthritis, these drugs, a subgroup of biologic response modifiers (BRMs), may decrease inflammation, pain and stiffness in people with AS. Potential risks of TNF inhibitors include serious infections.

Patients frequently will also undergo physical therapy and rehabilitation. This can help improve physical strength and increase flexibility, which may lessen the pain associated with AS. Patients may learn range-of-motion and stretching exercises, which can help increase the flexibility of joints. They may also learn breathing exercises to help them sustain lung capacity, which can be damaged by AS.

Therapeutic use of water (hydrotherapy) and heat (thermotherapy) may also help.

Patients may learn proper sleep and walking positions to help them maintain proper posture and ergonomics. Using a proper chair, bed, mattress and pillow also help in maintaining normal ergonomics. Abdominal and back exercises can also help these efforts. When AS progresses, the upper body tends to stoop forward, but these exercises can help prevent that from occurring. Patients who have difficulty performing daily tasks may be referred to occupational therapy.

AS does not usually require surgery. However, an operation may be recommended for patients with severe pain or joint damage. Depending on the area affected, possible options may include spinal osteotomy, vertebral column resection, hip replacement or knee replacement, according to the American Academy of Orthopaedic Surgeons.

Most patients with ankylosing spondylitis remain employable and continue to function well in society. Education about the disease is essential in the treatment of AS.