Although there’s currently no cure for spondylitis, many treatments are available to help ease symptoms and slow disease progression. Your healthcare provider will work with you to create a treatment plan based on the type of spondylitis you have, its severity, and factors like your age, overall health, and medical history. The best treatment approach is one that aligns with your symptoms and lifestyle while helping you maintain mobility and reduce pain.

Keep reading to learn about eight treatment options for spondylitis and how they can help manage your condition.

1. Nonsteroidal Anti-Inflammatory Drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs) are often the first treatment for spondylitis because they help manage pain and stiffness. They work by blocking enzymes called COX-1 and COX-2, which play a role in inflammation. Research suggests that NSAIDs may also help slow disease activity.

There are two main types of NSAIDs: over-the-counter (OTC) and prescription-strength.

Many people start with OTC NSAIDs, which are widely available at grocery stores and pharmacies. Common options include:

• Aspirin
• Diclofenac topical gel
• Ibuprofen
• Naproxen

If OTC NSAIDs are not effective, doctors may prescribe stronger versions. Some prescription NSAIDs include:

• Celecoxib (Celebrex) — A COX-2 inhibitor that targets inflammation while lowering the risk of stomach irritation
• Indomethacin (Indocin) — A potent NSAID often used for arthritis
• High-dose naproxen (Naprosyn) — A stronger version of OTC naproxen
• Diclofenac tablets (Voltaren) — A prescription form of diclofenac for systemic relief

It’s important to take NSAIDs exactly as directed by your doctor. Taking high doses or using them for long periods can increase the risk of stomach issues (such as ulcers or bleeding) and cardiovascular problems (such as high blood pressure or heart attack risk).

The Spondylitis Association of America (SAA) notes that NSAIDs can take several weeks to show full effects. If you have moderate to severe ankylosing spondylitis, your doctor may recommend additional treatments.

Disease-Modifying Antirheumatic Drugs

Disease-modifying antirheumatic drugs (DMARDs) target specific parts of the immune system to reduce inflammation and slow the progression of spondylitis. Unlike NSAIDs, which primarily relieve pain and stiffness, DMARDs help prevent long-term joint and spine damage.

Doctors divide DMARDs into two categories:

• Biologic DMARDs — Made from living cells, these target specific immune proteins involved in inflammation.
• Nonbiologic (synthetic) DMARDs — Lab-made medications that also regulate the immune system but in a broader way.

Before starting you on a biologic DMARD, your doctor may order blood tests and imaging to rule out infections, as these drugs can weaken the immune system. Regular checkups are important to monitor for side effects.

Types of DMARDs include tumor necrosis factor (TNF) inhibitors, interleukin (IL) inhibitors, and Janus kinase (JAK) inhibitors

2. Tumor Necrosis Factor Inhibitors

Tumor necrosis factor inhibitors block inflammatory proteins that play a role in spondylitis. According to the SAA, TNF inhibitors are effective for:

• Joint inflammation (arthritis)
• Spinal inflammation (ankylosing spondylitis)
• Eye and gut inflammation (uveitis and inflammatory bowel disease)
• Nonradiographic axial spondyloarthritis (nr-axSpA)

The U.S. Food and Drug Administration (FDA) has approved several TNF inhibitors. Many of these drugs also treat related rheumatic diseases, like rheumatoid arthritis. Examples include:

• Adalimumab (Humira)
• Certolizumab pegol (Cimzia)
• Etanercept (Enbrel)
• Golimumab (Simponi)
• Infliximab (Remicade)

3. Interleukin Inhibitors

Interleukins are signaling molecules made by your immune system. Some of them help create inflammation to activate your immune cells. Too many proinflammatory IL molecules lead to uncontrolled inflammation — causing diseases like spondylitis.

There are currently three FDA-approved IL-17 inhibitors for treating ankylosing spondylitis and nr-axSpA:

• Bimekizumab-bkzx (Bimzelx) — Blocks both IL-17A and IL-17F, making it an option for people who haven’t responded to TNF or other IL inhibitors.
• Ixekizumab (Taltz)
• Secukinumab (Cosentyx)

4. JAK Inhibitors

Janus kinase inhibitors are nonbiologic, targeted synthetic DMARDs that block JAK proteins. The proteins regulate more than 60 cytokines (inflammatory molecules), some of which are involved in spondylitis.

The FDA has approved two JAK inhibitors for treating spondylitis:

• Tofacitinib (Xeljanz) — Approved for ankylosing spondylitis
• Upadacitinib (Rinvoq) — Approved for both ankylosing spondylitis and nr-axSpA

A key benefit of JAK inhibitors is that they are taken as oral pills rather than injections, unlike biologic DMARDs. However, they do not remain in the body as long, meaning symptoms may return more quickly if treatment is stopped.

On the other hand, if side effects occur, the medication clears the system faster than biologics. JAK inhibitors should be used with caution in people with cardiovascular conditions.

5. Surgery

Surgery may be considered for severe spondylitis when other treatments are not effective. The type of procedure depends on the specific complications of the disease

For example, hip replacement surgery is a common option for people with ankylosing spondylitis when the hip joint becomes severely damaged. The damaged hip joint is replaced with metal, plastic, and ceramic parts to restore mobility and reduce pain.

Spinal surgery may also be an option for those with severe spinal deformities, such as kyphosis (an abnormal forward curvature of the spine). According to the Spondylitis Association of America, spinal surgery can help correct posture and improve function. However, these procedures are complex and carry risks, including nerve damage and infection.

If you are considering spinal surgery, it is important to consult with a spine specialist experienced in treating spondylitis to discuss the potential benefits and risks.

