How to Manage Neck Pain and Stiffness of Ankylosing Spondylitis

Medically Reviewed by Tyler Wheeler, MD on August 02, 2022
4 min read

Ankylosing spondylitis (AS) causes inflammation that can lead to pain and stiffness in areas of your body. One common area you may notice this discomfort is in your neck. The pain may be especially noticeable first thing in the morning, at night, or after you haven’t moved for a while.

Experts don’t fully understand what causes AS, but they know that it can cause your joints to fuse together. This can lead to a loss of movement in certain areas of your body.

Neck pain and stiffness usually happen a few months or years after your other AS symptoms start. But some people, specifically women, have reported that their AS pain actually starts in their neck and then spreads to other areas of their body.

Experts found that neck pain is pretty common and affects around 75% of people with AS.

With this type of pain, you may notice that:

  • Your discomfort wakes you up from your sleep
  • Pain gets better when you’re more active or when you exercise
  • Parts of your body may become less flexible

The good news is there are many ways to treat neck pain from AS at home. To ease this discomfort, it’s important to:

Make time for exercise. Too much downtime can stiffen your neck. Physical activity can reduce AS-related pain. If you want to ease neck discomfort, stay on top of your flexibility. Practice slow, turning movements that stretch your neck muscles and joints.

With these movements, start slow and work your way up over time. You don’t want to jump into an exercise program too fast.

You may also want to try yoga, Pilates, and tai chi to ease pain.

Focus on your posture. In addition to exercise, you can practice proper posture to help with neck pain. Stand straight up in front of a mirror and make sure your neck is in a comfortable position. This can help you avoid stiffness, especially if you spend a lot of time during the day sitting down.

Get enough sleep. Don’t forget the importance of rest. A quality night of sleep can help manage your AS pain, including neck discomfort. Create a bedtime routine that’ll help you wind down. To help yourself fall asleep at a good time, you can:

  • Take a warm bath before bed.
  • Use a heating pad to ease neck pain and allow you to fall asleep easier.
  • Avoid caffeine after lunchtime.
  • Create a sleep routine where you wake up and go to sleep at the same time.
  • Avoid naps, because they can throw off your routine.
  • Keep your bedroom tidy so that you feel relaxed.
  • Avoid screen time before bed.
  • Eat dinner earlier so you don’t go to bed with a full stomach.

Make sure that your bed is comfortable. This can help reduce neck pain. Your neck and head should be in line with the rest of your body while you sleep. Use a pillow, but make sure you’re not too propped up. This can hurt your neck.

Drive safely. When you go for extended trips in the car, it’s important to make time to stop and stretch. Pull over at a safe place and walk around for 5 minutes. Stretch your neck and body to loosen up.

If you have an extra stiff neck, you may want to look into special mirrors and parking sensors. It may be hard to turn your head while you drive.

A stiff neck can also put you at more risk for injury. Always double-check to see if your headrest is in the correct position. Make sure you adjust it so that your head can stay back against it.

In addition to at-home remedies, you might also need medical treatment for your AS-related neck pain. These may include:

Painkillers. Drugs like acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB), tend to be the first medication option for people with AS. These can help ease pain and discomfort in your neck.

Physical therapy. Without proper movement, your neck can become stiffened and bent with AS. Physical therapy can help you avoid this. This can be a great option to treat AS neck pain. A physiotherapist can work with you to create an exercise program that eases discomfort. They may have you work on movements that’ll improve your muscle strength and mobility. These workouts will allow you to target stiffness and maintain movement in your neck.

Your physiotherapist will also help you keep good posture. They may also offer hydrotherapy, or aquatic therapy. With this, you can practice certain exercises in a pool that will ease your neck discomfort.

Biological therapies. These treatment options can be very helpful for people with AS. The goal of these drugs is to stop inflammation. You’ll only want to consider these if anti-inflammatory drugs and physiotherapy can’t help your AS-related neck pain.

You may try options like etanercept (Enbrel), adalimumab (Humira Pen), certolizumab pegol (Cimzia), golimumab (Simponi), and secukinumab (Cosentyx). You can get these as an injection, done by yourself or by someone else.

Surgery. It’s not likely that you would need surgery for AS-related neck pain. But if your pain or stiffness is severe, it could be an option. A procedure like this can greatly improve your life with AS neck pain.

You may consider different types of surgery for your neck pain. They could include:

  • Laminectomy, which takes out bone spurs and tissues to create a space. It can take pressure off of your spinal cord or other nerves.
  • A spinal fusion will permanently connect two or more bones in your spine. This will help stop the movement between them. This can help deformities or weaknesses in your spine that may have caused neck pain.
  • Spinal osteotomies can help deformities in your spine. A spinal osteotomy can help improve your movement and reduce neck pain related to AS.