Ankylosing spondylitis is a form of inflammatory arthritis that primarily affects the spine, though it can also affect other joints within the body.

People with ankylosing spondylitis typically take medications that aim to slow the progression of the condition and alleviate the symptoms. Some people may also like to incorporate natural treatments into their treatment plans. These may include lifestyle changes, home remedies, and complementary therapies.

This article describes how natural therapies can help in the treatment of ankylosing spondylitis and provides a list of natural treatments that may be beneficial. It also outlines the medical treatment options available for ankylosing spondylitis.

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Natural treatments are non-medical treatments that may encompass complementary therapies, home remedies, and lifestyle changes.

Natural treatments cannot cure or slow the progression of ankylosing spondylitis. However, they may help alleviate some of the symptoms and inflammation associated with the condition. For this reason, a person with ankylosing spondylitis may wish to try natural treatments alongside medical treatments for additional symptom relief.

A person should talk with a doctor about the additional therapies that they want to incorporate into their treatment plan. The doctor may be able to provide recommendations based on the person’s medical history and current treatments.

People with ankylosing spondylitis may find that exercise helps alleviate symptoms of joint pain and stiffness.

The Spondylitis Association of America (SAA) states that a person with ankylosing spondylitis should regularly participate in the following types of exercise:

  • Strength training: This type of exercise may involve resistance training or lifting weights.
  • Cardiovascular training: These exercises raise the heart rate. Examples include running, cycling, and swimming.
  • Stretching: These exercises help improve flexibility and range of motion and reduce stiffness.
  • Balance: These exercises help promote and maintain good posture and can help prevent falls.

Stretching is a form of exercise that may be particularly beneficial in treating ankylosing spondylitis. It may provide the following benefits:

  • preventing stiffness in the spine and other joints
  • increasing range of motion and flexibility
  • improving posture
  • promoting circulation
  • reducing pain in the lower back
  • helping reduce stress

Some experts recommend that people with ankylosing spondylitis try the seated figure-four stretch to help alleviate lower back pain and improve hip mobility.

To perform this stretch, a person should follow the steps below:

  1. Place both feet flat on the floor while sitting in a chair.
  2. Lift one foot off the floor and rest the ankle on the opposite leg, just above the knee.
  3. Bend forward at the waist while keeping the back straight.
  4. Hold the stretch for 10–20 seconds.
  5. Repeat these steps on the opposite side.

Massage therapy may help alleviate ankylosing spondylitis symptoms. However, a person should take care when choosing a massage therapist, as deep tissue massages and other forceful techniques may trigger pain.

When choosing a massage therapist, a person may wish to consider the following:

  • the type of massage the therapist provides
  • the techniques the massage therapist uses
  • whether or not the therapist is experienced in providing massage for people with ankylosing spondylitis
  • whether or not the therapist is certified
  • whether or not the therapist has a license, which is a requirement in 45 states

A person can ask a doctor for recommendations for a therapeutic massage.

Some people with ankylosing spondylitis report that taking a warm shower helps loosen their stiff joints, while others report that hot or cold compresses help alleviate pain. However, there has been limited research into the effects of hot and cold therapies for alleviating ankylosing spondylitis symptoms.

For a warm compress, a person can apply a heat pad or hot water bottle to the affected joints.

For a cold compress, a person can use an ice pack wrapped in a towel. People should never hold ice directly against their skin, as doing so can cause permanent tissue damage.

Acupuncture is an ancient practice that involves inserting tiny needles into pressure points around the body in an attempt to alleviate pain.

A 2020 meta-analysis of 10 studies suggests that acupuncture-type treatments can safely and effectively alleviate the symptoms of ankylosing spondylitis.

However, the authors note that the studies they reviewed were of low quality and did not follow rigorous standards in their design and methodology. They add that additional research is necessary to prove the effectiveness of acupuncture for ankylosing spondylitis.

Transcutaneous electrical nerve stimulation (TENS) is a method of pain relief that uses a device to deliver weak electrical currents through the skin. A person can adjust the intensity of the current according to their needs.

TENS works on the premise that flooding the nerves with electrical stimulation may make them less able to communicate pain signals. The electrical stimulation may also stimulate the body’s production of natural pain relievers called endorphins.

