Can Ankylosing Spondylitis Be Cured? An Expert Weighs In

If ankylosing spondylitis (AS) had an “unsubscribe” button, rheumatologists would be handing it out at the door
like free stickers at a parade. But AS is not that polite. It’s a chronic inflammatory conditionmeaning it tends
to stick around, sometimes loudly, sometimes quietly, and occasionally like that neighbor who only shows up when
you’re trying to rest.

Still, “no cure” doesn’t mean “no hope.” Today’s treatments can reduce inflammation, ease pain and stiffness,
improve mobility, and help many people reach low disease activity (and even remission-like stretches) where AS
stops running the show. The more accurate question isn’t just “Can it be cured?” It’s:
How close can we get to feeling normaland how do we protect your spine and joints long-term?

The straight answer: Is AS curable?

Noankylosing spondylitis is not currently considered curable. In medical terms, a cure means the
disease is eliminated and doesn’t come back. With AS, the underlying immune-driven tendency to inflame the spine
and other areas can persist even when symptoms improve.

But here’s the part that matters in real life: AS is often treatable to the point that it becomes
manageable, and for some people it becomes background noise rather than a daily headline.
Many patients can achieve major symptom relief, better function, fewer flares, and improved quality of life
with the right combination of medication, movement, and long-term monitoring.

What AS really is (and why “cure” is complicated)

Ankylosing spondylitis is a form of inflammatory arthritis that primarily affects the spine and the sacroiliac
(SI) joints (where the spine meets the pelvis). Over time, ongoing inflammation can contribute to structural
changes, including new bone formation and possible fusion in parts of the spine. That’s one reason early control
of inflammation is a big deal.

AS can also involve other areas: hips, shoulders, ribs, and places where tendons/ligaments attach to bone
(called entheses). And it can show up outside the joints toosuch as uveitis (eye inflammation),
or associations with psoriasis and inflammatory bowel disease in the broader
spondyloarthritis family.

So why does this complicate “cure”? Because AS isn’t just “a sore back.” It’s an immune-mediated process that can
fluctuatecalm down for months, then flare, then calm again. The goal becomes controlling the process,
limiting damage, and keeping you living a full life.

What experts focus on instead of “cure”

When you ask a rheumatology expert, “Can AS be cured?” the answer is usually followed by a more useful framework:

1) Remission vs. cure: the “sleeping dragon” concept

Many people can reach periods of low disease activity where pain and stiffness are minimal, function improves,
and inflammation markers may look better. You could call it remission-like controlyour symptoms may be quiet,
but the underlying tendency can still be there. That’s why long-term follow-up matters, even when you feel great.

2) Treat-to-target: don’t settle for “barely tolerable”

Modern AS care often aims for a target (low disease activity) rather than simply “let’s see how bad it gets.”
The exact tools vary by clinician, but the theme is consistent: track symptoms, function, and sometimes labs or imaging,
and adjust treatment to reduce inflammation and protect mobility.

3) Preventing progression: the long game

A major aim is slowing or preventing structural damagebecause once bone fusion occurs, we can’t “un-fuse” it.
That’s why early diagnosis and an effective, consistent plan can be powerful.

Treatment options that can get AS under control

AS treatment is usually a mix of medication and movementlike a two-person tandem bike. If one side stops pedaling,
you’re going in circles (and not the fun kind). The best plan is personalized, but here are the main evidence-based
categories.

NSAIDs: often the first line for pain and inflammation

Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to reduce pain and stiffness, especially early on
or during flares. For many people, NSAIDs can be a meaningful first step and may be used regularly or as needed,
depending on symptoms and risk factors.

Important note: NSAIDs can cause side effects (stomach irritation/bleeding risk, kidney effects, blood pressure issues),
so clinicians weigh benefits vs. risks and may recommend protective strategies in higher-risk patients.

Biologics: targeted therapy when NSAIDs aren’t enough

If symptoms remain active despite NSAIDs, biologic medications are often considered. These therapies target specific
inflammatory pathways rather than “carpet-bombing” the immune system.

