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Pain and Spondylitis: How To Manage Symptoms

Medically reviewed by Ariel D. Teitel, M.D., M.B.A.
Written by Sarah Winfrey
Updated on November 1, 2021

Because of the chronic inflammation caused by spondylitis (also called spondyloarthritis), many people diagnosed with the condition experience significant back pain. Ankylosing spondylitis, one of these forms of arthritis, causes pain in the lower back or joint pain in the sacroiliac joints, which connect the hips to the spine. Other types of spondylitis, including cervical spondylitis, can cause neck pain.

If you struggle with pain because of spondylitis, there are many treatment options and ways to manage this common symptom. Here’s what you need to know about managing spondylitis pain, from medication to meditation.

Take the Right Medications

Many medication options are available to treat spondylitis. Your doctor or rheumatologist can work with you to determine which medications might be best for you in managing symptoms like back, neck, or other joint pain.

Nonsteroidal Anti-Inflammatory Drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs) help many people diagnosed with spondylitis. NSAIDs include over-the-counter medications such as Advil (ibuprofen) and Aleve (naproxen), as well as stronger options that are only available by prescription.

If you take NSAIDs regularly, it’s important to do so under the care of a health care provider, as these medications can have significant side effects. Your doctor can help you find one that works for you at the lowest possible effective dose.

Disease-Modifying Antirheumatic Drugs

Because spondylitis is caused, in part, by an overactive immune system, disease-modifying antirheumatic drugs (DMARDs, such as sulfasalazine) can help control the condition. When your immune system is not overactive, you will generally experience less pain and swelling.

Newer DMARDs, called biologics, can target specific areas of the immune system. The DMARDs most commonly prescribed for spondylitis include tumor necrosis factor (TNF) blockers and interleukin-17 (IL-17) inhibitors.

Corticosteroids

Corticosteroids are usually only prescribed for short-term pain management during spondylitis flare-ups. These drugs are not used for long periods of time. They can help reduce inflammation and swelling quickly to help you get back on your feet while waiting for another treatment to start taking effect.

These steroids may come in topical creams, which you can rub directly on painful areas. You may also be prescribed prednisone, which is taken orally (by mouth). If you experience side effects while taking topical or oral steroids, let your doctor know right away.

Other Pain Medications

If you are experiencing extreme pain, your doctor may prescribe strong painkillers or muscle relaxers. These medications will not treat your spondylitis, but they will help alleviate your pain so you can function in daily life while working with your doctor to find other long-term pain relief solutions.

Ongoing or worsening spondylitis pain may indicate that your current medication regimen is not working effectively. Talk to your rheumatologist if you start experiencing pain to determine which medications may offer relief and manage your symptoms in the long term.

Try Physical Therapy

Physical therapy (PT) can help people with spondylitis reduce pain. PT may also help preserve physical functioning, improve strength and balance, and stabilize the joints.

Physical therapists can help you adjust the ways that you move, sit, stand, or otherwise navigate your life so you don’t aggravate your spondylitis. These specialists know how to help you strengthen and stretch your muscles, ligaments, and other soft tissue so that your back works as well as it possibly can.

Physical therapists can also help you develop proper posture, maintain flexibility, and sleep in optimal positions for your back pain. The specialists may also be able to help you strengthen other muscles, like your abdominals and glutes, so that your lower back (also known as the lumbar spine) doesn’t have to do all the work.

Keep Exercising

While you might have to modify the way you exercise with spondylitis, you typically should not stop moving your body entirely. Staying physically active can help keep your range of motion and minimize the stiffness you experience.

You may want to combine your exercise with your PT. Physical therapists can help you learn how to exercise in ways that do not make your spondylitis worse. They may also facilitate exercise groups so you don’t have to exercise alone, or they may give you an exercise plan so you know what exercises or stretches to do every day.

Some people diagnosed with spondylitis find that hydrotherapy, or exercise in water, works well for them. With hydrotherapy, the water helps support some of your weight, making physical activity less painful on your spine. Exercising in warmer water can also help keep your back muscles relaxed.

Get the Most From Yoga

Some people diagnosed with spondylitis find that practicing yoga regularly helps keep them moving well and limits the pain they experience. Yoga can help the muscles around your spine stay both strong and flexible — an important combination when it comes to dealing with spondylitis pain.

What’s more, yoga can also help lower stress levels and help keep your mind focused on things other than pain and discomfort.

Learn about yoga poses for spondylitis.

Meditate Regularly

Meditation may not seem like it has much to do with pain, but it can play a major role in helping you feel better. Studies have shown that people who meditate manage their pain better and report a higher quality of life than people who do not practice mindfulness.

Watch rheumatologist Dr. Ashira Blazer explain how meditation can help reduce stress and pain.

Stress can be a major contributing factor to flare-ups of spondylitis. Stressors can be emotional, (such as work- or life-related stressors), or they can be physical (such as illness). Because meditation can help people lower their stress levels, meditation may also lower the number or intensity of spondylitis flare-ups that you experience.

There are several meditation techniques that doctors recommend for people dealing with chronic pain. You can try any or all of them until you find a method that works for you and helps lower your spondylitis pain.

Surgery

Most people diagnosed with spondylitis never need surgery, but some may need surgery to help alleviate their pain. Damage to the joints in the hip, in particular, can necessitate hip replacement surgery. Similarly, if spondylitis has led to a curved spine that exerts pressure on your spinal cord, you may need surgery to straighten the spine. This surgery can also alleviate related pain in your rib cage or other nearby joints.

If your joints are badly damaged or your pain is severe and nothing seems to help, talk to a rheumatologist about whether surgery may be right for you. They can offer medical advice and insight about the best way to manage your pain in the short and long term.

Find Your Team

MySpondylitisTeam is the social network for people with spondylitis and their loved ones. Here, more than 72,000 members come together to ask questions, give advice, and share their experiences of life with spondylitis.

How have you managed pain related to spondylitis? Share your experience and thoughts in the comments below or by posting on MySpondylitisTeam.

Updated on November 1, 2021

A MySpondylitisTeam Member

My Pain Dr. Will be asking my insurance for me to get a MRI on my back and neck. I suffer from Migraines from my neck I can't touch my chin to my chest or looking up. My hips hurt so bad that it… read more

posted August 7, 2023
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Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Sarah Winfrey is a writer at MyHealthTeam. Learn more about her here.

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