Medical treatments and complementary approaches for ankylosing spondylitis (spondylitis)

Medical treatments and complementary approaches for ankylosing spondylitis (spondylitis)

Medical treatments

There is no cure for the disease. However, many pharmaceuticals allow to control symptoms, reducing inflammation and pain.

As the ankylosing spondylitis progresses in flare-ups, some people will only need temporary treatment during painful periods.

Other people, on the contrary, will suffer from a more active form of the disease, with a higher risk of ankylosis. In these cases, a long-term treatment, called background treatment, may be necessary. Often, unfortunately, symptoms may return when treatment is stopped.

Medical treatments and complementary approaches ankylosing spondylitis (spondylitis): understand everything in 2 min

However, with current treatments, the majority of people with ankylosing spondylitis can lead normal lives.

Pain relief treatments

Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs are the mainstay of treatment for spondyloarthritis. They help reduce pain and inflammation. They include acetylsalicylic acid (Aspirin®), ibuprofen (Motrin®, Advil®, etc.) but also more powerful drugs, such as naproxen (Naprosyne®), diclofenac (Voltarene®), piroxicam (Feldene ®) or sulindac (Clinoril®), which must be prescribed by the doctor. Treatment with NSAIDs is usually prescribed until the pain and stiffness in the joints subside, sometimes for several weeks.

Taken over a long period of time, nonsteroidal anti-inflammatory drugs can lead to digestive complications, such as a stomach ulcer. The doctor will often prescribe a medicine to protect the stomach, either famotidine (Pepcid), omeprazole (Mopral®) or misoprostol (Cytotec), to be taken at the same time as the NSAID. Specific COX-2 inhibitors (such as Celebrex®) are other NSAIDs that cause less stomach problems. Always consult your doctor before taking an NSAID for a long time.

Corticosteroid injections. In case of severe pain, the doctor may inject corticosteroids (cortisone) directly into the painful joints. These are strong anti-inflammatory drugs that provide short-term relief.

Basic treatments

When NSAIDs are not enough to alleviate symptoms, disease-modifying therapy may be prescribed. The arrival of recent treatments, called biological treatments (or anti-TNF-alpha) has significantly improved the management of severe cases of spondylitis.

Sulfasalazine. This drug is sometimes used when the joints in the limbs are affected, but it is not very effective for pain in the spine. Methotrexate can also be used, but these 2 drugs can cause serious side effects, especially in the blood and liver.

Anti-TNF alpha drugs. Anti-TNF (Tumor Necrosis Factor) alpha, also called biological response modifiers, are recent drugs widely used for the treatment of inflammatory rheumatism. For ankylosing spondylitis, etanercept (Enbrel®) and infliximab (Remicade®) are commonly prescribed. They can quickly reduce morning pain and stiffness and decrease inflammation. However, these treatments are very expensive and are only prescribed in the event of failure of conventional treatments.

Physiotherapy

Exercise is an important part of treatment because it helps maintain good posture and increase breathing capacity. However, all exercises that require special effort on the spine, as well as contact sports, should be avoided. The swimming and certain Stretching that strengthen the back and abdomen are particularly beneficial.

It is advisable to consult a physiotherapist to set up with him an exercise program adapted to your pain and stiffness in your joints. Muscle building exercises, especially those that strengthen the back, are also beneficial for maintaining good posture.

Surgery

In severe ankylosing spondylitis, when the joints are badly damaged, a surgical intervention may be necessary. It allows the damaged joint, most often the hip joint, to be replaced by a prosthesis. This intervention helps restore mobility and reduce pain.

Complementary approaches

Based on our research, there are no studies showing the effectiveness of any herbs, supplements, or complementary approaches to specifically treat ankylosing spondylitis. However, various approaches, such as yoga or massage therapy, can provide relief for those affected.

 

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