Ankylosing Spondylitis Manual Therapy by Osteopaths

Ankylosing Spondylitis

Ankylosing spondylitis (AS) is a long-term (chronic) condition in which the spine and other areas of the body become inflamed.

AS tends to first develop in teenagers and young adults. It’s also around three times more common in men than in women.


The symptoms of AS can vary, but usually involve:

  • back pain and stiffness
  • pain and swelling in other parts of the body – caused by inflammation of the joints (arthritis) and inflammation where a tendon joins a bone (enthesitis)
  • extreme tiredness (fatigue)

These symptoms tend to develop gradually, usually over several months or years, and may come and go over time.

In some people the condition gets better with time, but for others it can get slowly worse.

When to seek medical advice

You should see your GP if you have persistent symptoms of AS.

If your GP thinks you may have the condition, they should refer you to a specialist in conditions affecting muscles and joints (rheumatologist) for further tests and any necessary treatment.

Further tests may include blood tests and imaging tests.

Read about diagnosing ankylosing spondylitis.

Causes of ankylosing spondylitis

It’s not known what causes the condition, but there’s thought to be a link with a particular gene known as HLA-B27.

The National Ankylosing Spondylitis Society does suggest treatment by osteopaths can be applied to people suffering with Ankylosing Spondylitis

Osteopaths provide a range of treatments aimed at managing pain and improving mobility utilising massage and passive mobilising techniques. A programme of treatment can also involve exercise, self management and advce tailored to individual needs.

Spinal manipulation is not recommended by osteopaths for patients with AS. Where appropriate an osteopath will refer you back to your GP or other healthcare professional.

There is some research that shows the benefits of Osteopathic treatment of patients with Ankylosing spondylitis in particular:

Self- and manual mobilization has been shown to improve chest expansion, posture and spine mobility in patients with ankylosing spondylitis over an eight week period. The treatment involved a massage protocol incorporating mostly Swedish strokes and stretching (consistent with published guidelines), with myofascial release and trigger point therapy introduced in later sessions (Widberg et al. 2009).

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Reference List

National Ankylosing Spondylitis Society (N.D).

NHS Choices (N.D).

Widberg K, Karimi H, Hafström I (2009). Self- and manual mobilization improves spine mobility in men with ankylosing spondylitis–a randomized study. Clin Rehabil. Jul;23(7):599-608.

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