Back pain — the most common symptom of ankylosing spondylitis — and stiffness get worse with rest, so they’re probably at their worst in the morning, just when you want to get your day started. You might also have pain and stiffness in other areas of your body, such as your neck, shoulders, hips, or feet. While it’s important to work with your doctor to find the right ankylosing spondylitis medications for you, there are also some natural pain-relief strategies you can try to help manage your back pain and other symptoms. The best part: You can use many of these every day.
1. Stretch and get regular exercise
“If you have ankylosing spondylitis, you need to stay active to maintain your flexibility,” says Rochella Ostrowski, MD, an associate professor in the division of allergy, immunology, and rheumatology at Loyola Medicine in Maywood, Illinois. Exercising and stretching can help ease pain and stiffness in your joints, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. “The best exercises are those that avoid high impact,” says Dr. Ostrowski. She suggests working with a physical therapist who can design the right exercise and stretching program for you, including when to work out. Later in the day when you’re less stiff may be the best time.
3. Check your sleep posture
“Sleep posture is also important,” Ostrowski says. “You need a firm bed and a pillow that supports your neck properly. Avoid a pillow that’s too high. Sleeping on your belly is best for your posture, but some people can only sleep on their side or back.” If you’re in that group, try spending a few minutes of your awake time practicing “prone lying,” the SAA suggests. This involves lying face down on a firm surface. For comfort, you can turn your head from side to side. This exercise helps promote better daily posture. Work up to 20-minute sessions to help with back pain relief.
4. Take a warm soak
“A warm bath or shower is a natural way to relieve the pain and stiffness of ankylosing spondylitis,” Ostrowski says. “Stretching to relieve pain and stiffness is also better after a warm shower. You should avoid stretching with cold joints and muscles.” Alternating hot and cold compresses on painful spots is another natural pain-relief strategy you can try, the Arthritis Foundation recommends.
5. Try acupuncture
This ancient technique that involves inserting thin needles through the skin may stimulate your body’s natural pain relievers. “Studies on acupuncture for back pain relief have had mixed results,” Ostrowski says. “But I don’t discourage it, and it’s helped some people with back pain.” A review of clinical trials published in September 2019 in the journal Medicina Clinica notes that acupuncture improved “pain and functionality” in people with low back pain, though more research is needed for its effects on ankylosing spondylitis. Acupuncture should be performed by a trained and licensed acupuncture professional.
6. Get a massage
“Massage therapy, when performed by a therapist accustomed to working with ankylosing spondylitis, may be helpful,” Ostrowski says. Massage may not only help relieve the pain and stiffness of ankylosing spondylitis but also help ease the stress commonly brought on by having a chronic condition, the SAA says.
7. Practice yoga
“Yoga is a great natural pain reliever for ankylosing spondylitis,” Ostrowski says. “You need to start with very basic poses and be patient, but if you work with an instructor who can modify the yoga positions for you, you can really benefit from this form of exercise.” Results from a clinical trial of yoga for chronic low back pain published in October 2019 in the Journal of General Internal Medicine found that yoga reduced pain and improved functionality while enhancing sleep quality in adults with the condition.
8. Consider transcutaneous electrical nerve stimulation (TENS)
TENS involves passing an electric current through the skin. It may work on the same principle as acupuncture — by bringing about the release of the body’s natural pain relievers, the SAA notes. Although there have been some studies on TENS for back pain, results are mixed. Ostrowski says physical therapists may use TENS for pain that’s not responding to exercise and stretching.
Other Tips for Ankylosing Spondylitis Pain Relief
Considering seeing a chiropractor? Chiropractic treatment generally is not recommended for ankylosing spondylitis, the SAA notes. “Chiropractic care isn’t advised for this type of back pain because changes from ankylosing spondylitis may increase the risk of injury during manipulation,” Ostrowski says. But there are a few other small steps you can take to help manage ankylosing spondylitis pain naturally. “I recommend lots of deep breathing to keep your rib cage flexible, and I strongly advise against smoking,” Ostrowski says. “Avoid physical and emotional stress as much as possible, have a good support system, and make sure to get enough rest. “Sometimes with ankylosing spondylitis,” she says, “you just need to take life a little slower.” Additional reporting by Diana K. Rodriguez and Brian Dunleavy
