Ankylosing Spondylitis

Ankylosing spondylitis is a chronic inflammatory condition that primarily affects the spine, causing pain, stiffness, and, over time, reduced spinal flexibility. Physiotherapy is a cornerstone of long-term management, helping to control symptoms, maintain posture and mobility, and slow the progression of spinal stiffness.

What is Ankylosing Spondylitis?

Ankylosing spondylitis is a form of inflammatory arthritis that primarily affects the joints and ligaments of the spine, particularly the sacroiliac joints connecting the spine to the pelvis. Persistent inflammation can, over time, cause the vertebrae to fuse, leading to reduced spinal mobility and postural changes if not properly managed.

Common Symptoms

• Chronic lower back and hip pain, often worse in the morning or after rest.
• Stiffness that improves with movement and worsens with inactivity.
• Reduced spinal flexibility over time.
• Fatigue related to ongoing inflammation.
• Pain and stiffness that may extend to the neck and upper back.
• In some cases, inflammation affecting other joints such as the hips or shoulders.

Causes and Risk Factors

• Genetic predisposition, often linked to the HLA-B27 gene.
• Family history of ankylosing spondylitis or related inflammatory conditions.
• Onset commonly occurring in young adults, more frequently in men.
• Autoimmune and inflammatory processes affecting spinal joints.

Goals of Physiotherapy for Ankylosing Spondylitis

• Reduce pain and stiffness through regular movement and exercise.
• Maintain and improve spinal flexibility and posture.
• Preserve chest expansion and breathing capacity.
• Strengthen postural and core muscles to support the spine.
• Slow the progression of spinal stiffness and fusion.
• Support long-term function and quality of life.

Physiotherapy Techniques Used

• Postural exercises – to maintain an upright spinal posture and prevent stooping.
• Spinal mobility exercises – regular stretching and movement to preserve flexibility.
• Breathing exercises – to maintain chest expansion, which can be affected as the condition progresses.
• Strengthening exercises – targeting the core, back, and postural muscles.
• Manual therapy – to ease stiffness and improve joint and soft tissue mobility where appropriate.
• Hydrotherapy – water-based exercise to support movement with reduced joint strain.
• Activity and lifestyle guidance – encouraging regular movement and avoiding prolonged inactivity.

A Consistent, Long-Term Approach

Because ankylosing spondylitis is a chronic condition, physiotherapy focuses on ongoing, consistent management rather than a short-term fix. Daily movement and exercise are essential — even brief periods of inactivity can increase stiffness. Physiotherapists work alongside rheumatologists to coordinate exercise-based management with any prescribed medical treatment for inflammation.

Through regular exercise, postural care, and hands-on therapy, physiotherapy helps patients with ankylosing spondylitis manage pain, preserve spinal mobility, and maintain an active, functional lifestyle.