Musculoskeletal
Medicines for Ankylosing spondylitis (axial spondyloarthritis)
An inflammatory arthritis that mainly affects the spine and the joints at the base of the back, causing gradual-onset back pain and stiffness in younger adults — managed chiefly with regular exercise and, where needed, medicines that reduce inflammation.
Education and reference only. This explains which medicines are used and why, in plain language — it deliberately contains no doses and is not a substitute for advice from your doctor or pharmacist. Always discuss your own treatment with a qualified clinician, and check the BNF and the product labelling for prescribing detail.
Quick answer
What is Ankylosing spondylitis (axial spondyloarthritis)?
Ankylosing spondylitis, now often grouped under the broader term axial spondyloarthritis, is a type of inflammatory arthritis that mainly affects the spine and the sacroiliac joints (where the spine meets the pelvis). Its hallmark is inflammatory back pain: a gradual onset of back pain and stiffness, typically beginning in a young adult, that is worse with rest and during the night, eases with movement and improves through the day.
- How it is treated: The foundation of treatment is keeping active: regular exercise and physiotherapy to maintain posture, flexibility and movement are central, and continue alongside any medication.
- Self-care: Regular exercise is the single most important self-care measure: a mix of stretching, posture work, and aerobic and strengthening activity helps maintain flexibility and reduce stiffness, and a physiotherapist can tailor a programme.
- When to seek help: See your GP if you have back pain and stiffness that has come on gradually, lasts more than three months, started before middle age, is worse with rest and at night, and improves with movement — this pattern should be assessed for inflammatory back disease.
What it is
Ankylosing spondylitis, now often grouped under the broader term axial spondyloarthritis, is a type of inflammatory arthritis that mainly affects the spine and the sacroiliac joints (where the spine meets the pelvis). Its hallmark is inflammatory back pain: a gradual onset of back pain and stiffness, typically beginning in a young adult, that is worse with rest and during the night, eases with movement and improves through the day. The stiffness is often most noticeable first thing in the morning. Over time, ongoing inflammation can reduce the spine's flexibility. It can also be associated with inflammation elsewhere — including the eye (uveitis), the bowel and the skin. The pattern and severity vary, and because the back pain comes on slowly it is sometimes mistaken for ordinary mechanical back pain, which can delay diagnosis.
How it is treated
The foundation of treatment is keeping active: regular exercise and physiotherapy to maintain posture, flexibility and movement are central, and continue alongside any medication. NSAIDs are the first-line medicine for pain and stiffness and, used regularly, help many people stay mobile. For those whose symptoms are not controlled by exercise and NSAIDs, biologic medicines — anti-TNF biologics and IL-17 (interleukin) biologics — can substantially reduce inflammation and symptoms. Before starting a biologic, screening for infections including tuberculosis (TB) is carried out, because these medicines dampen the immune system and can reactivate hidden infection. Care is usually shared with a rheumatology team, and associated problems such as eye inflammation are treated promptly when they arise.
For this condition, these medicines
Medicine classes used for Ankylosing spondylitis (axial spondyloarthritis)
Each links to a full, dose-free guide — what it is, how it works, who can and cannot use it, side effects, interactions and FAQs.
Symptom checker
Symptoms that can point to Ankylosing spondylitis (axial spondyloarthritis)
Ankylosing spondylitis (axial spondyloarthritis) can be one cause of these symptoms. Each guide explains the other possible causes and the red-flag warning signs that mean you should get urgent help:
Beyond medication
Lifestyle and self-care
Regular exercise is the single most important self-care measure: a mix of stretching, posture work, and aerobic and strengthening activity helps maintain flexibility and reduce stiffness, and a physiotherapist can tailor a programme. Keeping good posture, not smoking (which can worsen outcomes), and staying active even during quieter spells all help. Specialist support groups can offer exercise guidance and practical advice.
When to get help
When to see a doctor
See your GP if you have back pain and stiffness that has come on gradually, lasts more than three months, started before middle age, is worse with rest and at night, and improves with movement — this pattern should be assessed for inflammatory back disease. Seek urgent eye care if you develop a painful, red eye with blurred vision or light sensitivity, as this can be uveitis linked to the condition. If you take a biologic, contact your team promptly if you develop signs of infection such as fever or feeling very unwell.
Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.
Answers
Ankylosing spondylitis (axial spondyloarthritis): frequently asked questions
What medicines are used for ankylosing spondylitis?
Alongside regular exercise and physiotherapy, NSAIDs are the first-line medicine for pain and stiffness. For people whose symptoms are not controlled by exercise and NSAIDs, biologic medicines — anti-TNF biologics and IL-17 biologics — can substantially reduce inflammation. Biologics need screening for infection, including tuberculosis, before starting. The right choice depends on how active the condition is and your other health needs.
Why is exercise so important in ankylosing spondylitis?
Regular exercise is the cornerstone of managing the condition. Because the inflammation tends to stiffen the spine, keeping it moving with stretching, posture work and aerobic activity helps maintain flexibility, reduce stiffness and pain, and protect long-term function. A physiotherapist can design a programme suited to you, and this continues alongside any medicines.
Can ankylosing spondylitis affect more than my back?
Yes. As well as the spine and the joints at the base of the back, the condition can be associated with inflammation elsewhere — most notably the eye (uveitis, causing a painful red eye), the bowel (inflammatory bowel disease) and the skin (psoriasis). This is why a painful red eye or new bowel symptoms should be reported, as they may be connected.
Is there a cure for ankylosing spondylitis?
There is no cure at present, but it is very treatable. For many people a combination of regular exercise and, where needed, NSAIDs or biologic medicines keeps symptoms well controlled and helps maintain movement and quality of life. Early diagnosis and staying active give the best long-term outlook.
Keep reading
Related articles
Sources
Where this is drawn from
- NICE CKS: Ankylosing spondylitis.
- Versus Arthritis: Axial spondyloarthritis (ankylosing spondylitis).
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