Ankylosing spondylitis is a chronic inflammatory condition primarily affecting the spine and sacroiliac joints. When patients present with pain and stiffness, a structured first-line protocol targets measurable symptom control within 2–4 weeks, balancing pharmacological and non-pharmacological strategies.

First-line management centres on pharmacological anti-inflammatory therapy — used continuously when required to control symptoms — alongside patient education, regular exercise, and other supportive interventions. Full selection criteria, dosing guidance, and the complete step-by-step algorithm are provided in the protocol.

Goal: achieve control of back pain and spinal stiffness within 2–4 weeks of initiating treatment. Anti-inflammatory therapy, when appropriately used, often suffices in keeping disease activity under control.

References

DOI: 10.1136/ard-2022-223296

Patients suffering from pain and stiffness should use an NSAID as first-line drug treatment up to the maximum dose, taking risks and benefits into account.

For patients who respond well to NSAIDs, continuous use is preferred if needed to control symptoms.

Patients should be educated about axSpA and encouraged to exercise on a regular basis and stop smoking; physiotherapy should be considered.

By suppressing inflammation, NSAIDs often suffice in keeping disease activity and symptoms under control.

View source ↗

First-Line Treatment for Ankylosing Spondylitis: Controlling Back Pain and Spinal Stiffness

References