How to Manage Your Back Pain From Ankylosing Spondylitis

How to Manage Your Back Pain From Ankylosing Spondylitis

You may think of arthritis as a disease that appears in late adulthood, but that only applies to degenerative types like osteoarthritis. Inflammatory arthritis is different.

You can develop several types of inflammatory arthritis, including ankylosing spondylitis and rheumatoid arthritis, at a much younger age. In fact, 80% of people with ankylosing spondylitis have symptoms by the time they turn 30.

Ankylosing spondylitis is also a progressive disease that keeps spreading and causing more severe symptoms as time goes on. That’s why Behnam Khaleghi, MD, here at Pacific Rheumatology Medical Center, encourages you to seek treatment as soon as symptoms appear. Early treatment gives you a better chance of slowing the disease and staying healthy.

Ankylosing spondylitis explained

Ankylosing spondylitis is an autoimmune disorder that causes inflammatory arthritis in the facet joints between spinal vertebrae and the sacroiliac joints connecting the base of your spine to your hips.

As the disease advances, the arthritis progresses up your spine and the inflammation spreads to other body areas, causing problems in other joints, such as your ribs, shoulders, knees, and ankles. 

In many people, ankylosing spondylitis causes inflammatory conditions beyond their joints. For example, they may develop uveitis (eye inflammation) or inflammatory bowel disease.

Ankylosing spondylitis symptoms

The first symptoms are low back pain and stiffness. The inflammation also causes swelling in the joint and around ligaments and tendons where they attach to the vertebrae. Some people develop severe inflammation in their fingers and/or toes (dactylitis).

Over time, the inflammation spreads, causing pain and stiffness in other areas. Prolonged inflammation triggers new bone growth that fuses vertebrae together, severely limiting spine movement and often making it hard to breathe.

Ankylosing spondylitis treatment

We create a personalized treatment plan designed to ease your pain, reduce inflammation, preserve mobility, and prevent the disease from progressing to involve more joints and tissues.

Your treatment includes physical therapy, medications, and lifestyle modifications you can use to manage your back pain and control the disease.

Physical therapy and home exercise

With all types of arthritis, it’s essential to keep moving your joints. Physical therapy uses specialized treatments to help you maintain posture and spinal flexibility. Good posture reduces the stress on your spine, supports optimal mobility, and diminishes pain.

Your physical therapist also develops a home exercise plan, an indispensable part of your self-care for managing back and joint pain. Exercise reduces inflammation and pain and strengthens the supporting tendons, ligaments, and muscles.


Nonsteroidal anti-inflammatory drugs effectively reduce inflammation, stiffness, and pain for people in the early stages or with mild disease. The next step up in medication may include steroid injections.

Advanced biologic medications called tumor necrosis factor (TNF) blockers and interleukin-17 (IL-17) inhibitors suppress the immune system, reduce inflammation, and slow or stop disease progression. Even if you have severe disease, these medications can significantly improve mobility and function.

Another class of drugs, JAK inhibitors, can also substantially improve your pain and stiffness by blocking inflammation and reducing joint damage.

Lifestyle modifications

In addition to following an exercise regimen and watching your posture, there are several lifestyle modifications we recommend for managing pain and stiffness.

Fight inflammation. Fighting inflammation is vital. For this reason, we recommend following an anti-inflammatory diet. We may also suggest taking anti-inflammatory supplements or using IV vitamin therapy to reduce fatigue and support your overall health.

Stop smoking. If you smoke cigarettes (or use any tobacco products) or drink alcoholic beverages, it’s essential to stop. Smoking and drinking accelerate ankylosing spondylitis, increasing inflammation and causing more severe disease.

Improve your sleep. You need sleep to stay healthy and fight inflammation. Many people find that their pain and stiffness are worse at night — and just as bad in the morning after lying down throughout the night. 

As a result, they have a hard time getting enough sleep and have worse symptoms when they’re awake. If you’re caught in this cycle, we can help with therapies and recommendations for improving your sleep.

If you have questions about your symptoms or need expert care for ankylosing spondylitis, call Pacific Rheumatology Medical Center or request an appointment online today.

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