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Can You Prevent Ankylosing Spondylitis from Getting Worse?

How AS can be treated with exercise and medication to lessen symptoms and slow disease progression.

An exercise plan for AS should include core strengthening exercises, cardiovascular exercise, posture training, and exercises to improve strength, flexibility, mobility, and breathing.

Ankylosing spondylitis (AS) is a type of inflammatory arthritis. It affects the joints that connect the vertebrae that make up the spinal column, as well as the sacroiliac joints, the joints that hold the pelvis and spine together.

Pain and stiffness in the back are usually the first symptoms of ankylosing spondylitis. Over time, AS can cause permanent changes to the spine that can limit a person’s movement and alter their posture. People with AS sometimes experience arthritis symptoms in other joints and inflammation in other areas of the body.

While there is no cure for AS, there are therapies that can help put the disease in remission, slow the progression of the disease, and prevent further damage to the joints.

AS is a lifelong condition, and it requires lifelong treatment. Here, we look at what you can do to prevent AS from getting worse.

Exercise and medications

There is no single best treatment for ankylosing spondylitis—the condition is a little bit different for every person. But one thing that every treatment plan for AS will have in common is exercise.

Ideally, a person with AS should work with a physical therapist. A physical therapist can assess a person’s overall fitness and mobility, and they can build a personalized exercise plan based on individual needs. Most importantly, a physical therapist can help a person with AS exercise safely.

An exercise plan for AS should include core strengthening exercises, cardiovascular exercise, posture training, and exercises to improve strength, flexibility, mobility, and breathing.

In addition to exercise, there are a variety of drugs that can be used to treat AS. These can include medications to relieve inflammation and pain. It can also include disease-modifying antirheumatic drugs (DMARDs) and biologic therapies—medications that act on the immune system to reduce inflammation. Different medications work better for different people, and your healthcare provider can guide you through medication options.

Because AS is a lifelong condition, a person may need different medications at different times, and may follow different exercise routines at different times.

Following your treatment plan

A treatment plan will only be effective if it is followed as closely as possible. When living with and managing AS, this means taking medications as prescribed, following your exercise program, and keeping all appointments with your healthcare providers.

Following your treatment plan can help you prevent AS from getting worse and help you get the most benefit from treatment.

If you are having difficulty following any part of your treatment plan—for any reason—tell your healthcare providers. Here are a few questions you might want to ask yourself before talking to your healthcare provider:

  • Do you have questions about how exercise works to treat AS?
  • Do you have questions about how a medication works?
  • Do you feel that treatment is making a difference?
  • How would you describe your overall quality of life?
  • Is this treatment plan too expensive?
  • Is this treatment plan too time-consuming?
  • Are you concerned about side effects?
  • What do you like or dislike about this treatment plan?

Remember, your healthcare providers are there to help you find solutions to the challenges of living with and managing AS. They will also be your best source of information when you have a question or concern.

Article sources open article sources

UpToDate. Patient education: Axial spondyloarthritis, including ankylosing spondylitis (Beyond the Basics).
MedlinePlus. Ankylosing Spondylitis.
Kyle J. Wenker and Jessilin M. Quint. Ankylosing Spondylitis. StatPearls. April 9, 2022.
MedlinePlus. Ankylosing spondylitis.
National Institute of Arthritis and Musculoskeletal and Skin Diseases. Ankylosing Spondylitis: Diagnosis, Treatment, and Steps to Take.
Teresa Dumain. 6 Daily Stretches for Ankylosing Spondylitis that Can Help Ease Pain. CreakyJoints.org. March 5, 2019.
Sai Ma, Liang Zhang, et al. Patient-reported adherence to physical exercises of patients with ankylosing spondylitis. Clinical Rheumatology, 2022. Vol. 41, No. 8.
Basma R. Sakr, Heba E. Mohamed, and Dina A. Effat. Relationship of adherence to treatment with disease activity, physical function, quality of life, treatment satisfaction and beliefs in axial spondyloarthritis patients. The Egyptian Rheumatologist, 2022. Vol. 44, No. 3.
Fred Kleinsinger. The Unmet Challenge of Medication Nonadherence. The Permanente Journal, 2018. Vol. 22.

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