Ankylosing Spondylitis in Seniors: Exercise and Pain Management Guide
Posted inMobility & Exercise

Ankylosing Spondylitis in Seniors: Exercise and Pain Management Guide

No Comments
Published: July 21, 2026 | Last Reviewed: July 21, 2026 | Medically Reviewed by: Dr. Sarah Mitchell, MD, Geriatrics | Reading Time: 5 min




Key Takeaways

  • Understanding ankylosing spondylitis seniors is important for seniors and their caregivers.
  • AS starts with lower back pain that comes and goes but usually becomes present most of the time as the condition progresses.
  • Your health care provider may prescribe medicines such as non-steroidal anti-inflammatory drugs (NSAIDs) to reduce swelling and pain.
  • The course of the disease is hard to predict.
  • Contact your provider if:

To use the sharing features on this page, please enable JavaScript.


What Are the Common Causes and Risk Factors?

Understanding ankylosing spondylitis seniors is important for seniors and their caregivers. aS is the main member of a family of similar forms of arthritis called spondyloarthritis. Other members include psoriatic arthritis, arthritis of inflammatory bowel disease and reactive arthritis. This family of arthritis affects up to 1 in 100 people.

The cause of AS is unknown, however genes seem to play a role. The majority of people with AS are positive for the

HLA-B27

gene, but not everyone who has this gene has AS.

The disease often begins between ages 20 and 40, but it may begin before age 10. It affects more males than females.

What Are the Symptoms and Warning Signs?

What Are the Symptoms and Warning Signs? - illustration

AS starts with lower back pain that comes and goes but usually becomes present most of the time as the condition progresses.

  • Pain and stiffness are worse at night, in the morning, or when you are less active. The discomfort may wake you from sleep.
  • The pain often gets better with activity or exercise.
  • Back pain may begin in the joint between the pelvis and spine (sacroiliac joints). Over time, it may involve all or part of the spine.
  • Your lower spine may become less flexible. Over time, you may stand in a hunched forward position.

Other parts of your body that may be affected include:

  • The joints of the shoulders, knees and ankles, which may be swollen and painful
  • The joints between your ribs and breastbone, so that you cannot expand your chest fully
  • The eye, which may have swelling and redness called uveitis

Fatigue is also a common symptom.

Skeletal spine

Less common symptoms include:

  • Slight fever

AS may occur with other conditions, such as:

  • Psoriasis

  • Ulcerative colitis or

    Crohn disease

  • Recurring or chronic

    eye inflammation

    (

    iritis

    ,

    uveitis

    )

📖 What Are Exams and Tests?

What Are Exams and Tests?

Tests may include:

  • Anti-cyclic citrullinated peptide (CCP) antibody (which should be negative)

  • Complete blood count

    (CBC)

  • CRP (C reactive protein, a measure of inflammation)
  • ESR (

    erythrocyte sedimentation rate

    , a measure of inflammation)

  • HLA-B27 antigen

    (which detects the gene linked to ankylosing spondylitis)

  • Rheumatoid factor (which should be negative)

  • X-rays of the spine and pelvis

  • MRI of the spine and pelvis

📖 How Is It Treated?

How Is It Treated?

Your health care provider may prescribe medicines such as non-steroidal anti-inflammatory drugs (NSAIDs) to reduce swelling and pain.

  • Some NSAIDs can be bought over-the-counter (OTC). These include aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn).
  • Other NSAIDs are prescribed by your provider.
  • Talk to your provider or pharmacist before daily long-term use of any over-the-counter NSAID.

You may also need stronger medicines to control pain and swelling, such as:

  • Corticosteroid therapy (such as prednisone) used for short periods of time
  • Sulfasalazine
  • A biologic tumor necrosis factor (TNF) inhibitor (such as etanercept, adalimumab, infliximab, certolizumab or golimumab)
  • A biologic inhibitor of interleukin (IL)17A, secukinumab or Ixekizumab
  • Janus kinase (JAK) inhibitors such as tofacitinib and rinvoq

Surgery, such as hip replacement, may be done if pain or joint damage is severe.

Exercises can help improve posture and breathing. Lying flat on your back at night can help you keep a normal posture.

📖 What Is Outlook (Prognosis)?

What Is Outlook (Prognosis)?

The course of the disease is hard to predict. Over time, signs and symptoms of AS flareup (relapse) and quiet down (remit). Most people are able to function well unless they have a lot of damage to the hips or the spine. Joining a support group of others with the same problem may often help.

