Ankylosing Spondylitis and the Chiropractor: What to Know

Medically Reviewed by Minesh Khatri, MD on August 01, 2022
4 min read

If you have ankylosing spondylitis (AS), it can be hard to get consistent relief from pain. You may have thought about seeing another health care provider, such as a chiropractor, for help. Chiropractic medicine comes from the belief that the spine’s alignment affects how the body functions overall. Chiropractors offer therapies based on manipulating the spine with spinal and cervical adjustments. Some also provide additional treatments, such as electrical stimulation and dietary advice.

Chiropractors are licensed practitioners. They get their degree after completing a Doctor of Chiropractic university program. Many people swear by their chiropractic treatments. But some people are advised not to have spinal adjustments because of the high risk of serious complications related to their condition. This includes people with ankylosing spondylitis.

Ankylosing spondylitis is a type of arthritis that causes chronic inflammation that affects your spine. As the disease progresses, it leads to the bones fusing together. You could also have bone growths, adding to pain and stiffness. There is no cure for ankylosing spondylitis, but certain treatments could help slow down the condition and lessen the pain and other symptoms.

Chiropractic care is not usually recommended as an ankylosing spondylitis treatment. Spinal adjustments done by a chiropractor could, unintentionally, cause a fracture or dislocation in the neck or spine, given the way the bones are fused together. This is a particular worry when it comes to the neck.

In addition, many people with ankylosing spondylitis also have osteoporosis, a thinning of the bones. Chiropractic treatments are not usually recommended if you have osteoporosis. Spinal adjustments could cause harm since you may not even know you have osteoporosis in the earlier stages. The risks include fractures, injury to the spinal cord, and paralysis.

Researchers who looked at studies related to treating ankylosing spondylitis found little evidence that chiropractic spine adjustments help patients with AS. A panel made up of the American College of Rheumatology, the Spondylitis Association of America, and the Spondyloarthritis Research and Treatment Network issued a report saying that there is no evidence that chiropractic care provides any benefit, but there is evidence of “potential severe harms.” Because of this, the panel issued a strong recommendation against the high-velocity thrusts used for spinal manipulations in patients with ankylosing spondylitis whose spine has fused or who have advanced spinal osteoarthritis.

Painful conditions like ankylosing spondylitis can affect your quality of life. While chiropractic care may not be an option for you, here are some suggestions that might help you manage your pain:

  • Medications. Drugs like nonsteroidal anti-inflammatory drugs (NSAIDs) may help reduce inflammation and pain. Other drugs, such as disease-modifying antirheumatic drugs (DMARDs) and biologic therapies, are often used for arthritis and may be helpful for some people with ankylosing spondylitis. Steroids like prednisone are used for short periods, usually if you have a flare-up of pain and stiffness.
  • Physical therapy might help you keep moving and maybe get back lost mobility in the spine. It could improve your posture, too. A physical therapist would assess your condition and work with you to learn different ways to move and do tasks as comfortably as possible. Research suggests that a physical therapy program that includes a combination of exercise – such as range of motion, strengthening, and aerobic – is helpful.
  • Exercises may also help keep you as flexible as possible. If you don’t have a physical therapist, you should discuss safe exercises with your doctor. Exercises can stretch your spine, loosen your muscles, improve your posture, and help expand your chest for better breathing. They can also help strengthen muscles, improving your mobility and strength. Some people with advanced ankylosing spondylitis have difficulty with their balance. Balance exercises may help with this problem.
  • Surgery may be needed if your AS has seriously affected your quality of life. The most common procedure is called a laminectomy. Your surgeon would remove some bone, which takes the pressure off the nerves causing the pain.

Most people who visit a chiropractor for the first time go because they are experiencing back pain, tension headaches, or some other painful condition they feel could be managed with spinal manipulations.

The first symptoms of ankylosing spondylitis include pain in the:

  • Base of the spine
  • Pelvis
  • Lower back
  • Hips
  • Shoulders
  • Breastbone and ribs
  • Back of the heel

Because back and neck pain are the main reasons people go to see if chiropractic is right for them, sometimes a visit to the chiropractor can result in an ankylosing spondylitis diagnosis.

Chiropractors use different tests to diagnose their patients, including:

  • Listening to your descriptions of your symptoms
  • Getting your medical history
  • A physical exam, including checking your range of motion
  • Checking your posture
  • X-rays

A chiropractor may suspect you have ankylosing spondylitis because of your test results. You can then take that information and see your doctor or specialist.

Living with ankylosing spondylitis can be challenging, especially if you feel that you are not getting relief from what your doctor or health care team are recommending. Complementary therapies like chiropractic therapy are not recommended for this disease, but there are other options, like physical therapy, that can help. If you want to try other treatments, speak with your doctor about your ideas and see what else might be out there that is not likely to cause any harm or worsen your condition.