Signs Your Ankylosing Spondylitis Treatment Is Working

Reduced symptoms is just part of the equation.

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When you start treatment for ankylosing spondylitis (AS), it’s important to know what to expect. Your doctor should tell you what possible side effects you might experience, or how long it may take before you see improvement in your symptoms. Most importantly, you should know how to tell if your ankylosing spondylitis treatment is working.

There’s no one-size-fits-all approach to treating AS. As a result, you and your doctor will need to work together to find the right option—or options—for you. The first thing you try may or may not be the best fit.

Is Your Treatment Working?

A good treatment should meet your individual goals. In general, this means reduced symptoms and improved quality of life.

“Lack of pain, lack of stiffness in the morning, lack of functional limitations, the ability to do everything that they want to do, are good signs that there's fair control of the disease,” says Anca D. Askansase, MD, MPH, rheumatologist at Columbia University Irving Medical Center.

Treatment Progression for AS

Many people with AS start with basic over-the-counter pain relievers, such as ibuprofen. These are called nonsteroidal anti-inflammatory drugs, or NSAIDs. This is the recommended approach for anyone with mild to moderate AS symptoms.

“If getting in and out of the car or getting on a treadmill or the bicycle are difficult, … one needs to think about advancing the treatment,” says Dr. Askanase.

When NSAIDs aren’t enough, your doctor might bump you up to disease-modifying antirheumatic drugs (DMARDs). In particular, your doctor may recommend a subtype of DMARDs called biologics. Certain factors may make you a better candidate for biologics, such as having inflammation in your gastrointestinal tract or eyes.

“Depending on the whole picture, the doctor might decide to think about the disease-modifying drugs or about the biologics, and that step should be—and always is—a shared decision,” says Dr. Askanase.

DMARDs have an added benefit of helping to prevent joint deformity and spinal fusion for people with advanced AS. You’ll know your DMARDs are working if they’re successfully stopping or slowing the progression of joint damage.

The good news is that there are many options for treating AS, so if something doesn’t work for you, you might be able to try something else. That’s why it’s important to communicate with your doctor and form a partnership.

“With the new treatments and with a better understanding of the role of physical therapy and constant exercise, we believe … there's going to be less and less people that have terrible spine damage,” says Dr. Askanase.