Treatment with NSAIDs often reduces the pain and swelling. Treatments given by IV or injection such as TNF inhibitors early in the disease appears to slow progression of the spine arthritis. Other newer medicines such as Interleukin-17 inhibitors and oral medicines, JAK inhibitors may help people if other medicines have not worked well.

Rarely, people with ankylosing spondylitis may have problems with:

  • Psoriasis, a chronic skin disorder
  • Inflammation in the eye (uveitis)
  • Inflammation in the intestine (

    colitis

    )

  • Abnormal heart rhythm
  • Scarring or thickening of the lung tissue
  • Scarring or thickening of the aortic heart valve
  • Spinal cord injury after a fall
📖 When to Contact a Medical Professional?

When to Contact a Medical Professional?

Contact your provider if:

  • You have symptoms of ankylosing spondylitis
  • You have ankylosing spondylitis and develop new symptoms during treatment

Spondylitis; Spondyloarthritis; HLA – B27

  • Skeletal spine

    Skeletal spine

  • Cervical spondylosis

    Cervical spondylosis

Inman RD, Fitzgerald G. Classification and epidemiology of spondyloarthritis. In: Firestein GS, McInnes IB, Koretzky GA, Mikuls TR, Neogi T, O’Dell JR, eds.

Firestein & Kelley’s Textbook of Rheumatology

. 12th ed. Philadelphia, PA: Elsevier; 2025:chap 75.

Inman RD, Rahman P. Spondyloarthritis. In: Goldman L, Cooney KA, eds.

Goldman-Cecil Medicine

. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 244.

Taylor WJ, van der Linden SJEF, Robinson PC, Brown M, Østergaard M, Gensler LS. Axial spondyloarthritis. In: Firestein GS, McInnes IB, Koretzky GA, Mikuls TR, Neogi T, O’Dell JR, eds.

Firestein & Kelley’s Textbook of Rheumatology

. 12th ed. Philadelphia, PA: Elsevier; 2025:chap 76.

Ward MM, Deodhar A, Gensler LS, et al. 2019 Update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network Recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis.

Arthritis Care Res (Hoboken)

. 2019;71(10):1285-1299. PMID: 31436026

pubmed.ncbi.nlm.nih.gov/31436026/

.

Updated by: Diane M. Horowitz, MD, Rheumatology and Internal Medicine, Northwell Health, Great Neck, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.


  • Ankylosing Spondylitis

Frequently Asked Questions

Key Takeaways

Understanding ankylosing spondylitis seniors is important for seniors and their caregivers. AS starts with lower back pain that comes and goes but usually becomes present most of the time as the condition progresses. Your health care provider may prescribe medicines such as non-steroidal anti-inflammatory drugs (NSAIDs) to reduce swelling and pain.

What Are the Common Causes and Risk Factors?

Understanding ankylosing spondylitis seniors is important for seniors and their caregivers. aS is the main member of a family of similar forms of arthritis called spondyloarthritis. Other members include psoriatic arthritis, arthritis of inflammatory bowel disease and reactive arthritis.

What Are the Symptoms and Warning Signs?

AS starts with lower back pain that comes and goes but usually becomes present most of the time as the condition progresses. Pain and stiffness are worse at night, in the morning, or when you are less active. The discomfort may wake you from sleep.

What Are Exams and Tests?

Tests may include:

Anti-cyclic citrullinated peptide (CCP) antibody (which should be negative)

Complete blood count

(CBC)

CRP (C reactive protein, a measure of inflammation)

ESR (

erythrocyte sedimentation rate

, a measure of inflammation)

HLA-B27 antigen

(which detects the gene linked to ankylosing spondylitis)

Rheumatoid factor (which should be negative)

X-rays of the spine and pelvis

MRI of the spine and pelvis

📖 How Is It Treated?

How Is It Treated?

Your health care provider may prescribe medicines such as non-steroidal anti-inflammatory drugs (NSAIDs) to reduce swelling and pain. Some NSAIDs can be bought over-the-counter (OTC). These include aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn).

About the Author: This article was researched and written by the SilverWell Hub editorial team. It was medically reviewed by Dr. Sarah Mitchell, MD, Geriatrics.

Sources: This article is adapted from MedlinePlus, a service of the National Library of Medicine.

Disclaimer: This information is for educational purposes only. See our full Medical Disclaimer.

Published: July 21, 2026 | Next review: January 2027