Improving Posture With Ankylosing Spondylitis

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Ankylosing spondylitis (AS) is an autoimmune arthritis that primarily affects the spine. However, it can also spread to other joints of the body and affect internal organs. Because AS causes damage to the spine, it can have a serious impact on your posture.

This article discusses how ankylosing spondylitis affects the spine and causes poor posture. It also provides exercises and tips to help improve it.

Senior woman listens seriously as her physical therapist sits with her and holds a model of the human skeletal system. The therapist is discussing the affects of ankylosing spondylitis on posture.

SDI Productions / Getty Images

How Does Ankylosing Spondylitis Affect Posture?

Ankylosing spondylitis typically first affects the sacroiliac joints (joints that begin at the bottom of the spine where it attaches to the pelvis). Over time, the disease works its way to the upper spine.

Your spine consists of 26 vertebrae—small bones stacked on top of each other. AS can cause these bones to fuse together. This condition causes a kyphotic deformity, or rounding of the upper back, and flattening of the lower back. As the disease progresses, the spine gets "stuck" in this stooped-over position.

Poor posture from AS causes significant difficulty with daily tasks. It also leads to balance issues which can increase the risk of falls.

Tips for Improving Posture with AS

Below are tips you can take in different positions to improve your posture when you have ankylosing spondylitis.


It's important to support the natural curves of your spine for proper posture when you're sitting. It can be helpful to try these tips at your desk or while you're at the table eating:

  • Place a small rolled towel behind your lower back, or use a lumbar support pillow.
  • Position your computer screen at eye level to keep your upper spine straight.
  • Position the height of your chair so your hips and knees are bent at 90-degree angles.
  • Place your feet flat on the floor (or use a footstool if needed, based on your chair height).
  • Keep your keyboard and mouse close to you since reaching too far forward can increase the rounding of your shoulders and upper back.

Standing and Walking

Focus on keeping your spine straight when standing or walking, as follows:

  • Keep your ears, shoulders, hips, knees, and ankles in a straight line.
  • Squeeze your shoulder blades together and down, aiming them toward your back pockets.
  • Relax your arms at your sides.
  • Look straight forward and tuck your chin back slightly.

Lying Down

Lying down can be uncomfortable when you have ankylosing spondylitis. Try these tips to support your spine while you sleep:

  • Choose a semi-firm mattress or one made of a material, such as memory foam, that conforms to your body.
  • Place a pillow between your knees to help keep your spine straight when lying on your side.
  • Use one pillow under your head to avoid putting your upper spine in a rounded position.

Complications of Poor Posture

A stooped posture from ankylosing spondylitis can place pressure on your internal organs and lead to breathing difficulties.

Exercises for Correcting Posture

Stretching and strengthening exercises can help improve your posture if you have ankylosing spondylitis. If you experience pain, stop exercising and talk to your healthcare provider.

Chin Tucks

  1. Sit up straight. Squeeze your shoulder blades together and rest your arms by your sides.
  2. Looking straight ahead, pull your chin backward until you feel a stretch along the muscles at the back of your neck
  3. Hold for three to five seconds, then relax. Repeat 10 times.

Upper Trapezius Stretch

  1. Sit up straight.
  2. Tip your right ear toward your right shoulder.
  3. Place your left arm behind your lower back.
  4. Place your right hand on top of your head.
  5. Gently pull your head closer to your shoulder until you feel a stretch along the top of your left shoulder and the left side of your neck.
  6. Hold for 10 to 20 seconds, then relax.
  7. Repeat three times.
  8. Perform this exercise on the opposite side to stretch your right upper trapezius.

Corner Stretch

  1. Stand facing a corner.
  2. Raise your arms to shoulder-height and place one forearm flat against each wall.
  3. Stagger your feet.
  4. Slowly shift your weight over your front leg, leaning in toward the corner.
  5. Stop when you feel a stretch across your chest.
  6. Hold for 10 to 20 seconds, then relax.
  7. Repeat three times.

Scapular Squeezes

  1. Sit up straight with your arms resting at your sides.
  2. Squeeze your shoulder blades together as if you are trying to hold a pencil between them.
  3. Hold for three seconds and relax.
  4. Repeat 10 times.

Standing Rows with Resistance Band

  1. Secure the middle of a resistance band to a stable object at chest height.
  2. Stand up straight, holding one end of the band in each hand.
  3. Walk backward with your arms straight until there is tension in the band.
  4. Pull the band in toward your chest and hold for three seconds.
  5. Straighten your arms back out.
  6. Repeat 10 times.

Cobra Stretch

  • Lie on your stomach.
  • Place your palms flat on the ground, underneath your shoulders.
  • Slowly straighten your arms to arch your low back. Keep your hips on the ground.
  • Hold for 10 to 20 seconds, then lower back down.
  • Repeat three times.

Cobra Modification

If the cobra stretch is too intense, prop yourself up on your elbows instead of straightening your arms.


Poor posture is a common side effect of ankylosing spondylitis, an inflammatory arthritis that primarily affects the spine. Maintaining proper posture when you're sitting, standing, and sleeping can help prevent deformities in your spine. Exercises can also help stretch tight muscles and strengthen the muscles responsible for keeping your spine in proper alignment.

A Word From Verywell

Ankylosing spondylitis causes changes in your posture, but it doesn't happen overnight. Find the time to incorporate posture exercises into your day to help prevent significant complications from developing down the road. Maintaining your spine in proper alignment can also help decrease back pain that occurs with AS. For an individualized exercise program, see a physical therapist.

Frequently Asked Questions

  • Does ankylosing spondylitis cause hunchback?

    Ankylosing spondylitis can cause kyphosis in the upper back, a condition commonly called "hunchback."

  • Does sitting make ankylosing spondylitis worse?

    Yes, back pain and stiffness caused by ankylosing spondylitis tend to worsen with prolonged sitting. Get up every hour and walk around for five to 10 minutes if you have to sit for an extended period.

  • What exercises should you not do with ankylosing spondylitis?

    Regular physical activity can help combat stiffness and help you maintain your strength if you have ankylosing spondylitis. However, any exercises that cause pain should be avoided. If you are unsure if a particular activity is safe for you, talk to your healthcare provider.

2 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 Institute of Arthritis and Musculoskeletal and Skin Diseases. Ankylosing spondylitis.

  2. De Nunzio AM, Iervolino S, Zincarelli C, et al. Ankylosing spondylitis and posture control: the role of visual inputBiomed Res Int. 2015;2015:948674. doi:10.1155/2015/948674

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.