Physiotherapy for Ankylosing Spondylitis

What is ankylosing spondylitis?

Ankylosing spondylitis (axial spondyloarthritis) is a chronic inflammatory rheumatic disease that primarily affects the sacroiliac joints, spine, and entheses. In young adults in India, it frequently presents as persistent lower back and buttock pain with prolonged morning stiffness lasting over thirty minutes that improves with movement rather than rest. Long-term inflammation can lead to progressive spinal calcification and restricted thoracic cage expansion. While biologic or anti-inflammatory medications manage systemic inflammation, daily physiotherapy is critical to maintain spinal posture, thoracic lung expansion capacity, peripheral joint mobility, and overall cardiovascular endurance.

How physiotherapy helps

• Thoracic extension and rotational mobility
• Deep diaphragmatic and chest expansion drills
• Postural retraining against forward stoop
• Hip flexor stretching and gluteal activation
• Low-impact aerobic conditioning programmes

Common signs

• Persistent lower back and buttock pain that is worse in the second half of the night and early morning
• Morning spinal stiffness lasting greater than 30 minutes that eases with warm showers and walking
• Pain that improves with active exercise but worsens with prolonged sitting, lying, or bed rest
• Gradual reduction in spinal flexibility, neck rotation, or chest expansion during deep breathing
• Pain and tenderness at tendon insertions such as the Achilles tendon or the bottom of the heel

Clinical rehabilitation framework

Evidence-informed clinical progression and starter exercise targets for ankylosing spondylitis.

Frequently asked questions

Related conditions & care

Back PainBack pain is a common reason people see a physiotherapist in India. It can come from muscle strain, long hours of sitting, poor posture, disc problems, or general wear and tear. Most back pain can ease with the right movement and care. Physiotherapy focuses on relieving your current pain while building the strength and habits that can lower the chance of it returning.

SciaticaSciatica is pain that travels from the lower back through the buttock and down the leg, along the path of the sciatic nerve. It is usually caused by irritation or pressure on the nerve, often from the lower back. Physiotherapy can help reduce nerve irritation and ease pain, and rebuilds the movement and strength that protect your back.

Neck PainNeck pain often builds up from posture, long hours at a desk or phone, muscle tension, or stiffness in the neck joints. Sometimes it spreads to the shoulder or causes headaches. Physiotherapy can help reduce pain and stiffness and helps address contributing habits and movement patterns, so it is less likely to come back.

Clinical guides & articles for ankylosing spondylitis

Evidence-informed articles, recovery timelines, and home care advice from our clinical library.