Living Well With Ankylosing Spondylitis

Take It One Step and One Day at a Time

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Ankylosing spondylitis (AS) is more than just arthritis. It is a chronic, inflammatory disease of the spinal joints and other joints, like the shoulders, hips, and knees. Ankylosing spondylitis may create further havoc in the body by causing fatigue, eye pain, and even heart or lung problems.

Despite the complexity and "whole-body" involvement of AS, you can live well with this disease—it may require some preparation and resiliency, but it can be done by taking it one step and one day at a time.

Finding the Right Health Team

If you have ankylosing spondylitis, it is important to work with a healthcare team that has experience with your form of arthritis. The first step is finding a rheumatologist—a doctor who specializes in diseases of the joints and muscles. Even among rheumatologists, some of them tend to focus on specific diseases. Be sure to find a rheumatologist who has experience seeing patients with ankylosing spondylitis.

In addition to finding the right doctor, it is also important to work with a physical therapist who has experience working with people with AS, as daily exercise is a critical part of your treatment plan.

Be assured that it is OK to seek out second opinions or change therapists (or doctors). The doctor-patient relationship and the therapist-patient relationship is a two-way street, meaning both parties have to feel comfortable and at ease. A healing, trusting partnership is vital to your AS and overall health.

Adopting a Healthy Lifestyle

One way that you can take back some control over your disease is by adopting healthy lifestyle habits. A critical habit to break (if you do it) is smoking. Research shows that smoking is linked to a worse disease state, meaning more AS-related pain and inflammation.

In people with AS, smoking is also linked to reduced functioning in everyday life, as well as a poorer quality of life—and this is irrespective of how long a person has had AS, their age, or their gender.

In addition, ankylosing spondylitis is linked to disease complications like heart and lung problems. Of course, smoking too can negatively affect the heart and lung (regardless of whether a person has AS). This is a double whammy, so stopping smoking is really in your best interest.

When you are ready, talk with your doctor about the best strategy for you to stop smoking. The good news is that there are a number of ways (medications, counseling) and often a combination of them works the best.

Maintaining a healthy weight is also important if you have AS. Extra pounds can put additional strain on your joints. The good news is that you can attain a normal weight through calorie restriction, daily exercise (which will help maintain spine mobility anyway) and a nutritious diet. Make losing or maintaining your weight a family or partner affair, so the focus is not on you and more on living healthily and feeling well.

Coping With Pain

The pain experienced by those with ankylosing spondylitis has psychological consequences, commonly causing feelings of helplessness, fear, anxiety, and sadness.

But the good news is that pain can be effectively managed, often with the combination of AS-related medications (like NSAIDs) and physical therapy. Still, you may want to seek out additional therapies to help you cope with the emotional burden of your pain.

Some people find comfort in complementary therapies like yoga, tai chi, or meditation. While there is limited research into the role of complementary therapies in AS, the vast majority are relatively safe and may help you simply feel good and/or de-stress, if nothing else.

Watch out for signs of depression too. If you have stopped enjoying activities you once found pleasurable or are feeling sad every day, please contact a healthcare professional. Depression is a very real disease and can be treated with an antidepressant and/or talk therapy.

Preparing for a Flare

Like many other chronic illnesses, people with AS experience flares or worsening of their symptoms, notably back pain or other joint pain that can limit functioning. Having a plan in place on what to do when you or your loved one's pain flares can reduce any unnecessary panic.

This plan may include an ordered list of medications you should take to alleviate the pain—including dosages, how long you should wait between dosing, the maximum dosage allowed for that medication, and side effects to watch out for.

The plan may also include reminders about when to use a hot versus cold pack on your area of pain, as well as exercises or stretches you should engage in or avoid during a flare. Warning signs that warrant a phone call to your doctor is also a good idea to include.

It's also best to plan ahead of time how to manage daily activities like work tasks, driving, or chores. Consider asking a friend or family member to assist you when you are experiencing a flare. This way you can focus on healing and easing your discomfort, without worrying about life's everyday stresses.

A Word From Verywell

There are things you can do to ensure a healthy, happy life with AS. This is not meant to minimize the challenges that your disease may present. It can and will be difficult for some people more than others. But with a take-charge attitude, you can care for your body and mind the way it deserves.


Bagcivan G, Cinar F, Cinar M, Oflaz F, Uzun S, Pay S. Living with pain in ankylosing spondylitis: a qualitative study. Contemp Nurse. 2015 Oct-Dec;51(2-3):135-47.

Chatfield SM et al. Complementary and alternative medicines in ankylosing spondylitis: a cross-sectional study. Clin Rheumatol. 2009 Feb'28(2):213-7.

Mattey DL, Dawson SR, Healey EL, Packham JC. Relationship between smoking and patient-reported measures of disease outcome in ankylosing spondylitis. J Rheumatol. 2011 Dec;38(12):2608-15.

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