A therapeutic massage can provide relaxation, pain relief, and increased blood flow for a person with ankylosing spondylitis (AS). However, not everyone will benefit from a massage, and people with AS must be careful to select a qualified, experienced professional to perform the treatment.

AS is both a type of chronic inflammatory arthritis and an autoimmune disease. It primarily affects the spine, typically causing pain that starts in the lower back and can affect a person’s movement.

Over time, this disease can occasionally cause a person’s spinal bones to fuse, limiting their range of motion. If the disease progresses and involves the mid-spine and neck areas, it can create a hunched or rounded back posture.

Doctors typically recommend a combination of medications and physical therapy to ease AS symptoms. In some cases, a person may find that massage therapy helps alleviate pain and stiffness and improve circulation.

In this article, we examine massage for people with AS. We look at whether massage is safe and beneficial for these individuals and explore the best massage types for AS.

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Massage therapy is a broad term to describe a complementary practice of manipulating the body’s soft tissue to help decrease pain and stiffness.

Although there are several different massage therapies, most Western massage techniques base their routines on a Swedish or classical massage, according to the National Center for Complementary and Integrative Health (NCCIH).

In addition to Swedish massage, there are several other types of massage therapies, including:

  • clinical massage
  • sports massage
  • Eastern massages, such as tuina or shiatsu

Limited scientific evidence exists documenting the benefits of massage therapy for pain. There is even less research indicating that it specifically helps a person with AS find relief from their pain.

For example, in a 2015 review of studies, researchers looked at the effects of massage across 25 trials involving a total of more than 3,000 participants. They found that although massages could provide temporary pain relief, these treatments did not effectively treat the causes of lower back pain. They also noted that the studies were of low quality and that more research was necessary to confirm the findings.

The researchers behind an earlier 2011 study noted similar results. They found that massage could help with the symptoms of AS but stated that there was a need for further research in this area.

In general, doctors and researchers consider massage therapy safe for most people. However, a person should talk with a doctor and use a licensed, certified, and experienced therapist.

Some potential, although not common, side effects of a massage may include:

  • formation of blood clots
  • damage or injury to nerves
  • bone fracture

Also, according to the Spondylitis Association of America, several people with AS say that massages cause their symptoms to flare or worsen.

Massage therapy may not be effective for everyone. A person should talk with a doctor about the potential benefits and risks and whether they are a suitable candidate for a massage.

Some generally well-tolerated massage types include:

Swedish massage

Swedish massage is the most common massage technique, and it is often what a person will think of when they hear the word massage. Swedish massage involves long, fluid stroking of the muscles and other soft tissue to help provide pain relief.

The masseuse will often avoid areas of the body that are particularly sore or tender to the touch. If a person feels uncomfortable during a massage, they should stop the treatment. They should then contact a doctor for advice.

Hot stone massage

A hot stone massage uses strokes with warm stones to help relieve a person’s soreness. The technique may provide soothing relief, particularly if heating pads are effective in alleviating pain.

Myofascial release

Myofascial release involves a therapist manipulating the connective tissues around the muscles, nerves, and blood vessels. In some cases, a person may find that this technique helps improve circulation in the affected area following a flare in their symptoms.


A self-massage may help some people with pain in the lower back or other joints. The technique involves the person rubbing the area of the body that is sore with their own hands. Some people may enlist the help of a friend or family member.

When doing a self-massage, the Arthritis Foundation recommends using large, fast strokes first, as these will help increase blood flow to the area. After a few minutes, a person can switch to harder, more intense strokes in specific areas where there is pain.


Shiatsu is a massage type that comes from Japan. The practice aims to restore qi, which means healthy energy, to the person’s body. The technique involves applying pressure with the fingers and palm in a circular motion around areas that hurt.

This massage technique may help some people. However, if the massage makes someone feel more sore, they should stop the treatment and avoid having it again in the future.

Some types of massage are generally not suitable for people living with AS, such as:

Deep tissue massage

Deep tissue massage involves applying deep pressure to the muscles and soft tissue. The technique may help address severe pain and soreness, but it can cause lingering pain afterward.

According to the Arthritis Foundation, people with certain arthritis types should avoid this kind of massage because it may aggravate their symptoms.

A massage chair may alleviate pain and other symptoms of AS. However, these devices may not work well for everyone.

There is limited to no data on massage chairs specifically for AS symptoms. However, anecdotal evidence suggests that massage chairs have drawbacks, including not working well, making buzzing noises, and taking up lots of space.

A person interested in a massage chair should consider trying a few chairs out, if possible, before committing to a purchase.

The NCCIH says that in 45 states and the District of Columbia, therapists must get specialized training and certificates to perform massages.

When selecting a massage provider, a person should consider asking their doctor for recommendations. They may know therapists that specialize in working with people with conditions such as AS.

A person should avoid massage therapists without a license and be wary of those with no experience treating people with AS.

Some nonmedicinal treatment options that a person can try, either at home or at a local practice, include:

Additionally, a person could take steps at home to help prevent and treat AS symptoms, such as:

  • avoiding smoking
  • maintaining proper posture
  • eating a diet low in inflammatory foods, such as the Mediterranean diet
  • taking breaks as necessary throughout the day
  • stretching on a regular basis

Treatments for AS can vary depending on how the condition affects a person. Treatment aims to help alleviate symptoms, improve quality of life, and reduce the progression of the disease.

Treatment options that doctors commonly recommend include:

  • over-the-counter or prescription nonsteroidal anti-inflammatory drugs (NSAIDs) or analgesics, such as acetaminophen, to relieve pain
  • biologics that help control the disease and prevent it from getting worse
  • corticosteroids
  • disease-modifying antirheumatic drugs (DMARDs) for people who experience symptoms in other areas of the body and not just their back

People with ankylosing spondylitis may find that a massage can temporarily relieve AS-related back pain. However, for some people, it may make AS symptoms worse.

A person should seek the recommendations of a doctor and take care to select a certified and experienced therapist. Most massage side effects are mild, but they may include increased pain for a few days following the massage.