What to Know About Chiropractic Care for Ankylosing Spondylitis

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Ankylosing spondylitis is an autoimmune condition that primarily affects the spine. Over time, the bones in the spine can fuse together, causing permanent loss of range of motion. Manipulation of the spine by a chiropractor is not recommended in treating this condition, but other chiropractic interventions can help alleviate symptoms.

This article discusses chiropractic care for ankylosing spondylitis, including the risks and potential benefits.

Person with ankylosing spondylitis being examined by a chiropractor

Natalia Gdovskaia / Getty Images

Risks of Chiropractic Care for Ankylosing Spondylitis

Chiropractors perform spinal manipulation using a thrusting force to help improve the movement of joints in the spine. In addition to improved range of motion, spinal manipulation can help decrease pain and reduce muscle tightness.

Ankylosing spondylitis causes extra bone growth, or bone spurs, in the spine. This condition can also cause other bone-related complications, such as osteoporosis—the breakdown of bone that can cause your bones to become brittle.

Spinal manipulation in people with ankylosing spondylitis can lead to severe injuries, such as fractures, paraplegia (paralysis of the lower body), and spinal cord injuries. People whose bones have fused in the spine or who have advanced osteoporosis have an increased risk for such complications.

For these reasons, the American College of Rheumatology, Spondylitis Association of America, and Spondyloarthritis Research and Treatment Network strongly recommend against the use of spinal manipulation with high-velocity thrusts for people with ankylosing spondylitis.

Case studies have been published suggesting that spinal manipulation has helped relieve symptoms of ankylosing spondylitis in some patients whose symptoms were not active at the time of treatment. Patients in the study also received additional interventions, including soft tissue manipulation and home exercises.

It's important to note that patients in these case studies who were receiving chiropractic treatment for ankylosing spondylitis were also under the care of a medical rheumatologist (medical doctor specializing in conditions of the joints, muscles, bones, and the immune system).

When to Talk to Your Healthcare Provider

If you have ankylosing spondylitis, talk to your healthcare provider before seeing a chiropractor or receiving any other intervention that is not already a part of your treatment plan.

Benefits of Chiropractic Care for Ankylosing Spondylitis

Chiropractic care includes more than spinal manipulation. Other treatments provided by a chiropractor can include education about proper posture, exercise instruction, and training in ergonomics. These interventions are beneficial for people with ankylosing spondylitis.

In some cases, a chiropractor might be the first healthcare provider to treat a person with ankylosing spondylitis. First symptoms usually appear before age 40 and include chronic back pain and stiffness, symptoms commonly treated by chiropractors.

Diagnosis of ankylosing spondylitis is often difficult and delayed. Early symptoms are vague and can be attributed to many different causes, sometimes making an accurate diagnosis of ankylosing spondylitis a years-long process. This increases the risk of significant side effects, such as permanent loss of range of motion, difficulty breathing, bowel issues, loss of appetite, fatigue, rashes, and blindness.

Chiropractors who recognize the signs and symptoms of ankylosing spondylitis can help patients get the necessary treatment more quickly by referring them to a rheumatologist for further evaluation.

When to See a Chiropractor for Ankylosing Spondylitis

If you have ankylosing spondylitis, speak with your healthcare provider or rheumatologist about the risks and benefits of chiropractic care. A chiropractor may teach you exercises for pain management, explain ergonomics and help with soft tissue manipulation.


Ankylosing spondylitis is an inflammatory arthritis that initially affects the spine. This condition causes bone spurs that can eventually lead to fused joints. High-velocity thrust spinal manipulation is not recommended for people with this condition due to the high risk of fractures and nerve injury.

However, chiropractors perform other types of intervention that can be beneficial for people with ankylosing spondylitis, such as soft tissue manipulation, ergonomic training, and exercise instruction.

A Word From Verywell

Living with ankylosing spondylitis can make daily tasks challenging. Follow your healthcare provider's instructions and schedule regular follow-up visits so your treatments can be adjusted as needed to help reduce your symptoms. Take your medications as prescribed and talk to your provider about any complementary treatments that might be helpful, including some of the interventions provided by chiropractors.

Frequently Asked Questions

  • Can a chiropractor help ankylosing spondylitis?

    Spinal manipulation is a mainstay treatment of chiropractors. This treatment is not recommended for people with ankylosing spondylitis. However, chiropractors provide other services that can be beneficial to people with this condition. This includes soft tissue manipulation, ergonomics training, and exercise instruction.

  • What should you not do with ankylosing spondylitis?

    If you have ankylosing spondylitis, avoid spinal manipulation therapy. You should also avoid activities that increase your pain and sitting for long periods, which can worsen your stiffness. Move around for five to 10 minutes every hour.

  • What is the best treatment for ankylosing spondylitis?

    Treatment of ankylosing spondylitis includes medications to target the proteins in your immune system attacking your healthy cells and exercises to decrease stiffness and improve or maintain your range of motion in the joints affected by this condition.

4 Sources
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.
  1. National Center for Complementary and Integrative Health. Spinal manipulation: what you need to know.

  2. Ward MM, Deodhar A, Gensler LS, et al. 2019 update of the american college of rheumatology/spondylitis association of america/spondyloarthritis research and treatment network recommendations for the treatment of ankylosing spondylitis and non-radiographic axial spondyloarthritisArthritis Care Res (Hoboken). 2019;71(10):1285-1299. doi:10.1002/acr.24025

  3. Cornelson SM, Beavers D, Harvey A, et al. Chiropractic care in the management of inactive ankylosing spondylitis: a case seriesJ Chiropr Med. 2017;16(4):300-307. doi:10.1016/j.jcm.2017.10.002

  4. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Ankylosing spondylitis basics.

By Aubrey Bailey, PT, DPT, CHT
Aubrey Bailey is a physical therapist and professor of anatomy and physiology with over a decade of experience providing in-person and online education for medical personnel and the general public, specializing in the areas of orthopedic injury, neurologic diseases, developmental disorders, and healthy living.