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The goal of ankylosing spondylitis treatment is to alleviate the pain and stiffness, and prevent or delay complications including spinal deformity. Ankylosing spondylitis treatment is usually most successful if it starts before the disease causes irreversible damage to the joints. The medications most typically used include nonsteroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation, and (TNF) blockers, which have been shown to decrease activity by blocking a protein called TNF that’s involved in inflammation.
NSAIDs such as naproxen and indomethacin are most commonly used to treat ankylosing spondylitis, as they work to relieve pain and inflammation. In people who are not helped by NSAIDS, TNF blockers like adalimumab and etanercept may be prescribed. These drugs, given intravenously, block a protein called TNF that increases inflammation and have been shown to reduce disease activity. Anti-interleukin-6 inhibitors such as tocilizumab, currently approved for the treatment of rheumatoid arthritis, and the monoclonal antibody rituximab are currently under study.
Physical therapy can also be very beneficial in relieving pain and improving strength and flexibility. Range of motion exercises can improve flexibility and posture. In addition to exercise, the most important lifestyle change that people with ankylosing spondylitis can make is to quit smoking. Because the disease can affect the mobility of your rib cage, smoking can further restrict your ability to breathe. Surgery is usually reserved for people with severe joint damage.