Treatments for Ankylosing Spondylitis
Medication to Tame a Flare: Corticosteroids
If you have severe inflammation in a joint (called a flare), your doctor may give you a shot of corticosteroid in that spot. These drugs are also called steroids.
A steroid shot may give you short-term relief from pain and swelling in your joint. Your doctor can inject steroids in your joints, including your sacroiliac (where your lower back meets your pelvis), knee, or hip joints. While these can help, you don’t want to rely on them as your main treatment.
Other Medications to Stop Inflammation and Save Your Joints: Biologics
If NSAIDs or DMARDs do not control your AS, your doctor may prescribe drugs called biologics. These drugs aim to fix the problems with your immune system. They target your body’s production of specific proteins that cause inflammation.
Biologic drugs slow your immune system to help ease AS symptoms (pain, swelling, tenderness, and stiffness) as well as inflammation. These drugs may also help protect your joints from damage.
You are at higher risk of infections like tuberculosis when you take biologics. If you have signs of an infection, such as a fever or congestion, you should tell your doctor. Your doctor will test you for tuberculosis before you start a biologic drug and while you take it. These drugs also may raise your risk of getting certain types of cancer, but this is rare.
Biologic drugs used to treat AS include:
- Adalimumab (Humira)
- Certolizumab (Cimzia)
- Etanercept (Enbrel)
- Golimumab (Simponi)
- Infliximab (Remicade)
Inflammation may damage your joints over time. If the damage is severe, surgery may help.
Joint replacement. Total joint replacement or arthroplasty surgery may help give you movement again in your knees or hips. Your surgeon removes the damaged joint. Then he will replace it with a metal, plastic, or ceramic artificial joint.
There is research going on now to find new treatments for AS. Some studies focus on genes, including HLA-B27, that raise your risk for getting the disease. Others focus on proteins that may trigger inflammation. Researchers hope to develop new drugs to stop AS before it can damage your back and other joints.
In addition to what your doctor suggests, you may want to try complementary or alternative treatments for your AS pain and stiffness. Some people find treatments like massage, yoga, acupuncture, and transcutaneous electrical nerve stimulation (TENS) helpful. Talk to your doctor before you try any of these.
Treating the causes of your AS inflammation should help ease your pain. Talk with your doctor about specific pain medications, back stretches, and posture exercises.