Many people with ankylosing spondylitis (AS) struggle with symptoms for several years before getting a diagnosis. Once they finally start treatment, they may be hopeful for quick results. That said, not everyone finds the right treatment for AS on the first try.
You may find that you’re still having some AS symptoms even after you’ve been taking your medication for a couple months. Does this mean it’s as good as it gets, or is more relief possible?
If you’re continuing to have AS symptoms — and you’ve been following your doctor’s treatment plan exactly as prescribed — it’s possible your current treatment is not the right fit.
The right medication for AS should help to address your your treatment goals, which include:
Improving symptoms and quality of life
Reducing disability
Preventing spinal fusion and other complications
Maintaining good posture
Constant back pain may be a sign that you are under-treating your AS. This means your current medication(s) may not be strong enough to manage the disease.
Under-treating AS may be dangerous because it increases the risk of complications. As AS progresses, it may lead to joint damage, including spinal fusion. The inflammation may also increase the risk for complications beyond the spine, such as heart disease.
Even with the right treatment, you may still have mild or occasional symptoms. You also might still have flares where your symptoms are worse, especially if you miss a dose of your medication or are exposed to a trigger.
The goal is to find a treatment that minimizes symptoms enough that you can live a relatively normal life without disability.
If your current treatment isn’t relieving symptoms, your doctor may change to a different AS medication in the same class, or may need to alter your treatment to a more aggressive medication.
Healthy habits may also help support your treatment and reduce AS symptoms. Certain habits (like smoking) are likely to worsen AS, make treatments less effective, or trigger flares. You can work with your doctor to help tweak your lifestyle to support your AS treatment.
Finally, if your current treatment isn’t working, you shouldn’t get discouraged. It’s normal for your AS treatment plan to change over time. There are so many medication options available today, and there are many changes your doctor can make to help improve your treatment outcomes.
Magrey, M., et al. (2019). Delayed diagnosis of ankylosing spondylitis: results from a survey of 1690 US physicians from 10 specialties. Annals of the Rheumatic Diseases.
National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2023). Ankylosing spondylitis.
National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2023). Ankylosing spondylitis: diagnosis, treatment, and steps to take.
Wenker, K. J., et al. (2023). Ankylosing spondylitis. StatPearls [Internet].