Connect with others who understand.

sign up Log in
Resources
About MySpondylitisTeam
Powered By
See answer

Foot and Heel Pain With Ankylosing Spondylitis: 5 Ways To Relieve Enthesitis

Medically reviewed by Florentina Negoi, M.D.
Posted on June 26, 2024

Ankylosing spondylitis (AS) is a type of chronic inflammatory arthritis. In ankylosing spondylitis, the body’s immune system attacks healthy tissues, like the joints, causing pain and stiffness. Inflammation commonly affects the lower body, and the heel of the foot is one of the most common problem areas.

“I’ve been dealing with heel pain since my early 20s,” said a MySpondylitisTeam member. “It turns out heel pain and Achilles enthesitis were early symptoms of my ankylosing spondylitis.”

Images A and B show different views of edema around the feet of a 16-year-old boy with chronic ankylosing tarsitis. This condition is a severe form of spondyloarthritis, a family of diseases characterized by inflammatory arthritis in joints, including ankylosing spondylitis. (Modified from Burgos-Vargas)


The connecting points between bones with tendons and ligaments are called the entheses. Enthesitis is the condition that occurs when this area becomes inflamed. If you’re like most people with ankylosing spondylitis, foot pain is an ongoing issue that affects your quality of life. Learning strategies to manage it can minimize further damage and help you feel your best.

1. Avoid High-Impact Movements

Studies show that repetitive movements on commonly affected joints can cause damage in people with ankylosing spondylitis. It’s not always possible or desirable to stay off your feet, but you can choose to do lower-impact exercises rather than pound the pavement with running or jumping. Try water aerobics, swimming, bicycling, or other activities that aren’t as hard on your joints.

One MySpondylitisTeam member suggested, “Swimming or water therapy is excellent for AS. Floating in the water takes the stress off of joints. It is important that the water is not cold — that just increases discomfort! Years ago, I used to use two empty bleach bottles as flotation devices and just gently kick myself around the pool or tread water. I have also had professional water therapy.”

2. Meet With a Physical Therapist

Most people with ankylosing spondylitis can benefit from physical therapy, which can help them find safe and beneficial ways to stay physically active. It’s important to learn how to perform exercises in the correct way to avoid further harm. A physical therapist can also show you how to wrap your foot in athletic tape for support or how to gently stretch the plantar fascia (the tissue at the bottom of the foot) to help relieve some of the pain. Ask your doctor for a referral to a physical therapist who can help you learn new exercises to add to your routine.

3. Take Medication That Works for You

International spondylitis groups recommend nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) as a fundamental component of condition management. These drugs help reduce pain and inflammation in the short term and also help prevent AS-related bone changes over time. NSAIDs frequently cause gastrointestinal side effects, so talk to your doctor about other medications to protect your stomach. Applying a cream with NSAIDs to the painful area can also help relieve discomfort.

However, besides causing side effects, NSAIDs don’t work well for some people with ankylosing spondylitis. For these people, known as nonresponders, targeted therapies that block specific immune system pathways are more effective. New biologics and disease-modifying drugs (DMARDs) are being developed to help people with autoimmune conditions like ankylosing spondylitis.

4. Get Custom Orthotics

Foot pain can feel worse if you also have an underlying problem with the structure of your foot or the way you walk. A podiatrist can design specialized inserts that make your shoes more comfortable and adjust the pressure on your foot.

“I saw a foot doctor once, and he gave a prescription to the person who makes custom shoe inserts,” one member said. “I always bring a new pair of New Balance shoes, and he makes a custom insert. I walk around for 30 minutes, he checks my shoes, and I’m released. I can put shoe inserts in other shoes. I also have one insert for dress shoes.”

5. Rest During Flare-Ups

If inflammation is particularly painful, your doctor may encourage you to try resting your foot first. Using crutches or a cane can remove pressure and give your foot a break from additional stress. You can also try applying ice to reduce inflammation. However, if this isn’t helping, you may need a stronger intervention, like a corticosteroid injection to the affected area.

Tips From MySpondylitisTeam Members

The same treatments don’t always work for everyone with spondylitis, and you should always talk to your doctor rather than follow medical advice from someone else. However, it’s helpful to hear how others with ankylosing spondylitis experience and manage symptoms. Even just knowing that someone else is dealing with the same problems can provide some comfort.

One member of MySpondylitisTeam adds ingredients to bathwater to help with joint pain. “Soaking in a hot bath with 1 cup of Epsom salt and 1 cup of vinegar helps more than you would expect,” they shared. “I add a little bath oil to my water as the others are drying on my skin, and I feel like the oil helps my joints. Adding essential oils such as lavender, chamomile, peppermint, and eucalyptus help too.”

