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Physical Therapy for Ankylosing Spondylitis – Information, Exercises, and More

Stiffness. Inflammation. Pain. This is where ankylosing spondylitis begins.

This chronic inflammatory disease can progress to the point of debilitating bony fusion, inflammatory eye disease, breathing difficulties, and more.

Although there is no cure, you can find relief from your symptoms and likely reduce the risks of advanced complications through physical therapy.


What Is Ankylosing Spondylitis?

Ankylosing spondylitis (AS) is an inflammatory disease — specifically a type of arthritis (axial spondyloarthritis) — that primarily affects the joints and ligaments of the spine and pelvis. 

It can also lead to pain and stiffness in other joints throughout the body, such as the:

  • Shoulders
  • Hips
  • Knees
  • Feet 

AS can lead to abnormal bone growth, which, in severe cases, may cause fusion of joints in the spine and sacroiliac joints (the joints between the hip and pelvis).

Any area where fusion occurs becomes stiff and inflexible. If the rib cage is affected, lung capacity and function can be restricted.

Other complications of AS can lead to:

  • Eye inflammation
  • Heart disease
  • Fractures

What Causes Ankylosing Spondylitis?

There is no specific cause of AS, but researchers believe there is a genetic factor. The majority of people diagnosed with AS carry a gene called HLA-B27. But not everyone who carries this gene develops the disease. In fact, approximately 80% never develop symptoms that would lead to an AS diagnosis.

Who Ankylosing Spondylitis Affects

Males tend to develop AS at a higher rate than females and experience more severe symptoms. The average age of onset is 24 — and onset usually occurs between the ages of 17 and 45. 

Individuals with psoriasis, ulcerative colitis, or Crohn’s Disease may be more likely to develop AS.

How Ankylosing Spondylitis Is Diagnosed

Diagnosis begins with a thorough evaluation to identify any and all factors that might contribute to your condition. If AS is suspected, further tests are usually ordered. 

These may include:

  • X-ray
  • MRI
  • Blood tests
  • Genetic tests (to check for the HLA-B27 gene)

Ankylosing Spondylitis Symptoms

Symptoms of AS typically worsen over time and are more severe if you are routinely inactive or leave symptoms untreated. 

General Symptoms

Early and common symptoms of AS include:

  • Pain in the lower back and sacroiliac joints
  • Pain during the night
  • Stiffness in the morning (that lasts more than one hour)
  • Stiffness after long periods of inactivity
  • Gradually spreading pain (typically into the hips and shoulders)
  • Fatigue
  • Loss of appetite
  • Poor sleep

Advanced Symptoms

When symptoms of AS are not addressed, bony fusion (ankylosis) can occur in the neck, spine, hips, and other areas. 

Ankylosis can cause:

  • Stooped posture – making walking difficult and increasing the risk of falls
  • Increased stiffness – limiting the ability to turn your head, bend, or stand upright
  • Low bone mass – increasing the risk of broken bones, particularly in the spine and hips
  • Breathing issues – caused by the stiffness in the joints where the spine and ribs connect

Additional complications of AS include:

Ankylosing Spondylitis Treatment

Unfortunately, AS is a chronic, lifelong condition with no cure. However, treating the symptoms can offer relief from pain and stiffness. Treatment can also delay or prevent fusion from occurring.


Staying active is one of the most important ways to manage AS symptoms, primarily for reducing pain and stiffness and keeping joints healthy. 

Exercise offers many benefits for those living with AS, including improved:

  • Flexibility
  • Range of motion
  • Posture
  • Sleep

Physical Therapy

Physical therapy is one of the most recommended treatment options for individuals suffering from AS. It can help improve your range of motion, core strength, and joint mobility in an attempt to reduce your risk of bony fusion.


NSAIDs are the most common medications recommended by doctors to treat inflammation and pain. These may include drugs such as naproxen sodium (Aleve) and ibuprofen.

If NSAIDs do not provide relief, your doctor may suggest:


Surgery is not a common treatment for those suffering from AS but may be recommended if a joint (such as the hip) is so damaged that replacement is the most viable option for pain relief.

Ankylosing Spondylitis Physical Therapy – Will PT Help?

Physical therapy will absolutely help manage symptoms of AS and may slow or prevent the disease’s progression. 

A licensed physical therapist can help AS symptoms through:

  • Exercises
  • Patient education
  • Posture training
  • Movement retraining
  • Deep breathing
  • Balance training

The goal of physical therapy for AS is to improve strength, flexibility, joint mobility, movement efficiency, and conditioning in order to help patients perform everyday activities with reduced pain and stiffness.

Best Ankylosing Spondylitis Exercises

Range of Motion Exercises

People suffering from AS tend to limit movement in areas where there is pain, stiffness, and inflammation. This lack of movement can lead to loss of mobility which, over time, can cause fusion.

Range of motion exercises should be performed daily to move joints and muscles through their full range of motion to reduce stiffness and improve flexibility.

Strengthening Exercises

AS sufferers tend to shift their posture to relieve pain and stiffness. Over time, these shifts in posture can lead to more pain and weakness in the muscles and joints of the “core.”

Strengthening exercises for AS focus on the muscles that support efficient, safe movement and good posture — typically the abdominal and back muscles that support the spine.

It’s recommended to perform strengthening exercises two to four times per week.

Aerobic Exercises

Aerobic exercises help with breathing function, endurance, pain, and fatigue — all things that can be negatively affected by AS.

75 to 150 minutes per week of aerobic exercise is recommended. 

Always check with your physician or physical therapist before starting a new exercise routine and work up to the recommendations at a pace your body can handle.

How In Motion O.C. Can Help With Ankylosing Spondylitis

In Motion O.C. is top-rated on both Google and Yelp! Their licensed physical therapists are qualified to help manage AS symptoms, and they have advanced rehabilitation programs if your disease has progressed to joint replacement.

They will develop a treatment plan specifically designed for your needsincluding all exercises, stretches, and other therapy modalities.

Request a free screening with In Motion O.C. today and find relief from your AS symptoms.

*The content in this blog should not be used in place of direct medical advice/treatment and is solely for informational purposes.

In Motion O.C.