Stephen J. Schueler, M.D.

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Spondylitis Treatment

There is no cure for ankylosing spondylitis. Treatment focuses on maintaining flexibility and treating pain. Nonsteroidal anti-inflammatory medications are the most effective medication for pain. As the condition worsens, regular physical therapy and stretching exercises help improve posture, strength, and flexibility. Surgical treatment is preserved for those who have severe pain or severe damage to the joints.

Treatment for ankylosing spondylitis may include:

Spondylitis Drugs

The following drugs are used in the treatment of ankylosing spondylitis.

Nonsteroidal anti-inflammatory drugs
These medications relieve pain and reduce inflammation. Examples include:

Immunomodulatory agents
Etanercept is a monoclonal antibody that exerts its effect by binding to a compound known as tumor necrosis factor. Once bound by the antibody tumor necrosis factor cannot function. Tumor necrosis factor is a chemical that is involved in normal inflammatory and immune responses. Another option in this class is infliximab (Remicade).

Disease-modifying antirheumatic drugs
Also referred to as DMARDs these medications help to reduce inflammation. Examples include sulfasalazine (Azulfidine) and methotrexate (Rheumatrex).

Steroid medications, such as prednisone, can suppress inflammation and slow damage to joints. Although most commonly taken as pills, severe episodes of inflammation or persistent pain may require treatment with injections.

Tumor necrosis factor inhibitors
Tumor necrosis factor (TNF) is a protein that increases in the presence of inflammation. TNF blockers target this protein and help to reduce pain, stiffness, and swelling. Examples include adalimumab (Humira), etanercept (Enbrel) and infliximab (Remicade).

Spondylitis Questions For Doctor

The following are some important questions to ask before and after the treatment of ankylosing spondylitis.

Questions to ask before treatment:

  • What are my treatment options?
    • Is surgery an option for me?
  • What are the risks associated with treatment?
  • Do I need to stay in the hospital?
    • How long will I be in the hospital?
  • What are the complications I should watch for?
  • How long will I be on medication?
  • What are the potential side effects of my medication?
  • Does my medication interact with nonprescription medicines or supplements?
  • Should I take my medication with food?

Questions to ask after treatment:
  • Do I need to change my diet?
  • Are there any medications or supplements I should avoid?
  • When can I resume my normal activities?
  • When can I return to work?
  • Do I need a special exercise program?
  • Will I need physical therapy?
  • What else can I do to reduce my risk for complications?
  • How often will I need to see my doctor for checkups?
  • What local support and other resources are available?

Spondylitis Specialist

Physicians from the following specialties evaluate and treat ankylosing spondylitis:

Continue to Spondylitis Home Care

Last Updated: Mar 9, 2011 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Spondylitis References
  1. Reveille JD, Arnett FC. Spondyloarthritis: update on pathogenesis and management. Am J Med. 2005 Jun;118(6):592-603. [15922688]
  2. Zochling J, Braun J. Management and treatment of ankylosing spondylitis. Curr Opin Rheumatol. 2005 Jul;17(4):418-25. [15956838]
  3. Zochling J, van der Heijde D, Dougados M, Braun J. Current evidence for the management of ankylosing spondylitis a systematic literature review for the asas/eular management recommendations in ankylosing spondylitis. Ann Rheum Dis. 2005 Aug 26. [16126792]
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