It’s important to remember that you have options for managing foot pain and other AS symptoms. If your current treatment plan isn’t helping, talk to your rheumatologist. They may suggest participating in a clinical trial, trying a new medication, scheduling a surgical procedure, or getting therapeutic injections.

It can take some trial and error to find the best way to keep your condition under control. Even if one plan works for a while, you may need to change it if your ankylosing spondylitis progresses. You should never stop searching for solutions to the issues that interfere with your everyday life.

Talk With Others Who Understand

MySpondylitisTeam is the social network for people with spondylitis and their loved ones. On MySpondylitisTeam, more than 97,000 members come together to ask questions, give advice, and share their stories with others who understand life with spondylitis.

How does joint pain affect your daily life? Have you found effective ways to reduce disease activity in the back of the heel or Achilles tendon? Share your experience in the comments below, or start a conversation by posting on your Activities page.

    Posted on June 26, 2024
    All updates must be accompanied by text or a picture.

    We'd love to hear from you! Please share your name and email to post and read comments.

    You'll also get the latest articles directly to your inbox.

    This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
    All updates must be accompanied by text or a picture.

    Subscribe now to ask your question, get answers, and stay up to date on the latest articles.

    Get updates directly to your inbox.

    This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
    Florentina Negoi, M.D. attended the Carol Davila University of Medicine and Pharmacy in Bucharest, Romania, and is currently enrolled in a rheumatology training program at St. Mary Clinical Hospital. Learn more about her here.
    Anastasia Climan, RDN, CDN is a dietitian with over 10 years of experience in public health and medical writing. Learn more about her here.

    Related Articles

    Headaches aren’t among the most common symptoms of ankylosing spondylitis...

    Can Ankylosing Spondylitis Cause Headaches?

    Headaches aren’t among the most common symptoms of ankylosing spondylitis...
    For some people, ankylosing spondylitis can lead to less common symptoms like changes in their fi...

    6 Ways Ankylosing Spondylitis Can Affect the Nails

    For some people, ankylosing spondylitis can lead to less common symptoms like changes in their fi...
    Jaw pain is a common complication for people with ankylosing spondylitis and other types of arthr...

    Jaw Pain With Ankylosing Spondylitis: Causes and Management

    Jaw pain is a common complication for people with ankylosing spondylitis and other types of arthr...
    Do you experience bone pain, especially when resting? This may be a symptom of bone marrow edema ...

    Bone Marrow Edema and Ankylosing Spondylitis

    Do you experience bone pain, especially when resting? This may be a symptom of bone marrow edema ...
    Many people with ankylosing spondylitis (AS) are surprised by symptoms of abdominal pain and bloa...

    Ankylosing Spondylitis: How To Manage Bloating?

    Many people with ankylosing spondylitis (AS) are surprised by symptoms of abdominal pain and bloa...
    “Anyone else suffering from neck pain and shoulder pain?” one MySpondylitisTeam member asked. Ano...

    Managing Shoulder Pain With Ankylosing Spondylitis

    “Anyone else suffering from neck pain and shoulder pain?” one MySpondylitisTeam member asked. Ano...

    Recent Articles

    MyHealthTeam does not provide health services, and if you need help, we’d strongly encourage you ...

    Crisis Resources

    MyHealthTeam does not provide health services, and if you need help, we’d strongly encourage you ...
    MySpondylitisTeam surveyed members about how symptoms affect their lives and how they feel about ...

    How Spondyloarthritis Symptoms and Treatments Affect Lives

    MySpondylitisTeam surveyed members about how symptoms affect their lives and how they feel about ...
    In a recent survey of MySpondylitisTeam members, many reported feeling unwell, living with pain, ...

    Living With Ankylosing Spondylitis Flares: MySpondylitisTeam Members on What It’s Like

    In a recent survey of MySpondylitisTeam members, many reported feeling unwell, living with pain, ...
    Welcome to MySpondylitisTeam — the place to connect with others living with spondylitis. This vi...

    Getting Started on MySpondylitisTeam (VIDEO)

    Welcome to MySpondylitisTeam — the place to connect with others living with spondylitis. This vi...
    Watch this video for some guidance on what questions to ask your doctor about side effects for a ...

    Side Effects of Biologics: What To Know (VIDEO)

    Watch this video for some guidance on what questions to ask your doctor about side effects for a ...
    Watch this video featuring commonly asked questions about nr-axSpA treatment for questions you mi...

    Finding the Right nr-axSpA Treatment (VIDEO)

    Watch this video featuring commonly asked questions about nr-axSpA treatment for questions you mi...
    MySpondylitisTeam My spondylitis Team

    Thank you for subscribing!

    Become a member to get even more:

    sign up for free

    close