Spine arthritis treatment is varied, depending on the progression of the disease. It’s important to work closely with a rheumatologist or other health professional to develop an individualized plan for your arthritis symptoms.

Arthritis of the Spine Exercises and Physical Therapy
Conditioning your muscles can strengthen the joint areas and increase flexibility. Regular exercisers with this condition have less pain and stiffness than those who are not active. Good posture practices can assist in maintaining the correct curvature of the spine.

You may find that applying heat helps relax the joints and gives you pain relief, while cold packs can reduce inflammation. Hot showers and baths can ease arthritis pain and soreness.

Alternative Therapies
Yoga increases flexibility and muscle tone, while having the added benefit of easing tension. You may find that acupuncture provides relief for soreness. Therapeutic massage relaxes tight, sore muscles and detoxifies the body. Some people with arthritis of the spine use a TNS unit, which incorporates electrical stimulators for arthritis pain relief.

Assistive Devices
You may never need to use an assistive mobility device, depending on when your arthritis of the spine was diagnosed and how quickly it progresses. However, at some point a cane or walker may allow you mobility and independence you wouldn’t be able to maintain on your own.

Medical Approaches to Ankylosing Spondylitis Treatment
A number of medications are available to treat  ankylosing spondylitis symptoms. Different people respond to the same drug with varying levels of arthritis pain relief, and some of the medications take several weeks to work. You and your doctor will decide on an ankylosing spondylitis treatment plan from the many options available, and you may have to make adjustments in your medication.

NSAIDs Combat Inflammation
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) are the first line of defense against the pain and stiffness associated with arthritis of the spine. Some people find increased benefit from taking them on a daily basis, rather than waiting until they are experiencing inflammation and pain. Common NSAIDs are aspirin, ibuprofen, phenylbutazone, indomethacin and naproxen.

The downside of NSAIDs are the possible side effects, usually involving the gastrointestinal tract. They can suppress the protective mucus in the stomach, leading to heartburn, gastritis and even ulcers. Antacids may provide arthritis pain relief, or your doctor may prescribe medications such as Carafate to coat and protect the stomach, or Cytotec to restore the mucus.

Research has shown that opioid analgesics are very effective in reducing the chronic pain that is symptomatic of ankylosing spondylitis. Low dose, time-release formulations appear to be the most effective, and may be given in concert with NSAIDs.

A newer class of NSAIDs comprised of COX-2 inhibitors combined the anti-inflammatory qualities of traditional arthritis medication, along with reduced gastrointestinal complications. However, they were found to have their own side effects, which are more serious and involved the heart. Vioxx and Bextra were both removed from the market for that reason.

Second Line Spine Arthritis Medications
Sometimes, NSAIDs alone may not be enough to control ankylosing spondylitis symptoms, or the side effects become too severe to continue their use. In that case, other anti-rheumatic drugs known as second line medications may be prescribed.

Sulfasalazine can control arthritis pain in the small joints. Methotrexate, originally developed to combat cancer, is widely used in much smaller doses for rheumatoid arthritis. Anyone using the drug should also take folic acid to suppress its side effects, such as oral ulcers and nausea.

Corticosteroid injections into swollen joints can provide temporary pain relief. Prednisone, which is usually taken orally, can be very effective in combating inflammation. However, long-term use can result in osteoporosis, glaucoma and weight gain.

The newest and most promising drug treatment option is the biologics. Tumor necrosis factor-alpha (TNF-a) blockers have slowed and even halted the progression of arthritis of the spine in research studies. They appear to be effective not only for the joints, but also in treating the inflammation and pain that occur around the spine.

Three TNF-a blockers have been approved for treatment since 2003. Enbrel is a self-injectible administered once or twice a week. Humira is also injected under the skin, but only every other week. Remicade is given as an intravenous infusion every six to eight weeks, usually in the doctor’s office.
A tuberculosis test is required before starting this class of drugs, due to their tendency to cause an increased frequency of infections.

Surgery for Severe Arthritis
Severely disabled knees and hips can benefit from joint replacements. Surgery is also an option in the case of severe flexion deformities of the spine, although it is considered risky.

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