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Arthritis Health Center

Treatments for Ankylosing Spondylitis

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There are many treatments that can help you feel and function better with ankylosing spondylitis. These treatments include medications to help ease pain and inflammation and surgeries to help you move better. Your goal is to manage your AS so you can live an active life.

Medications to Fight Pain: NSAIDS

Your first step to treat AS will be taking drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs help relieve your inflammation, pain, stiffness, and swelling. Still, NSAIDs do not treat the problems with your immune system when you have AS. These problems cause damage to your joints and bones.

NSAIDs used to treat AS pain and stiffness include:

  • Celecoxib (Celebrex)
  • Diclofenac (Cataflam, Voltaren-XR, Zorvolex)
  • Ibuprofen (Motrin, Advil)
  • Indomethacin (Indocin)
  • Meloxicam (Mobic)
  • Misoprostol (Cytotec)
  • Naproxen (Aleve, Naprosyn)

Most NSAIDs are available in generic forms. Some, like ibuprofen and naproxen, are available over the counter in drugstores.

Unfortunately, NSAIDs can increase your risk for heart attack or stroke. They can also break down the barriers that protect your stomach. This can cause an upset stomach and heartburn. In time, NSAIDs can even cause ulcers even if you don’t have symptoms. Your doctor may prescribe another medicine to protect your stomach. Celecoxib is an NSAID that may ease inflammation without hurting your stomach.

Drugs to Stop Damage: DMARDs

If NSAIDs do not ease your AS symptoms, your doctor may prescribe stronger drugs called disease-modifying anti-rheumatic drugs (DMARDs). These drugs change your immune system to curb inflammation. They may help slow your disease to delay damage to your back and other joints. They may also ease symptoms like joint pain and swelling. DMARDs don’t work very well for inflammation in the spine.

DMARDs used to treat AS include:

  • Methotrexate
  • Sulfasalazine (Azulfidine)

Methotrexate comes in both pills and shots you can give yourself at home. You may take folic acid supplements to help ease side effects like mouth sores or nausea. Methotrexate can affect your liver, so your doctor will test your blood to make sure your liver is healthy.

Sulfasalazine is available as pills. You may have side effects like headaches, bloating, nausea, or mouth ulcers. Your doctor will test your blood periodically to watch for side effects.

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