6. Physical Therapy and Exercise

Physical therapy can help people with spondylitis manage symptoms, improve flexibility, and maintain mobility. A physical therapist will evaluate how you move and where your pain is located. They’ll then create a treatment plan to address your specific symptoms. This can include:

• Posture training to help you adjust your spine and prevent falls
• Deep breathing exercises to expand the chest and improve lung capacity
• Movement retraining to maintain mobility while saving energy

Exercise is a key part of treating spondylitis. Research shows that regular physical activity can help ease pain and stiffness while preserving flexibility and mobility. The Spondylitis Association of America recommends four types of exercise:

• Aerobic exercise (walking, jogging, biking)
• Stretching and range-of-motion exercises
• Balance exercises
• Strength training (weight lifting, resistance bands)

Many studies show that exercise makes it easier to perform daily activities with spondylitis. You may notice it gets easier to control your posture, breathing, and joint function. Your physical therapist can help you create an exercise plan that fits your abilities and needs.

Other Medications for Spondylitis

In some cases, doctors may recommend less common medications for spondylitis. Many of these treatments are older and may come with more side effects than newer options.

7. Traditional DMARDs

Older DMARDs can help reduce inflammation and slow disease progression, particularly in peripheral arthritis (joint involvement outside the spine). These conventional synthetic DMARDs include:

• Azathioprine (Imuran)
• Methotrexate
• Sulfasalazine (Azulfidine)

While effective for peripheral joint inflammation, these medications are not useful for spinal symptoms in spondylitis. None of these treatments are specifically indicated for spondylitis, though doctors sometimes prescribe them off-label. With the development of newer DMARDs, traditional options are prescribed less frequently.

8. Corticosteroids

Although not commonly used for spondylitis, corticosteroids can help manage flare-ups in certain cases. Short-term use of oral or intravenous steroids, such as prednisone, may help control severe inflammation.

Doctors may also recommend cortisone injections for persistent inflammation in peripheral joints that does not respond to other treatments. These injections can provide targeted pain relief and reduce swelling.

Steroids cause serious side effects when taken long-term. They include:

• Weight gain
• Mood changes
• High blood sugar levels
• Hypertension (high blood pressure)
• Osteoporosis (bone thinning)

Because of these risks, corticosteroids are typically used at the lowest possible dose for the shortest duration needed to control symptoms.

Side Effects of Spondylitis Medications

All medications come with potential side effects, and spondylitis treatments are no exception. However, side effects vary by medication and person, and not everyone will experience them.

Doctors follow treatment guidelines that recommend trying certain medications first. If a treatment is not effective or causes intolerable side effects, other options are available.

When recommending a spondylitis medication, doctors consider:

• Your personal and family medical history
• Potential benefits and risks
• How the medication interacts with other conditions you may have

For example, DMARDs can help prevent joint damage and slow disease progression, but they may increase the risk of infections, stomach problems, or, in rare cases, certain cancers. It’s important to talk with your doctor about the risks and benefits of any medication you are considering.

Paying for Spondylitis Medication

Many people with private or employer-sponsored health insurance are eligible for copay assistance programs. Some drug manufacturers offer copay cards that reduce out-of-pocket costs, sometimes as low as $0 per month for certain treatments.

For those with low income or no health insurance, nonprofit organizations and pharmaceutical companies may provide free or low-cost spondylitis medications through patient assistance programs. If you need financial assistance, your doctor or pharmacist can help you explore these options.

Can a Healthy Diet Help Treat Spondylitis?

Health experts don’t recommend a specific diet to treat spondylitis. Most guidelines suggest following a healthy diet to support bone health. People with spondylitis are at a higher risk of osteoporosis. Be sure to get enough calcium and vitamin D to keep your bones strong.

Foods high in vitamin D include:

• Canned fish (such as salmon and sardines)
• Egg yolks
• Fortified foods like milk, yogurt, and breakfast cereals (which often contain both vitamin D and calcium)

The SAA also recommends dietary changes such as:

• Eating more fruits and vegetables to add color and variety to your diet
• Getting omega-3 fatty acids from sources like nuts, fish, and flaxseed to help fight inflammation
• Limiting alcohol, as it can contribute to bone thinning
• Reducing sugar, salt, and unhealthy fats, which may support better overall health

While diet alone cannot replace medical treatment, maintaining good nutrition can help protect bone strength and general health in people with spondylitis.

Is There a Natural Cure for Spondylitis?

Studies haven’t found any natural, alternative treatments that can cure or significantly slow spondylitis progression, but some complementary or alternative therapies may help manage symptoms. Some people with spondylitis find symptom relief by using:

• Medical marijuana
• Herbal supplements
• Chiropractic treatment
• Acupuncture

Some natural or holistic treatments can interfere with spondylitis medications and cause side effects. It’s important to talk to your doctor before trying any alternative treatments to ensure they are safe.

Talk to Your Doctor About the Best Treatment Plan

Although there is no cure for spondylitis, a variety of treatments can help manage symptoms and slow disease progression. Because every person’s condition is different, it’s important to work closely with your doctor to create a treatment plan tailored to your needs. If your current treatment isn’t working or causes unwanted side effects, talk to your healthcare provider about alternative options.

Find Your Team

On MySpondylitisTeam — the social network for people living with spondylitis and their loved ones — more than 99,000 members come together to ask questions, offer advice and support, and meet others who understand life with spondylitis.

Which treatments have helped you manage your spondylitis symptoms? Have you experienced side effects that led you to switch medications? Share your experiences in the comments below, post to your Activities page, or connect with like-minded members in Groups.