Mayo Clinic Health Manager
Get free personalized health guidance for you and your family.
Get Started
About our e-newsletters
- Free e-newsletters
- Mayo Clinic expertise
- We do not share your e-mail address
Housecall, our weekly general-interest e-newsletter, keeps you up to date on a wide variety of health topics with timely, reliable, practical information, recipes, blogs, questions and answers with Mayo Clinic experts and more. Our biweekly topic-specific e-newsletters also include blogs, questions and answers with Mayo Clinic experts, and other useful information that will help you manage your health.
Housecall Archives
Mayo Clinic Housecall
Stay up to date on the latest health information.
What you get
- Free weekly e-newsletter
- Mayo Clinic expertise
- Recipes, tools and other helpful information
- We do not share your e-mail address
Treatments and drugs
By Mayo Clinic staffThe goal of treatment is to relieve your pain and stiffness, and prevent or delay complications and spinal deformity. Ankylosing spondylitis treatment is most successful before the disease causes irreversible damage to your joints, such as fusion, especially in positions that limit your function.
Medications
Your doctor may recommend that you take one or more of the following medications:
- Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs — such as naproxen (Aleve, Naprosyn) and indomethacin (Indocin) — are the medications doctors most commonly use to treat ankylosing spondylitis. They can relieve your inflammation, pain and stiffness. However, these medications aren't without side effects. One of the more serious side effects attributed to NSAID use is gastrointestinal bleeding. Rarer side effects include kidney and liver problems.
- Disease-modifying antirheumatic drugs (DMARDs). Your doctor may prescribe a DMARD, such as sulfasalazine (Azulfidine) or methotrexate (Rheumatrex), to treat inflamed joints of the legs and arms and other tissues. This class of drugs helps limit the amount of joint damage that occurs. Serious side effects that can occur while using these medications include low blood counts and liver damage.
- Corticosteroids. These medications, such as prednisone, may suppress inflammation and slow joint damage in severe cases of ankylosing spondylitis. You usually take them orally, ideally for a limited period of time because of their side effects, such as bone loss. Occasionally, corticosteroids are injected directly into a painful joint.
- Tumor necrosis factor (TNF) blockers. TNF is a cytokine, or cell protein, that acts as an inflammatory agent in rheumatoid arthritis. TNF blockers target or block this protein and can help reduce pain, stiffness, and tender or swollen joints. These medications, such as adalimumab (Humira), etanercept (Enbrel) and infliximab (Remicade), may decrease inflammation and improve pain and stiffness for people with ankylosing spondylitis. When taking these medications, there's a risk of reactivating latent infections, such as tuberculosis, as well as a risk of certain neurological problems.
Physical therapy
Physical therapy can provide a number of benefits, from pain relief to improved physical strength and flexibility. Your doctor may recommend that you meet with a physical therapist to provide you with specific exercises designed for your needs.
Range-of-motion and stretching exercises can help maintain flexibility in your joints and preserve good posture. In addition, specific breathing exercises can help to sustain and enhance your lung capacity.
As your condition worsens, your upper body may begin to stoop forward. Proper sleep and walking positions and abdominal and back exercises can help maintain your upright posture. Though you may develop spine stiffness despite your treatment regimen, proper posture can help to ensure that your spine is fused in a fixed upright position.
Surgery
Most people with ankylosing spondylitis don't need surgery. However, your doctor may recommend surgery if you have severe pain or joint damage, or if a nonspinal joint is so damaged that it needs to be replaced.
- Yu DT, Patient information: Ankylosing spondylitis, http://www.uptodate.com/home/index.html. Accessed Nov. 10, 2008.
- Mercier LR, Ankylosing spondylitis. In: Ferri FF. Ferri's Clinical Advisor 2009. Philadelphia, Pa.: Mosby Elsevier; 2009. http://www.mdconsult.com/das/book/body/109354214-4/0/1701/48.html?printing=true. Accessed Nov. 5, 2008.
- Ankylosing spondylitis. Genetics Home Reference. http://ghr.nlm.nih.gov/condition=ankylosingspondylitis. Accessed Nov. 6, 2008.
- Taurog JD. The Spondyloarthritides: Anklyosing Spondylitis. In: Fauci AS, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, N.Y.: The McGraw-Hill Companies; 2008. http://www.accessmedicine.com/content.aspx?aID=2862756&searchStr=ankylosing+spondylitis. Accessed Jan. 9, 2009.
- Song IH. Benefits and risks of ankylosing spondylitis treatment with nonsteroidal antiinflammatory drugs. Arthritis and Rheumatism. 2008;58(4):929-938.
- Yu DT. Treatment and prognosis of ankylosing spondylitis in adults. http://www.uptodate.com/home/index.html. Accessed Nov. 10, 2008.
