5 Signs You May Need a Change in Your Ankylosing Spondylitis Treatment

An ankylosing spondylitis treatment plan isn’t static — it may need to change for several reasons. Here are clues that it’s time to talk to your rheumatologist about adjusting your AS treatment.

Because ankylosing spondylitis (AS) progresses over time, your treatment plan may need to evolve right along with it. How will you know? There are telltale signs that indicate you might benefit from a change in treatment plan. Being aware of them will help you know when to talk to your rheumatologist. Watch out for these signs:

Your pain has gotten worse. One of the top signs you might need to change treatment is when you’re feeling more pain than usual, says Eric Ruderman, MD, professor of rheumatology in the department of medicine at the Northwestern University Feinberg School of Medicine in Chicago.

Your ankylosing spondylitis pain affects your daily routine. “When your condition prevents you from doing the things you want to do, it may be time for new treatment. It’s as simple as that,” Ruderman says.

You don’t like the side effects of your current medications. Medication-related side effects occasionally occur, Ruderman says. The most common problem is with heartburn or stomach issues from taking NSAIDs or nonsteroidal anti-inflammatory drugs, which are frequently used as initial ankylosing spondylitis therapy for pain relief. “We can change the therapy, use a different NSAID, or give up on those altogether,” Ruderman says. Another drug class that may be used to treat AS is called anti-tumor necrosis factor, or anti-TNF agents. However, they come with their own side effects, including an increased risk for infections.

It takes more than an hour to get moving in the morning. Mornings can be rough when you have ankylosing spondylitis because of difficulty sleeping at night and pain and stiffness upon waking, says Nortin M. Hadler, MD, rheumatologist and professor of medicine and microbiology/immunology at the University of North Carolina at Chapel Hill. However, the right treatment should help minimize these problems. “If I hear that despite taking an NSAID, someone takes that long to get going in the morning, that’s an indication to me to change treatment,” he says.

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