How is ankylosing spondylitis treated?

Ankylosing spondylitis (AS) can be managed through various approaches, including daily posture and exercise therapy, localized physical therapy, oral anti-inflammatory medications, biologic agent therapy, and surgical intervention. As a chronic inflammatory disease primarily affecting the sacroiliac joints and spine, the main therapeutic goals are to control inflammation and preserve joint function. If symptoms such as progressive spinal deformity or sudden onset of redness, swelling, and pain in the eyes occur, prompt medical evaluation and treatment are essential.

1. Daily Posture and Exercise Therapy: This serves as foundational management. Maintaining correct sitting, lying, and standing postures—avoiding prolonged forward bending or kyphosis—is crucial. Regular stretching exercises targeting the lumbar back and thoracic cage help elongate surrounding soft tissues and preserve joint range of motion. Exercise intensity should be appropriately regulated; excessive loading or strenuous labor must be avoided. A mattress of suitable firmness is recommended for sleep to slow down the progression of joint adhesion and ossification.

2. Localized Physical Therapy: Localized physical therapy—including heat application, extracorporeal shockwave therapy, and traction—is applied to the affected lumbar and dorsal regions to improve local spinal blood circulation and relax spastic, stiffened musculature. It helps alleviate low back pain, soreness, and morning stiffness. Periodic physical therapy sessions support maintenance of spinal mobility and reduce systemic discomfort caused by inflammation.

3. Oral Anti-Inflammatory Medications: These medications should be taken strictly under professional guidance to suppress systemic inflammatory responses, thereby reducing low back pain, joint swelling, and morning stiffness. While providing symptomatic relief, they also mitigate ongoing inflammatory damage to bone and joint structures.

4. Biologic Agent Therapy: Biologics are typically reserved for patients with inadequate response to conventional medications. They selectively inhibit key pro-inflammatory cytokines to slow disease progression and minimize structural damage to the spine and hip joints. Prior to initiation, comprehensive clinical assessment is required to determine eligibility and safety.

5. Surgical Intervention: Surgery is considered in advanced cases featuring severe spinal or hip joint deformities unresponsive to conservative measures, significantly impairing quality of life. Procedures aim to correct bony deformities, restore joint mobility, and alleviate functional limitations. Preoperative thorough evaluation is mandatory, followed by structured, stepwise postoperative rehabilitation to consolidate functional recovery.

In daily life, avoid cold, damp environments; ensure adequate warmth for the lumbar spine and joints; maintain a healthy weight to reduce mechanical stress on joints; cultivate a positive mindset; and undergo regular follow-up examinations to delay further joint deterioration.