Chiropractic care for ankylosing spondylitis: benefits and risks


Ankylosing spondylitis is an autoimmune disease that primarily affects the spine. Over time, the bones in the spine can fuse together, causing a permanent loss of range of motion. Spinal manipulation by a chiropractor is not recommended in the treatment of this condition, but other chiropractic interventions may help relieve symptoms.

This article discusses chiropractic care for ankylosing spondylitis, including potential risks and benefits.

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Risks of chiropractic care for ankylosing spondylitis

Chiropractors perform spinal manipulation using pushing force to help improve the movement of the joints in the spine. In addition to improving range of motion, spinal manipulation can help decrease pain and reduce muscle tension.

Ankylosing spondylitis causes extra bone growth, or bone spurs, in the spine. This condition can also lead to other bone-related complications, such as osteoporosis, bone breakdown that can make your bones brittle.

Manipulation of the spine in people with ankylosing spondylitis can lead to serious injuries, such as broken bones, paraplegia (lower body paralysis) and spinal cord injury. People whose bones have fused in the spine or who have advanced osteoporosis have an increased risk of such complications.

For these reasons, the American College of Rheumatology, the Spondylitis Association of America, and the Spondyloarthritis Research and Treatment Network strongly advise against the use of spinal manipulation with high velocity thrusts for people with ankylosing spondylitis.

Case studies have been published suggesting that spinal manipulation helped relieve symptoms of ankylosing spondylitis in some patients whose symptoms were not active at the time of treatment. Patients in the study also received additional interventions, including soft tissue manipulation and home exercises.

Importantly, the patients in these case studies who were receiving chiropractic treatment for ankylosing spondylitis were also under the care of a medical rheumatologist (a doctor who specializes in conditions of the joints, muscles, bones, and immune system ).

When to talk to your health care provider

If you have ankylosing spondylitis, talk to your healthcare provider before seeing a chiropractor or having any other procedure that isn’t already part of your treatment plan.

Benefits of chiropractic care for ankylosing spondylitis

Chiropractic care includes more than spinal manipulation. Other treatments provided by a chiropractor may include proper posture training, exercise instruction, and ergonomics training. These interventions are beneficial for people with ankylosing spondylitis.

In some cases, a chiropractor may be the first healthcare provider to treat someone with ankylosing spondylitis. The first symptoms usually appear before the age of 40 and include chronic back pain and stiffness, symptoms commonly treated by chiropractors.

The diagnosis of ankylosing spondylitis is often difficult and delayed. Early symptoms are vague and can be attributed to many different causes, sometimes making an accurate diagnosis of ankylosing spondylitis a years-long process. This increases the risk of significant side effects, such as permanent loss of range of motion, difficulty breathing, bowel problems, loss of appetite, fatigue, rashes, and blindness.

Chiropractors who recognize the signs and symptoms of ankylosing spondylitis can help patients get needed treatment faster by referring them to a rheumatologist for further evaluation.

When to see a chiropractor for ankylosing spondylitis

If you have ankylosing spondylitis, talk to your healthcare provider or rheumatologist about the risks and benefits of chiropractic care. A chiropractor can teach you pain management exercises, explain ergonomics, and help you manipulate soft tissue.


Ankylosing spondylitis is an inflammatory arthritis that initially affects the spine. This condition causes bone spurs which can eventually lead to fused joints. High-velocity thrust spinal manipulation is not recommended for people with this condition due to the high risk of fractures and nerve damage.

However, chiropractors perform other types of procedures that may benefit people with ankylosing spondylitis, such as soft tissue manipulation, ergonomic training, and exercise instruction.

A word from Verywell

Living with ankylosing spondylitis can make daily tasks difficult. Follow your healthcare provider’s instructions and schedule regular follow-up visits so your treatments can be adjusted as needed to help reduce your symptoms. Take your medications as prescribed and talk to your provider about any complementary treatments that might be helpful, including some of the procedures provided by chiropractors.

Frequently Asked Questions

  • Can a chiropractor help with ankylosing spondylitis?

    Spinal manipulation is a staple treatment of chiropractors. This treatment is not recommended for people with ankylosing spondylitis. However, chiropractors offer other services that may benefit people with this condition. This includes soft tissue manipulation, ergonomics training, and exercise instruction.

  • What not to do with ankylosing spondylitis?

    If you have ankylosing spondylitis, avoid spinal manipulation therapy. You should also avoid activities that increase your pain and sitting for long periods of time, which can make your stiffness worse. Move for five to 10 minutes every hour.

  • What is the best treatment for ankylosing spondylitis?

    Treatment for ankylosing spondylitis includes medications to target proteins in your immune system that attack your healthy cells and exercises to decrease stiffness and improve or maintain your range of motion in the joints affected by this disease.

Verywell Health only uses high quality sources, including peer-reviewed studies, to support the facts in our articles. Read our editorial process to learn more about how we fact check and ensure our content is accurate, reliable and trustworthy.

By Aubrey Bailey, PT, DPT, CHT

Aubrey Bailey is a physical therapist and teacher of anatomy and physiology with over a decade of experience providing in-person and online training for medical personnel and the general public, specializing in the areas of orthopedic injuries, neurological diseases, developmental disabilities and healthy lifestyles. .


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