Ankylosing spondylitis (AS) is an inflammatory condition and, like many of thise spectrum of disease, has a seemingly random course of relapses and remissions. Manual therapy may aid in retaining some of the flexibility through the joints via mobilisation and manipulation, though these treatments should be gentle considering the inflammatory nature of the condition.
For symptomatic relief, application of heat packs to stiff joints and tight muscles can reduce soreness and improve motion. Cold packs applied to inflamed areas may also help reduce swelling. Hot showers and baths may also help.
Ongoing maintainence of good posture is important, to reduce the stress on joint capsules that are affected, a musculoskeletal specialist such as a chiropractor, osteopath or physiotherapist should be able to assist you with this.
A small study showed that patients who underwent a mixed exercise program of aerobic exercises, stretching and deep breathing exercises exhibited improved physical work capacity and vital capacity, versus those who did not participate (Ince G., Sarpel T., Durgun B., Erdogan S., 2006. Effects of a multimodal exercise program for people with ankylosing spondylitis.). These non-invasive, non-medication therapies are preferred by many due to the fact that they do not have any risk of side effects some medications may carry. In cases where conservative treatment becomes insufficient however, medication may be warranted.
Medications may also help, including anti-inflammatory drugs or, where these are not sufficient, disease-modifying anti-rheumatic drugs; you should consult your GP or rheumatologist concerning these, as they may have side effects (for instance, pain medications may have intestinal and urinary tract consequences). A new class of drugs has also been showing promising results, these are called TNF blockers, again, you should consult your primary physician regarding these.
Severe cases may require surgery to correct flexion deformities or replace joints, but this should always be a last resort.
In all cases it is important to get regular checkups to monitor the progress of your condition, especially in severe cases where cardiac and pulmonary involvement needs to be considered.
I hope this has shed some light on the matter for you. All the best.
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