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11 Ways to Ease Pain With Ankylosing Spondylitis

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Amy McGorry on August 15, 2021
  • back pain
    Manage the pain of ankylosing spondylitis symptoms.
    Ankylosing spondylitis is an inflammatory condition where the joints and ligaments surrounding your spine become inflamed and stiff. In advanced cases, the vertebrae of the spine may fuse together, leaving your spine rigid and inflexible. Other joints, such as the shoulders and hips, may also be affected. Stiffness and back pain can make living with ankylosing spondylitis (AS) difficult at times. However, you can ease the pain of ankylosing spondylitis by trying a few of these tips.
  • smiling-businesswoman-sitting-in-chair
    1. Maintain good posture.
    Because fusion of spinal segments may occur with AS, it is important to maintain good posture to avoid fusing the spine in a non-upright position. Sustained poor postures puts undue stress on ligaments, tendons and joints. Practice standing upright. Stand with your back against the wall. Be sure your weight is equally distributed on both feet. Also practice lying on your stomach on a firm surface. Perform these techniques 15 minutes, twice a day to reinforce good posture.
  • Happy family of four at park during autumn
    2. Move your body.
    Many people with ankylosing spondylitis complain that the body gets stiff quickly. One way to alleviate stiffness is to change positions often. Set a timer to remind you to stand up after sitting for 20 minutes or take short walks around the office. Performing range of motion exercises throughout the day may also help keep you limber. Begin by moving your arms up and down, then bend and straighten your knees. Pump your feet up and down. Do 15 repetitions of each. Discuss specific motions that may be beneficial to your condition with your physician or physical therapist.
  • woman-stretching-at-desk
    3. Stretch your chest muscles.
    AS can lead to stiffness around the ribs. Limited mobility of the ribcage, with a flexed thoracic spine, can lead to discomfort and stiffness in the upper back and rib region. Exercising your pectoral muscles (chest muscles), and doing deep breathing exercises each day can help stretch the intercostal muscles that surround your ribs and help get them moving.  With your back against the wall, and arms overhead, stretch over and out. Do this for a 15 second count for each side of your body.  This simple stretch will help alleviate stiffness in ribs and spine.
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  • Female hands hold pill and glass of water
    4. Ask your doctor about medication.
    Decreasing inflammation is an important component in alleviating symptoms associated with AS. Ask your physician about the different types of medications available such as non-steroidal anti-inflammatory drugs (NSAIDs). Studies also suggest anti-tumor necrosis factor (TNF) medications have been successful in treating symptoms associated with this condition. Your doctor will explain the benefits and risks of each drug to determine which medication is right for you.
  • Woman doing sit-ups
    5. Strengthen your core muscles.
    Strength training that addresses your abdominals and core muscles helps muscle imbalances that may lead to faulty postures. A balanced muscle system can help maintain a neutral posture and alleviate strain on your spine and joints.  Clinical research has proven that osteoporosis can be a complicating factor with AS. Strengthening muscles helps address this issue by providing shock absorption and support to your vertebra of the spine.
  • woman-in-bathtub
    6. Take a hot bath.
    If morning stiffness plagues you at the start of the day, try taking a warm bath! Moist heat eases stiffness by increasing blood flow. It also helps remove lactic acid, a waste product of muscles, and other toxins that can trigger stiff muscles. Experts say moist heat penetrates muscles deeper than dry heat so try using a moist hot pack, hot shower or warm bath. A hot tub is another suggestion. But be sure to ask your physician if it is safe for you to use, especially if you have a heart condition or diabetes.
  • woman-stretching-legs-holding-feet
    7. Start stretching!
    Researchers have discovered that a general stretching program performed daily can help maintain flexibility and promote good range of motion in the spine and extremities. Pick a time during the day when you feel most able to tolerate stretching and stick to that time daily. Fitness experts recommend holding stretches for 30 seconds and repeating them twice. Use a cushioned mat to support your spine during the stretches.
  • man getting massage
    8. Get a massage.
    Treat yourself to massages regularly. A gentle soft tissue massage may help relieve stiff muscles. Massage has been shown to help muscle fibers lay in a more parallel fashion enabling more flexibility. Studies show massage helps with the intensity and duration of pain levels associated with patients with AS. Be sure to go to a licensed massage therapist and that the massage is not too aggressive.
  • Women meditating
    9. Try yoga.
    Yoga reportedly helps relieve back pain. It’s also a great way to address flexibility which is an issue with ankylosing spondylitis. An added bonus to practicing yoga is that it helps strengthen your body overall and incorporates breathing techniques into the postures. This can enhance range of motion in the rib cage and thoracic spine which is often affected in AS. Research shows yoga has a positive impact on stress which can be high when dealing with chronic pain symptoms.
  • Man Sleeping on His Side
    10. Pay attention to your favorite sleeping positions.
    Some studies found significantly higher sleep disturbances in patients with AS and a correlation between disrupted sleep with increased morning stiffness and pain. If aches keep you from getting zz’s, experts suggest trying different sleep positions. Try sleeping on your stomach with a pillow under your pelvis and abdomen. If you are a side sleeper, place a pillow between your knees when you go to bed. Your mattress should be firm, not hard, and experts caution against using thick pillows that will push your neck forward.
  • No Smoking
    11. Quit smoking.
    Smoking reportedly increases symptoms of ankylosing spondylitis, so now is a good time to put that cigarette out. Recent studies show smokers with AS have more spinal damage than non-smokers with the same level of disease activity – especially in men. So kick the habit.
11 Ways to Ease Pain With Ankylosing Spondylitis
  1. Bulstrode SJ, Barefoot J, Harrison RA, Clarke AK. The role of passive stretching in the treatment of ankylosing spondylitis.Br J Rheumatol. 1987 Feb;26(1):40-2.
  2. Fernández-de-Las-Peñas C, Alonso-Blanco C, et al. Two exercise interventions for the management of patients with ankylosing spondylitis: a randomized controlled trial. Am J Phys Med Rehabil. 2005 Jun;84(6):407-19.
  3. Klingberg E, Lorentzon M, Mellström D, et al. Osteoporosis in ankylosing spondylitis - prevalence, risk factors and methods of assessment. Arthritis Res Ther. 2012 May 8; 14(3): R108.
  4. Pehlivan, O, Yalçınkaya Y, Huseyinsino N ,et al. Effects of Smoking in Patients with Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis Receiving TNF Inhibitors. Rheumatology (2014) 53 (suppl 1): i145.
  5. Uhrin, MD, Z. Kuzis, MD, S, Ward, MD,MPH, M. Exercise and changes in health status in patients With ankylosing spondylitis.JAMA Internal Medicine. 2000 Oct 23; 160(19).
  6. Yan Li,Shengli Zhang,Jian Zhu, et al. Sleep disturbances are associated with increased pain, disease activity, depression, and anxiety in ankylosing spondylitis: a case-control study. Arthritis Res Ther. 2012; 14(5): R215. Epub 2012 Oct 11.
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Last Review Date: 2021 Aug 15
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