How effective is physiotherapy for ankylosing spondylitis?

Ankylosing spondylitis can make the spine and pelvis stiff, especially after rest. A tailored programme may use spinal mobility exercises, chest expansion work, posture practice, strengthening and aerobic activity. The aim is to preserve the movement you have, reduce strain during everyday tasks and help you stay active. A physiotherapist can adjust exercises during a flare and account for hip, knee or shoulder symptoms. Physiotherapy works alongside the medical treatment plan; it should not be used to replace assessment of inflammation or medication prescribed for it.

Ask for an assessment that considers your spinal movement, posture, breathing pattern, strength, pain and usual activities. Practise the agreed home exercises regularly, using the technique and intensity shown by your therapist. Gentle movement through the day may be easier than one demanding session. Avoid forcing a stiff joint or continuing an exercise that causes sharp pain, new tingling or symptoms that keep worsening. Review the programme when your symptoms, work demands or fitness change.

Arrange medical review for a marked change in pain or stiffness, repeated night waking, a new swollen joint or loss of function. Seek urgent care after significant trauma, or for new weakness, numbness, difficulty walking, loss of bladder or bowel control, or severe breathing difficulty. These symptoms need assessment rather than an exercise adjustment alone.

Which movements should I prioritise for my spine and hips? How should I modify exercises during a flare? Could my posture or chest movement benefit from a formal physiotherapy review? What symptoms should prompt an earlier appointment?