February 25, 2024


A Passion for Better Health

How to Manage Ankylosing Spondylitis With Lifestyle Changes

Ankylosing spondylitis (AS) causes inflammation of the spine’s joints and ligaments (connective tissue); its symptoms range from mild and occasional to severe and chronic. In severe cases, and as the condition progresses, it can limit mobility as bones in the spine fuse together and impact other organs in the body.

There isn’t a cure, but there are treatments and medications. Additionally, there are recommended lifestyle changes that can help manage pain, increase your ability to move comfortably, and improve your quality of life.

Keep reading for more on the changes and behaviors that can help treat AS when used with medication and other medical treatments.

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Exercise and Stretching

Physical activity is a standard part of AS treatment. Studies have shown that there are benefits to long-term physical activity for people with AS. Engaging in low-impact exercises may help you strengthen your muscles and increase your flexibility and ability to move comfortably. In addition, exercise can also:

  • Decrease pain
  • Improve sleep quality
  • Support healthy weight maintenance
  • Improve mood

Working With a Physical Therapist for Exercise Recommendations

AS treatment aims to reduce pain, slow the condition’s progression, and help you maintain good posture. Your healthcare provider may recommend that you work with a physical therapist as part of your treatment.
A physical therapist can help you find exercises that strengthen your muscles to support your back and recommend sleeping positions.

Healthy Eating Habits

People with AS who also have a higher body mass index (BMI) may experience more symptoms. Obesity is also associated with increased inflammation in the body. Though no specific diet is recommended for people with AS, it’s wise to eat in a way that helps you maintain a healthy weight. Having a healthy weight can also reduce stress on your joints.

Stress Management

People with chronic pain caused by arthritis, including those living with AS, often experience psychological distress. Chronic pain can increase distress, and distress can increase the intensity of pain. Furthermore, decreased physical functioning due to the condition can also negatively impact your mood.

Incorporating stress management strategies can complement AS treatment. For example, practicing yoga may increase physical functioning and help to address psychological distress. Other strategies may include deep breathing, meditation, or tai chi.

Smoking Cessation

Smoking nicotine products can make AS worse in several ways. It increases inflammation and pain in people with AS and may lead to increased severity and physical disability. Researchers have also found that smoking can increase the likelihood of lower back pain and spinal diseases, such as AS.

Quitting smoking reduces inflammation. Studies have found that physical functioning and quality of life increase among people living with AS when they quit smoking.

Practice Good Posture

Generally, maintaining good posture can reduce the severity of AS-related complications. In severe cases, AS causes the bones (vertebrae) in the spine to fuse, resulting in a stooped-over position over time. This can make it difficult to move and complete daily tasks.

Strategies to utilize that can help with good posture include:

  • Use pillows when you sleep, such as on your back with a pillow under your knees or between your legs if you’re a side sleeper. You will also want a pillow under your head that allows your neck to be straight at night.
  • Use support for your lower back in a chair when seated.
  • Bring your shoulder blades together on your back when you stand.
  • Take breaks to lift your head if you frequently look down (e.g., to check your phone).

Prioritize Quality Sleep

People who have AS commonly report experiencing fatigue and sleep problems. Unfortunately, the medications typically used to treat the condition do not help with fatigue. How these issues impact your quality of life will differ from person to person. Fatigue may even vary between seasons.

While some people may be prescribed medication to help with sleep problems and fatigue, others may be encouraged to adopt better sleep hygiene habits and avoid napping to get higher-quality sleep overnight.


Ankylosing spondylitis (AS) is a genetic, autoimmune condition that can cause chronic pain, limit your ability to function physically, and impact your quality of life. While there’s no cure, lifestyle changes can help with treatment.

Research shows that lifestyle behaviors, such as exercising, maintaining good posture, strengthening muscles, eating healthy, practicing good sleep hygiene, managing stress, and quitting smoking if you smoke, can help slow disease progression. Your healthcare provider can discuss how to include these strategies in your treatment plan or help you find additional support.

A Word From Verywell

Being diagnosed with a condition that does not have a cure can be discouraging, especially if it impacts all aspects of your daily life. However, researchers have helped highlight the significant impact of lifestyle behaviors on effective treatment.

Learning about AS and its treatments, regularly speaking with your healthcare provider, and reaching out for additional support can help you cope and have the best quality of life possible while living with AS.

Frequently Asked Questions

  • What lifestyle choices can make ankylosing spondylitis worse?

    Several factors can make ankylosing spondylitisworse. These include smoking, having obesity, and not being physically active. These factors are associated with poor physical functioning, quality of life, and less response to AS treatment.

  • What medications are used to treat ankylosing spondylitis?

    A few types of medication are used to treat AS, particularly to ease inflammation. Nonsteroidal anti-inflammatory drugs (NSAIDs), injectable corticosteroids, and disease-modifying antirheumatic drugs (DMARDs) are all taken to help reduce inflammation.

  • Can you reverse AS?

    There is no cure for AS. Treatments, lifestyle changes, and sometimes surgery can help manage the condition and increase your quality of life.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Katie Wilkinson, MPH, MCHES

Katie Wilkinson is a public health professional with more than 10 years of experience supporting the health and well-being of people in the university setting. Her health literacy efforts have spanned many mediums in her professional career: from brochures and handouts to blogs, social media, and web content.