TNF inhibitors

Tumor necrosis factor (TNF) inhibitors were a major leap forward in AS care and remain a common biologic option.
They can reduce inflammation, improve pain and function, and help many people regain quality of life.
Some references also note that TNF inhibitors started earlier in the course may help slow progression in some patients,
although progression is complex and varies by individual.

IL-17 inhibitors

Interleukin-17 (IL-17) inhibitors are another biologic option used in AS and axial spondyloarthritis.
They may be considered in certain scenarios, including when TNF inhibitors aren’t effective or tolerated,
or when a clinician’s judgment suggests IL-17 targeting is a better fit.

Clinical guidelines have historically recommended a TNF inhibitor as a first biologic for many patients,
while also supporting IL-17 inhibitors as effective options, especially in specific response patterns.
Your rheumatologist’s choice depends on your disease features, other health conditions,
prior medication response, insurance realities, and your personal preferences.

JAK inhibitors: an oral option for some patients

Janus kinase (JAK) inhibitors are oral (pill) medications that affect signaling involved in inflammation.
One JAK inhibitor, upadacitinib (brand name Rinvoq), has U.S. FDA labeling that includes ankylosing spondylitis
in adults who had an inadequate response or intolerance to one or more TNF blockers.
This can be an option for some people who need another approach.

Because JAK inhibitors influence immune signaling broadly, they come with important safety considerations.
Clinicians screen for risks (like infections) and monitor patients closely.
This is not a “try it on a whim” categoryit’s a guided decision.

DMARDs and steroids: sometimes used in specific situations

Traditional DMARDs (like sulfasalazine) may be considered more for peripheral arthritis
(for example, knees/ankles) than for purely spinal symptoms, depending on the clinical picture.
Steroids are generally not a long-term solution for axial disease, but local steroid injections may be used
in certain joint or tendon-attachment pain scenarios.

Physical therapy and exercise: not optional “extras”

If there’s one “prescription” that shows up again and again in reputable guidance, it’s movement.
Regular exercise and targeted physical therapy can help with posture, stiffness, pain, breathing capacity, function,
and overall quality of life. Think of it as maintenance for your spine’s range of motion and your ribcage’s mobility.

The goal isn’t to become a triathlete overnight. It’s consistency:
a daily routine (even short sessions), plus a plan that respects your current pain level and mobility.
Many people benefit from a physical therapist who understands inflammatory back pain and can tailor stretching,
strengthening, and posture work.

Lifestyle moves that support your treatment plan

• Quit smoking (if applicable): smoking is linked with worse outcomes in many inflammatory conditions.
• Sleep and stress management: flares and fatigue often worsen when rest is poor or stress is high.
• Posture habits: small daily posture choices add upespecially when stiffness is a regular guest.
• Workstation tweaks: supportive seating, screen height, and movement breaks can reduce strain.

Surgery: for severe joint damage or complications

Surgery isn’t common for most people with AS, but it may be considered in specific situationslike severe hip damage
requiring replacement or spine complications where a specialist recommends intervention.

If AS isn’t curable, why do some people feel “almost normal”?

This is one of the most encouraging parts of modern AS care: symptom control can be dramatic.
When inflammation is well-controlled, many people regain function, return to work and hobbies,
and experience far fewer “AS days” that derail life.

Here are common reasons people can feel significantly better:

1. Inflammation is reduced (less pain, less stiffness, better energy).
2. Movement improves mobility (your body relearns range of motion and strength patterns).
3. Flares become less frequent (with the right long-term strategy).
4. Comorbid issues get treated (sleep problems, mood, deconditioning, posture strain).

The tricky part: improvement can tempt people to stop the plan that caused the improvement.
(Classic human behaviorsee also: stopping flossing the moment your gums stop bleeding.)
That’s why expert care usually involves ongoing monitoring and a long-term maintenance mindset.

What’s “new” in AS treatment and research?

While we can’t claim a cure, AS research has gotten smarter and more targeted. Areas of progress include:

More targeted immune pathways

Beyond TNF and IL-17, researchers continue studying additional immune targets and combinations,
aiming to improve response rates and help people who don’t respond well to first-line biologics.

