Ankylosing Spondylitis Treatment

Ankylosing spondylitis is a chronic, degenerative condition, with some suffering a steady progression in symptoms and severity, and some having significant episodes of relapse and remission. There is no cure for ankylosing spondylitis, although ankylosing spondylitis treatment and medications are often used to ameliorate the symptoms and reduce back and neck pain.

Ankylosing spondylitis does respond well to moderate exercise, with stiffness and pain reducing along with inflammation as the patient engages in physiotherapy, and gentle physical activity. Care should be taken not to stress the spine during exercise, with contact sports and high impact activities probably more harmful than beneficial in this condition. Water-based activities, like aqua-aerobics and some swimming styles may assist with relaxation and pain relief. It is usual to take some anti-inflammatory medication prior to exercise to avoid exacerbating the condition, and to engage in activities only as advised by the consulting physician.

Alternating standing and sitting can provide relief from chronic neck pain for a large number of ankylosing spondylitis sufferers, who may also require the assistance of canes, or walking frames depending on the severity of the disease. Postural aids may reduce the disease’s progression to spinal fusion or curvature of the spine.

Diet Change for Ankylosing Spondylitis Treatment

As there is some speculation that bacterial infection is at the heart of ankylosing spondylitis pathology, there are those that recommend abstaining from the consumption of foods which are likely to feed this bacteria. Klebsiella feeds on starches, which suggests that a low-starch diet would reduce the number of antibodies present in the circulation as the antigen load is decreased (i.e. less bacteria = less antigen = less antibodies triggering an autoimmune cross-reaction). There is no firm evidence for this association and, unfortunately, this hypothesis is unlikely to be studied further as there are easier, more financially lucrative, ways to rid the body of these bacteria (although these pharmaceutical treatments may have side-effects).

Medications for Ankylosing Spondylitis

NSAIDs are often used by ankylosing spondylitis sufferers, although there are side-effects associated with these medications. Natural anti-inflammatories and analgesics are also used although caution is needed in light of the autoimmune component to the disease as some natural remedies boost production of some immune system cells. Opioid analgesics have been found to alleviate the chronic neck pain associated with ankylosing spondylitis.

Specific immunosuppressive drugs are used in the treatment of ankylosing spondylitis, including medication such as methotrexate and ciclosporin. Corticosteroids are also included in many treatment plans, whether through oral use or as epidural steroid injections. There are serious side-effects to these pharmaceuticals which need to weighed against their potential benefits for pain and inflammation relief. TNF-alpha blockers are indicated for ankylosing spondylitis treatment as they also work as immunosuppressants. TNF-alpha antagonists include infliximab and adalimumab, known as biologics, and are incorporated where a patient scores at a certain level on the BASDAI index test which can be found online at BASDAI. Unfortunately, there is an increased risk of infection with these medications as they do compromise the immune system as their mechanism of action. Avoiding risk of infection is important whilst on these medications, as are regular check ups and suspension of treatment if recurrent sore throats or other conditions occurs.

Ankylosing Spondylitis Surgery

Surgery is reserved for severe cases of ankylosing spondylitis, and may involve the replacement of damaged joints, or correction of curvature of the spine. Cervical ankylosing spondylitis is rarely corrected through surgery as the procedure has significant risk of complication. One such complication is the compromised lung capacity in the condition, which can make anaesthetic administration highly dangerous. Epidural anaesthetic may be challenging due to spinal ligament calcification, making surgery a last resort in most cases.


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