Ankylosing Spondylitis: Symptoms, Treatments, and Medication Management

When your back feels stiff every morning — not from sleeping wrong, but from something deeper — you might be dealing with ankylosing spondylitis, a chronic inflammatory arthritis that mainly targets the spine and sacroiliac joints. Also known as Axial Spondyloarthritis, it doesn’t just hurt; it can fuse vertebrae over time if left unchecked. This isn’t just aging or bad posture. It’s an autoimmune disease, where the body’s immune system attacks its own tissues, causing inflammation in the spine and sometimes other joints. Men are more commonly affected, often starting in their late teens or early 20s, but women get it too — and it’s often underdiagnosed because symptoms start slowly.

One of the first signs is lower back pain that gets worse with rest and improves with movement. Unlike regular back pain, this doesn’t go away after a few days. It lingers for months, wakes you up at night, and makes getting out of bed feel like climbing out of a pit. Many people mistake it for a herniated disc or muscle strain until they see a rheumatologist and get an MRI or HLA-B27 blood test. NSAIDs, nonsteroidal anti-inflammatory drugs like ibuprofen or naproxen are usually the first line of defense. They work for most people, reducing pain and stiffness fast. But if they stop helping, or if inflammation keeps creeping up, doctors turn to biologic drugs, targeted therapies like TNF inhibitors that block specific parts of the immune system driving the inflammation. These aren’t pills — they’re injections or infusions — but they can stop the disease from progressing.

Physical therapy isn’t optional here. Stretching, swimming, and posture training aren’t just helpful — they’re necessary to keep your spine mobile and prevent fusion. Sitting for long hours? That’s the enemy. Standing up every 30 minutes, doing a few cat-cow stretches, or walking around the office can make a real difference. You also need to watch what else you’re taking. Some medications for other conditions — like certain antibiotics or corticosteroids — can interfere with your treatment or worsen side effects. And while there’s no cure, early diagnosis and consistent management mean most people live full, active lives. Below, you’ll find real-world guides on tracking medication effects, avoiding dangerous interactions, and using tools like medication logs to stay in control. This isn’t just about pain relief. It’s about keeping your body working, one day at a time.