Earlier diagnosis and earlier control

Recognizing inflammatory back pain patterns sooner (and using imaging and clinical criteria more effectively)
can move people toward treatment earlierpotentially improving long-term outcomes.

Oral options and personalized strategies

Oral therapies like certain JAK inhibitors offer another route for some patients.
Meanwhile, personalized carematching therapy to disease features, response patterns, and patient goals
is becoming more central than a one-size-fits-all approach.

Microbiome and whole-body inflammation

There’s ongoing interest in how gut health and the microbiome might influence inflammatory arthritis.
This is an active research areapromising, but not a “magic probiotic cured my spine” situation.
(If you see that headline, hold your wallet and blink twice.)

What to ask your rheumatologist (so you leave with answers, not just a parking ticket)

• Based on my symptoms and imaging, do I have radiographic AS or non-radiographic axial spondyloarthritis?
• What is our target: symptom control, low disease activity, preventing progressionor all of the above?
• Which medication class best matches my situation (NSAID, TNF inhibitor, IL-17 inhibitor, JAK inhibitor), and why?
• How will we measure whether treatment is workingsymptoms, function, labs, imaging?
• What’s my exercise/physical therapy plan, and what should I avoid during flares?
• What symptoms should prompt urgent care (for example, red/painful eye changes suggesting uveitis)?

The bottom line

AS isn’t curable todaybut it’s often controllable. With modern therapies and consistent movement,
many people reduce symptoms substantially, protect function, and live full lives. The “expert” perspective is simple:
don’t chase a miracle wordchase measurable control. Fewer flares. Better sleep. More mobility.
Less inflammation. More of your life back.

If you suspect AS or you’re newly diagnosed, the most important step is working with a rheumatologist and starting a plan
that fits your disease pattern and your real-world goals. Because “getting better” isn’t a vibeit’s a strategy.

Real-World Experiences: What Living With AS Often Feels Like (and What Helps)

The medical facts matterbut so does the day-to-day reality. People living with ankylosing spondylitis often describe
a long “mystery tour” before diagnosis: years of back pain that doesn’t behave like typical back pain. It may feel worse
after rest, show up at night, or greet you in the morning like an overenthusiastic alarm clock. Some people report that
moving around helps more than lying down, which can be confusing when your instinct is to “rest an injury.”

After diagnosis, the experience is frequently a mix of relief (“I’m not imagining this”) and frustration (“So it’s chronic?”).
Many people go through a trial-and-error phase with treatment. NSAIDs might be a game-changer for one person and “meh”
for another. Biologics can be life-altering when they work wellpeople often talk about realizing they forgot they had pain,
which is both wonderful and mildly infuriating (because you didn’t know how much mental bandwidth pain was stealing).
Others need a different class or a second try to find the best fit.

A recurring theme: movement becomes medicinebut not in a cheesy poster way. It’s more practical than that.
People often learn that a short, consistent routine beats a once-a-week heroic workout. A few minutes of stretching after a shower.
A walk broken into smaller chunks. Gentle mobility work on flare days, stronger work when symptoms settle.
Many describe posture training as surprisingly helpful: not because posture is a moral virtue, but because stiffness tends to pull the body
into positions that create more strain. Small adjustments at a desk, a different pillow, a reminder to change positionsthese can add up.

Flares can feel unfair. You may do “everything right” and still wake up stiff, sore, and tired. That’s where coping strategies matter:
having a flare plan (heat, gentle movement, pacing your day), knowing which symptoms need quick medical attention (especially sudden eye pain/redness),
and giving yourself permission to adjust without guilt. Many people also mention the emotional sideanxiety about progression, frustration about limitations,
and the sense that others don’t understand because you might “look fine.” Support groups, therapy, or simply connecting with people who get it can be a
surprisingly effective part of care.

Finally, a common “aha”: the best AS management is rarely one single magic fix. It’s a layered systemright medication, consistent movement,
smart lifestyle supports, and regular check-ins. Over time, many people become experts in their own pattern: they learn what triggers flares,
what helps them recover faster, and how to balance ambition with sustainability. That’s not a curebut it can be the difference between AS running your life
and AS being a condition you manage while you live it.