The pain can interrupt sleep, while poor sleep can intensify the pain. Pain management techniques can interfere with this feedback loop, leading to better rest and less fatigue.
Analgesic
NSAIDs (non-steroidal anti-inflammatory drugs) are a first-line treatment for inflammation and pain in ankylosing spondylitis. A 2020 study estimated that 70 to 80% of people living with AS take NSAIDs, such as ibuprofen (Advil, Motrin), Celecoxib (Celebrex) or Naproxene (Aleve).
“Certainly speak with your doctor first, but sometimes taking an NSAID at night can help in pain, which can then improve your sleep and then reduce fatigue,” said Dr. Ogdie.
A 2024 study revealed that the use of opioids to treat pain associated with AS and other forms of inflammatory arthritis is common in the United States, both at the time of diagnosis and after. But rheumatologists are wary of prescribing opioids due to potential interactions with some as drugs as well as other serious health risks.
Exercise
Good types of exercises for ankylosing spondylitis can help prevent the spine and joints from becoming stiff and painful.
“Research shows that the regular exercise improves the function and mobility of patients with AS and that exercise in a supervised clinic or at home is both beneficial for patients,” explains Dr. Danilovich.
As for what type of movement is the most useful, it says: “The best exercise is the one you will do!” For some, this can be the resistance exercise and lift weights. For others, it may be yoga or pilates. ”
The Spondyltis Association of America offers a number of free resources and videos for anyone interested in incorporating yoga in their pain management plan.
Pool training can be well suited to people with AS, adds Danilovich, because the buoyancy of water can reduce the impact on the joints.
