What to expect from hydrotherapy for ankylosing spondylitis

A physiotherapist assesses spinal movement, hip and shoulder function, balance, pain and fatigue before choosing exercises. In the pool, buoyancy supports the body while water resistance gives muscles a controlled challenge. You may practise upright posture, spinal and hip mobility, gentle strengthening, walking patterns and breathing expansion. The temperature and depth are selected around your comfort, safety and goals.

Hydrotherapy can complement medical treatment for [Ankylosing Spondylitis](/conditions/ankylosing-spondylitis/); it does not replace prescribed medicines or assessment of active inflammation. Sessions can feel tiring, so the therapist may alternate movement with rests and adjust the programme as symptoms change. More detail is available in [Hydrotherapy](/treatments/physiotherapy-and-rehabilitation/hydrotherapy/).

Tell the team about a flare, fever, skin problem, wound, bowel or bladder concern, dizziness, heart or breathing condition, and any difficulty entering the pool. Bring suitable swimwear, water and any prescribed support. Start at a manageable effort, keep movements controlled, and report sharp pain, unusual breathlessness or light-headedness during the session. Notice how your back stiffness, posture, walking and fatigue respond later that day and the next morning; this helps guide pacing.

Pause and seek advice for severe or rapidly increasing pain, new weakness, numbness, loss of balance or symptoms after a fall. Urgent assessment is needed for new loss of bladder or bowel control, numbness around the inner thighs, chest pain, severe breathlessness or fainting. Contact your clinician promptly if a flare remains unusually intense or a joint becomes hot and swollen.

Ask whether hydrotherapy suits your current symptoms, which movements support posture and chest expansion, how to pace during a flare, what pool access support you need, and how progress will be reviewed.