Ankylosing spondylitis (AS) is a chronic condition. It’s a form of arthritis that causes inflammation in the joints of the spine. The joints where the spine meets the pelvis are most affected. The condition may also impact areas where tendons and ligaments attach to bones. It may cause inflammation in other areas of the body, such as:

  • shoulders
  • ribs
  • hips
  • knees
  • feet
  • eyes
  • jaw
  • bowel
  • heart (rare)
  • lungs (rare)

Many people with AS experience stiffness and pain in the lower back. This pain may be sporadic and range in severity. These symptoms can progress into the upper spine.

Other symptoms vary from person to person. These symptoms can include:

  • loss of flexibility
  • spinal fusion
  • blurred vision
  • sensitivity to light
  • red, watery eyes
  • eye pain
  • reduced lung capacity
  • difficulty breathing
  • cauda equina syndrome
  • general unwell feeling
  • stomach or bowel problems

Although AS is progressive, not everyone will experience spinal fusion or severe complications.

AS symptoms may be atypical in women. For example, symptoms may begin in the neck instead of the lower back.

The exact cause of AS is unknown, though genetics play a role. The genetic marker HLA-B27 is present in of Caucasians with AS. This gene association varies across ethnic and racial groups. Overall, carrying the HLA-B27 gene may present a risk for developing AS. Many people with this genetic marker don’t develop AS, and you don’t have to be HLA-B27 positive to have AS.

Five or six other genes may have a connection to AS. When these genes combine with a bacterial infection or other environmental factor, they may trigger AS. More research is needed in this area.

AS usually begins in adolescence or young adulthood and continues throughout your life. It occurs more often in men than women. As a result, if you’re an adolescent or young adult male, your risk for AS is higher. Other risk factors are a family history of AS, having the HLA-B27 genetic marker, and frequent GI infection.

There isn’t a cure for AS. It’s a lifelong condition, but effective treatments are available. Treatment goals are to minimize pain and stiffness and reduce flares. Natural treatments may be used on their own or with traditional AS treatments.

These 10 natural therapies may help relieve symptoms:

1. Stretching

Stretching helps build flexibility and may reduce pain. Consider adding the spine stretch or the low-back rotation stretch to your daily routine.

2. Heat therapy

Apply a hot water bottle or heating pad to the affected area to reduce stiffness and pain. You may also use moist or dry heat. A warm bath may also help, especially before exercise. Don’t use heat therapy without consulting your doctor if you have diabetes, deep vein thrombosis, vascular disease, an open wound, or a skin condition such as dermatitis.

3. Cold therapy

Applying an ice pack, cold gel pack, or a bag of frozen vegetables to painful joints can help reduce swelling. After exercise, cold therapy may help reduce inflammation. Don’t apply ice for more than 20 minutes at a time. Don’t use cold therapy without consulting your doctor if you have circulation problems.

4. Acupuncture

Acupuncture is an ancient remedy for pain. It involves inserting thin needles into specific points in your skin. This is thought to activate your body’s pain-relieving hormones. Some people report acupuncture relieves AS pain.

5. Massage therapy

Massage helps you relax. It may also help you feel more flexible or “loose” so that you can exercise or stretch. Massage may cause pain at tender points around your spine. If this happens, avoid those areas and only use light massage techniques until the pain improves.

6. Movement

The more you sit, the stiffer you’re likely to feel. Get up, move around, and stretch regularly. If you have a desk job, take a “get up and move” break every hour.

7. Exercise

Gentle exercise programs such as yoga and Pilates are great for AS because they incorporate stretching. Swimming may also be beneficial because it’s easy on your joints. Strengthening exercises with weights can help build muscle, which supports joints affected by AS. Talk with your doctor or a physical therapist to determine the best exercise plan for you.

8. Alexander Technique

AS often leaves you hunched over. Practicing good posture is critical. The Alexander Technique teaches you to be aware of your posture throughout your day. It also teaches you how to correct poor posture and may be helpful for people with AS. To find a qualified teacher, visit the .

9. TENS therapy

TENS stands for transcutaneous electrical nerve stimulation. This therapy uses electrical current to stimulate nerves through the body for pain control. Electrodes are usually applied at the pain site and connected to a TENS machine. It’s thought that when TENS stimulates nerves, it overrides pain signals. The TENS technique is usually taught by a physical therapist and may be continued at home.

10. Stop smoking

Smokers, especially men, are at risk for greater spine damage from AS than non-smokers. Quitting smoking not only helps reduce AS damage, but also improves your overall health.

Check out: Most effective ankylosing spondylitis exercises »

A good night’s sleep can often be an elusive goal if you have AS. Pain may be worse at night due to inadequate bedding. Your mattress should keep your spine straight when you lie on your side. Your mattress should also allow your spine to have an “S-curve” when you lie on your back.

Try these tips for a good night’s sleep:

  • Use a medium-firm mattress, which can mold to the shape of your spine.
  • Use only enough pillows to keep your neck aligned.
  • Use heat therapy before bed to help reduce pain.
  • Don’t sleep with a pillow between your legs.

Traditional treatments are also used to manage pain, reduce stiffness, and help prevent flares. Several types of medications may be used.

NSAIDs are anti-inflammatories that reduce pain. Ibuprofen, naproxen, and aspirin are NSAIDs. Corticosteroids may be offered when AS symptoms are severe and don’t respond to other medications. They also help reduce inflammation and pain. Corticosteroids are usually injected into the affected joint for fast pain relief.

Disease modifying anti-rheumatic drugs are used to help slow down the inflammatory process. Examples include sulfasalazine and methotrexate. These drugs are used for long-term treatment.

Biologic agents are used to block proteins that cause inflammation. Seven different biologics are approved by the U.S. Food and Drug Administration to treat AS:

  • adalimumab (Humira)
  • etanercept (Enbrel)
  • golimumab (Simponi)
  • infliximab (Remicade)
  • Certolizumab pegol (Cimzia)
  • Secukinumab (Cosentyx)
  • Infliximab-dyyb (Inflectra)

These drugs are injected or given intravenously.

Although most people require some type of medical therapy for AS, natural remedies may also help reduce symptoms.

Not all alternative treatments are right for everyone with AS. Some people may have success with yoga and acupuncture. Others may feel better using cold therapy and massage.

It’s important to consult your doctor about your medications and any alternative therapy that you’re considering. If you’re experiencing any side effects or pain related to alternative therapies, talk with your doctor as soon as possible.

Keep reading: Tips for finding the right ankylosing spondylitis specialist »