Treating AS - Taking control

The goals of AS treatment are to relieve pain and stiffness, to maintain mobility and function of the spine and other affected joints, and to maximize quality of life. For some people, treatment may even slow down or stop the progression of AS. Treatment plans often encompass a combination of exercise programs, physical therapy, joint protection, rest or relaxation, diet, emotional support, and medications.

Biologic response modifiers, or biologics, are a group of medications that work by blocking the actions of chemicals that are part of the immune system, called cytokines. One type of cytokine is tumour necrosis factor alpha (TNF-α). High levels of TNF-α have been found in the affected joints of people with ankylosing spondylitis (AS). TNF-α is believed to send signals leading to joint inflammation and damage.

Corticosteroids are medications that act like the naturally occurring hormone cortisol in the body. Corticosteroids can be used to relieve the pain in joints affected by ankylosing spondylitis (AS). They work by decreasing inflammation and are usually used when there is acute pain or a flare-up. Corticosteroids, such as methylprednisolone acetate (Depo-Medrol®), are usually given by injection by a health care provider into or near joints affected by AS, often the sacroiliac joints of the lower back.

Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce joint pain and inflammation. They do not prevent joint damage, but they can relieve pain and stiffness and improve joint function. NSAIDs may even slow the progression of the disease, as shown on X-rays. There are many NSAIDs available. NSAIDs commonly used for AS include: acetylsalicylic acid (Aspirin®, generics) flurbiprofen (Ansaid®, generics) ibuprofen (Advil®, Motrin®, generics) indomethacin (generics) naproxen (Naprosyn®, generics) Side effects associated with NSAIDs can include stomach upset, nausea, heartburn, abdominal pain, ulcers, and even stomach bleeding.

Pain relievers such as acetaminophen (Tylenol®, generics) and opioids such as codeine or hydrocodone may be used for the short-term relief of pain for people with AS whose pain is not sufficiently relieved by other medications (e.g., NSAIDs). Acetaminophen relieves pain but not swelling. Opioids relieve more severe pain.