Ankylosing Spondylitis: Treatment Options

Dr. Johnson: Ankylosing spondylitis is a type of arthritis that's an autoimmune inflammatory disorder that can cause pain in the low back and the hips as well as stiffness. To treat a flare-up for ankylosing spondylitis, we typically will have them take a nonsteroidal anti-inflammatory medication. Dr. Hoffman: Ibuprofen is a nonsteroidal anti-inflammatory drug. Naproxen is a nonsteroidal anti-inflammatory drug. Dr. Tieng: If a patient with ankylosing spondylitis did not respond to at least two different nonsteroidal anti-inflammatory drugs, or NSAIDS, for at least two to four weeks each, then I would prescribe a biologic. Biologics are genetically engineered medications that closely resemble proteins that naturally occur in the body. They target parts of the immune system that fuel inflammation. Dr. Hoffman: This group of medications dramatically changes the quality of life. It controls their pain significantly. Dr. Tieng: Some people with ankylosing spondylitis require surgery if they have severe hip pain with limited range of motion. Dr. Johnson: In the worst-case scenario, the spine is very brittle. Patients can fracture. Sometimes they end up having spinal surgery because they have a fracture in the back. So we recommend that patients avoid contact sports such as football. Dr. Tieng: Remove any clutter on the floor, loose rugs, or any electrical cords that might cause them to trip. Dr. Hoffman: One of the most important social recommendations to patients with ankylosing spondylitis is don't smoke. Dr. Tieng: I strongly encourage patients with ankylosing spondylitis to follow regularly with a rheumatologist and also to take their medications as prescribed. Dr. Hoffman: We are ages and ages ahead of where we ever were before. Dr. Tieng: It is absolutely possible that patients with ankylosing spondylitis can live a fulfilling life, pain-free and without stiffness and without fatigue as well.