TENS may help provide temporary pain relief. However, there is a lack of high quality clinical research investigating its efficacy in the treatment of ankylosing spondylitis pain.

Certain foods can have either a positive or negative effect on inflammation in the body.

The SAA provides dietary guidelines for people with ankylosing spondylitis. The guidelines suggest the following:

  • limiting alcohol consumption
  • limiting the intake of fat, salt, and sugar
  • eating plenty of fresh fruits and vegetables
  • getting adequate amounts of calcium and vitamin D
  • taking a multivitamin, as needed
  • asking a doctor which foods to eat to counteract any nutritional side effects of medication
  • drinking eight to 10 glasses of water per day

Following a healthy, balanced diet may help reduce inflammation, which could help prevent pain and stiffness.

People with ankylosing spondylitis often experience a disturbed sleep schedule due to nighttime pain. In fact, one 2015 study found that people experiencing an active flare of ankylosing spondylitis reported significantly worse sleep than participants who did not have ankylosing spondylitis.

The SAA provides the following recommendations to help improve sleep quality in people with ankylosing spondylitis:

  • selecting a comfortable mattress that offers the following:
    • comfortable support
    • an even distribution of body weight
    • spinal alignment
  • ensuring that the sleep environment is cool, dark, and quiet
  • using an ambient noise machine
  • developing a relaxing bedtime routine, which may involve taking a warm bath or reading a book
  • avoiding caffeine consumption, particularly before going to bed
  • avoiding eating fried, spicy, or citrus foods before going to bed to help prevent heartburn
  • performing regular exercise
  • not napping during the day

A doctor will work with a person to develop a tailored treatment plan for their ankylosing spondylitis. The plan will typically consist of medical treatments to alleviate symptoms, slow disease progression, and treat any comorbidities.

Some common treatment options include:

  • Pain medications: These may include over-the-counter or prescription medications.
  • Nonsteroidal anti-inflammatory drugs: These drugs help reduce inflammation and pain.
  • Corticosteroids: These drugs help reduce inflammation.
  • Biologics: These are medications that target proteins responsible for inflammation. Some examples include TNF inhibitors and IL-17 inhibitors.
  • Disease-modifying antirheumatic drugs: These are medications that suppress immune and inflammatory responses to reduce joint pain, inflammation, and swelling. One example is methotrexate.
  • Surgery: In some cases, surgery may be necessary to:
    • correct spinal irregularities
    • stabilize the spine
    • restore nerve function

Experts are currently unsure as to the exact cause of ankylosing spondylitis. However, some risk factors that increase a person’s likelihood of developing the condition include:

  • Age: Ankylosing spondylitis typically affects young adults under the age of 30 years.
  • Sex: Males are more likely to develop ankylosing spondylitis than females, but the condition in females is under-diagnosed.
  • Race: White people are more likely to develop ankylosing spondylitis than African American people.
  • Genetics: People who have the HLA-B27 gene variant are more likely to develop ankylosing spondylitis, but they are not guaranteed to develop the condition.
  • Family history: People who have a parent or sibling with ankylosing spondylitis are 10–20 times more likely to develop it themselves.
  • Environmental factors: Exposure to chemicals, toxins, or infections could increase the risk of ankylosing spondylitis.
  • History of inflammatory bowel disease (IBD): Both ankylosing spondylitis and IBD may involve inflammation of the gastrointestinal tract. Having IBD can increase the risk of ankylosing spondylitis and vice versa.
  • Uveitis: There appears to be a link between eye inflammation, or uveitis, and ankylosing spondylitis. The more episodes of uveitis a person has, the higher their risk of developing ankylosing spondylitis.

Ankylosing spondylitis is a form of inflammatory arthritis that primarily affects the spine. People with ankylosing spondylitis typically take medications to help slow the progression of the condition and alleviate some of the symptoms, including joint pain and stiffness.

People receiving medical treatment for ankylosing spondylitis may also benefit from natural treatments, such as lifestyle changes, home remedies, and complementary therapies.

A person should talk with a doctor about the types of therapies they intend to incorporate into their treatment plan. The doctor may be able to offer recommendations based on the person’s medical history and current medical treatments.