Treatment and Prevention
Currently, there is no cure for AS. But it can be managed using medications, surgery, and physiotherapy.
Medications:
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as indomethacin*, diclofenac, ibuprofen, naproxen, and others work by reducing inflammation, which helps relieve the pain, stiffness, and swelling of AS. They do not slow down the progression of the condition. In other words, they don't stop the disease from getting worse. Possible side effects of NSAIDs include nausea, abdominal pain, stomach ulcers, and bleeding.
Corticosteroids, such as prednisone, triamcinolone, and methylprednisolone, work by reducing inflammation. They are used to relieve symptoms. Corticosteroids do not slow down the progression of the condition. They may be injected into an affected joint or taken by mouth. Side effects of the injection include joint damage (if the injection is used too often). Short-term side effects of the pills include increased appetite, weight gain, menstrual changes, and stomach irritation. Long-term use of high doses can lead to diabetes, cataracts, glaucoma, increased risk of infection, high blood pressure, osteoporosis (bone thinning), moon face (rounding of the face), mood changes, acne, or increased body hair.
Biologics, such as etanercept and infliximab, are used to relieve symptoms, including symptoms in the spine, and to slow down the progression of the condition. They work by neutralizing a molecule called tumor necrosis factor alpha (TNF-µ). TNF-µ, which is involved in causing inflammation. Etanercept is given once or twice weekly as a subcutaneous (under the skin) injection. Infliximab is given at an infusion clinic as an intravenous (into a vein; IV) infusion at weeks 0, 2, and 6, and then every 6 to 8 weeks. Possible side effects include infusion reactions (such as rash, flushing, headache, and difficulty breathing), irritation at the injection area, nausea, headache, vomiting, diarrhea, fatigue, joint pain, or an increased risk of infection.
Disease modifying antirheumatoid drugs (DMARDs), such as methotrexate, are used to relieve AS symptoms and slow down the progression of the condition. They do not relieve inflammation in the spine. Possible side effects include nausea, diarrhea, increased risk of infections, liver damage, and bleeding.
Surgery:
Surgery may be used to repair joint damage or replace damaged areas. For example, some people with AS may need a hip replacement.
Physiotherapy:
A physiotherapist can show you special exercises to improve your flexibility, strength, and mobility.
*All medications have both common (generic) and brand names. The brand name
is what a specific manufacturer calls the product (e.g., Tylenol®).
The common name is the medical name for the medication (e.g., acetaminophen).
A medication may have many brand names, but only one common name. This article
lists medications by their common names. For more information on brand names,
speak with your doctor or pharmacist.