First-line treatment for ankylosing spondylitis

Ankylosing spondylitis is an inflammatory condition that can cause persistent back or pelvic pain, stiffness, and reduced movement. Treatment aims to control inflammation, preserve spinal and hip mobility, support posture, and maintain daily function. The plan depends on symptoms, examination findings, other health conditions, and how you respond over time.

Book a review with a rheumatology or musculoskeletal clinician if symptoms suggest ongoing inflammation. A physiotherapist can design Exercise Therapy for spinal mobility, posture, breathing movement, and strength. Some people find Hydrotherapy useful when land-based movement is uncomfortable. Anti-Inflammatory Medication may reduce pain and stiffness, but it should be selected with attention to stomach, kidney, heart, pregnancy, and other medication considerations. Keep moving regularly within tolerable limits and record changes in stiffness and function.

Seek urgent help for new leg weakness, loss of bladder or bowel control, numbness around the saddle area, severe unrelenting pain, fever with a painful rigid back, or a significant injury. Arrange review if morning stiffness, joint stiffness, or reduced range of motion is progressing, disrupting sleep, or limiting work despite the current plan.

Ask what findings support the diagnosis, which movements are appropriate, how medication safety will be checked, and when treatment should be reassessed. Ask whether Physiotherapy should include a home programme and how you can measure progress.