Treatment for Axial Spondyloarthritis

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Axial spondyloarthritis (axSpA) is an autoimmune disorder that causes pain, inflammation, and stiffness, primarily in the spine and pelvis. While this condition can't be cured, several treatments are available to help manage your symptoms.

This article discusses medications, lifestyle changes, physical therapy, and surgeries that are used to treat symptoms of axial spondyloarthritis.

Seated back stretches

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Axial spondyloarthritis is treated with medications to decrease inflammation and reduce pain, including:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs): These drugs are available over the counter and are typically the first type of medication used to treat axial spondyloarthritis. Common NSAIDs include Ecotrin (aspirin), Advil (ibuprofen), and Aleve (naproxen). However, higher doses of these medications are often needed to effectively treat axSpA, requiring a prescription from your doctor.
  • Steroids (glucocorticoids): This group of drugs includes strong oral anti-inflammatory medications that are prescribed by a doctor. Steroids can also be injected directly into a particularly painful joint to decrease inflammation.
  • Pain relievers: Over-the-counter (OTC) pain relievers, such as Tylenol (acetaminophen), are also used to treat axSpA. However, prescription pain relievers might also be needed for more severe symptoms.
  • Biologics: Biologic medications are made of complex proteins that specifically target your overactive immune system to slow down its attack on your joints. The biologics most commonly used for axSpA are tumor necrosis factor (TNF) and IL-17A inhibitors.

Physical Therapy

Exercise significantly improves flexibility, strength, mobility, and endurance for people with axSpA. However, the wrong types of exercise can make your symptoms much worse. This is why physical therapy is an important component of treatment for axial spondyloarthritis.

Axial spondyloarthritis primarily affects the spine and pelvis, which negatively impacts posture over time. Poor posture can lead to pain in other joints of the body, and can eventually cause serious issues with breathing and digestion.

A physical therapist will teach you specific exercises to help improve your posture and address your other symptoms, including pain. Your therapist will also help you choose appropriate types of exercise to improve your overall cardiorespiratory fitness. Low-impact activities such as walking and swimming are often recommended

Occupational Therapy

If your mobility is significantly limited, you might also benefit from occupational therapy (OT). Occupational therapists can improve your independence by teaching you how to use assistive devices to manage daily tasks, such as bathing, cooking, and getting dressed.

Home Remedies and Lifestyle

Home remedies and lifestyle changes, such as the following, can help reduce pain and joint stiffness caused by axSpA:

Use heat and cold: Apply heat to your joints to increase blood flow and decrease stiffness. Use a cold pack to decrease pain and reduce blood flow when joints are swollen.

Pace yourself: Axial spondyloarthritis can cause significant fatigue. Spread out your daily activities and take rest breaks to help conserve energy.

Stop smoking: Tobacco has been shown to make symptoms of axSpA worse. Talk to your doctor about resources that are available to help you break your smoking habit.

Get a massage: Massage therapy can help decrease stiffness and relieve pain from axSpA.

Monitor your posture: Spine position plays a big role in axSpA. Pay attention to your posture throughout the day by doing the following:

  • Sleep on your back, on a firm mattress. Use one pillow only under your head.
  • Use a lumbar cushion in your chair and car seat.
  • Raise your computer screen to eye level.
  • Avoid sitting for long periods of time. Get up and move around at least once every hour.

Lower your stress levels: Living with axSpA can be very stressful. Incorporate stress-relieving techniques into your schedule on a regular basis, such as:

  • Meditation
  • Acupuncture
  • Guided imagery
  • Visualization
  • Deep breathing

Seek support: Axial spondyloarthritis can take a toll on you—not just physically, but also emotionally. Talk to your family and friends about your symptoms. Consider joining a support group to learn from other people living with the same condition. If emotional challenges are impacting your daily life, seeing a counselor for talk therapy can also help.

Maintain a healthy body weight: Obesity is common in people with axSpA, and excess weight can increase pain and stiffness in your inflamed joints. Talk to your doctor to see if weight loss would be appropriate for you.

Eat a healthy diet: While there's no specific diet for axSpA, there are certain foods that are known to increase inflammation in the body. Other foods either have no effect on inflammation or even decrease inflammation levels. Talk to your doctor or a dietitian about including anti-inflammatory foods in your diet.


In severe cases of axial spondyloarthritis, surgery might be required. While surgery does not directly treat the underlying medical condition, it can significantly reduce pain and stiffness in specific joints affected by the condition.

Joint replacement surgery is sometimes required when joint structures have been severely damaged by axSpA. Chronic inflammation can cause extra bone growth in the joint leading to severe pain and decreased range of motion. Total hip replacement is one type of surgery that can be beneficial for patients with advanced axSpA.

Surgery on the spine is not performed very often, unless you have a broken bone or a severely curved spine that needs to be straightened.


There is no cure for axial spondyloarthritis. However, symptoms caused by this condition are treated with medications, physical therapy, home remedies, lifestyle changes, and, in rare cases, surgery. Lifestyle factors, such as eating a healthy diet, practicing good posture, and not smoking can help with managing symptoms.

A Word From Verywell

While a diagnosis of axial spondyloarthritis can be overwhelming at first, educating yourself about treatments available to reduce your symptoms can be empowering. Talk to your doctor and consider joining a support group for additional suggestions from other people living with the same condition.

8 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.
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  5. Harvard Health Publishing. 3 surprising risks of poor posture. Updated February 15, 2021.

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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.