There is no cure for AS yet, but there are effective treatments that can help relieve pain and improve the condition. AS is generally treated conservatively with medication, physical therapy, and exercise. Surgery may be necessary at some point to treat problems caused by AS in the spine and other joints of the body.
Your doctor will suggest medications to reduce inflammation and pain. The preferred way to treat AS, if they prove effective, is with NSAIDs, particularly indomethacin. It is best to take these medications as prescribed by your doctor. Possible side effects of NSAIDs include nausea, stomach upset, diarrhea, and abdominal pain. Taking them with food will help ward off side effects.
If NSAIDs are not sufficient, a medication called sulfasalazine may also be suggested. Corticosteroids, such as prednisone, are also very effective at reducing inflammation, but their side effects can be serious if taken on a long-term basis.
If anti-inflammatory medications do not control the pain and inflammation sufficiently, there are medications available that block the immune system in order to reduce inflammation. These medications have many side effects, so patients who take them must be closely monitored.
Your doctor may have you work with a physical therapist. A well-rounded rehabilitation program assists in calming pain and inflammation, improving your mobility and strength, and helping you do your daily activities with greater ease and ability.
Safe movement can improve spine mobility and posture. Physical therapy assists in pain control and prevention of deformities from AS. Patients are advised against prolonged sitting and best rest and encouraged to keep their spine straight, walk erect, and avoid stooping over for long periods. Therapy sessions may be scheduled two to three times each week for up to six weeks.
The goals of physical therapy are to help you
- Learn correct posture and body movements to counteract rounding of the upper back (kyphosis)
- Use appropriate sleep positions upon a firm mattress and thin pillow
- Maintain appropriate activity levels
- Implement daily stretching and strengthening exercises
- Learn ways to manage your condition
Surgical intervention is uncommon with AS. It is only necessary if the disease has led to severe deformity, such as extreme kyphosis, that prevents standing up and looking forward. In this case a spinal osteotomy might be considered. This operation involves cutting through the spinal bones and realigning them into a position that allows better upright posture. The spinal cord is never cut, only the vertebrae.
Surgery may also be recommended if the hip joints have been affected by the arthritis associated with AS. If the hips become severely damaged by arthritis, an artificial hip replacement may be required. Patients with AS commonly need this surgery.
More information on artificial hip replacement can be found at www.allaboutarthritis.com.