Living with ankylosing spondylitis can raise a lot of questions, especially about treatment and next steps. Knowing how to prepare for appointments and what questions to ask can help you and your doctor work as a team to create a plan that fits your needs.

The first step to managing your ankylosing spondylitis (AS) is scheduling regular check-ins with your doctor. Just as important? Showing up prepared.

Being ready to discuss symptoms, treatment options, and what’s working (or not) in your care plan can help you get the most out of every visit.

Not sure what to ask or discuss? Read on for treatment-related AS questions that will help guide the conversation and get you the answers you need.

Your answer to this question is as important as your doctor’s. Start by sharing what you hope to get out of treatment, whether that’s reducing pain, staying active at work, or protecting your spine long term.

Common treatment goals for AS include:

  • slowing disease progression
  • easing pain and inflammation
  • preventing permanent damage to your spine and other joints
  • maintaining or improving the overall quality of life

You might also have personal goals like being able to keep up with certain physical activities or meeting job demands. Let your doctor know what matters to you. It helps guide the treatment plan.

Because AS looks different for everyone, your doctor will tailor their recommendations based on your current condition, with your personal preferences in mind. Together, you can weigh the benefits and side effects of each option before deciding on next steps.

AS symptoms can change over time, it’s worth checking in on your progress at each visit. Ask if you’re on track to meet your goals and whether any adjustments might be needed to help you meet them.

Several types of medication can help manage AS. The best one for you depends on your symptoms, treatment goals, and the severity.

Most people start with the lowest effective dose and adjust over time. If one medication doesn’t work, there are other options to try. It might take some trial and error to find the one that works for you.

Ask your doctor about the benefits and risks of each drug, including how often you’ll need follow-up monitoring. The following are some of your options:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs): These oral medications help relieve pain and stiffness. Over-the-counter versions are available, but stronger prescriptions may be needed. It can take a few weeks to notice improvement. Long-term use increases the risk of side effects, including stomach ulcers, liver or kidney problems, and heart issues.
  • Disease-modifying antirheumatic drugs (DMARDs): Traditional DMARDs can help slow disease progression, especially if peripheral joints (like hips or shoulders) are affected. These drugs often require routine blood tests to monitor liver function and other safety markers.
  • Biologics: These targeted therapies block specific inflammatory pathways and are usually given as injections or infusions. They include tumor necrosis factor (TNF) inhibitors and interleukin-17 (IL-17) inhibitors. Biologics can be highly effective but may increase the risk of infections, so ongoing monitoring is important.
  • Janus kinase (JAK) inhibitors: This newer class of oral medications also targets inflammation and may be an option if biologics aren’t effective or tolerated.
  • Corticosteroids: Steroid injections can quickly reduce inflammation in specific joints, but they’re usually used short term and aren’t typically injected into the spine.

Your doctor will work with you to decide which medication fits your needs and when to reassess your plan.

Staying active is one of the most important parts of treating AS. The right exercises can:

  • ease pain
  • improve posture
  • keep your joints flexible
  • help you feel stronger overall

Building muscle around your spine and hips also gives those joints extra support.

Not all movements are safe or helpful, though. Doing the wrong exercises, or even the right ones incorrectly, can stress your joints and make symptoms worse. Ask your doctor to review your routine and suggest any changes to keep it safe and effective.

A physical therapist can be especially helpful. They can teach you exercises tailored to your symptoms and show you how to do them correctly. Research even shows that supervised exercises often work better than going it alone. If you don’t already have a PT, consider asking your doctor for a referral.

Your treatment plan isn’t just about medication. Small changes in daily habits can also help prevent long-term spine and joint damage. Based on your medical history, lifestyle, and treatment goals, your doctor may suggest the following:

  • Posture tips: how to sit, stand, and move to reduce strain on your spine
  • Sleep support: the best positions for sleep and whether specific pillows or mattresses might help
  • Assistive tools or home adjustments: devices or ergonomic changes that make everyday tasks easier and safer
  • Activity guidance: which movements or sports to avoid — and which to focus on — to protect your joints.
  • Specialist referrals: physical therapists, occupational therapists, or other experts who can help you stay active and independent

If you smoke, quitting is one of the best things you can do for your spine health. Smoking has been linked to worse outcomes in people with AS. If quitting feels overwhelming, ask your doctor about cessation programs or medications that can help.

There’s no one-size-fits-all diet for AS, but eating well can support your overall health and help manage symptoms. A balanced diet rich in whole foods like fruits, vegetables, lean proteins, and whole grains may also help reduce inflammation. Maintaining a healthy weight takes stress off your spine and joints.

Your doctor can help identify any dietary changes that might benefit you, especially if you need to lose weight or have other health concerns like heart disease or diabetes.

If you want more personalized guidance, ask for a referral to a registered dietitian or nutritionist who can tailor a plan to your needs and preferences.

Doctor’s visits can move fast. You might ask one question, then suddenly be talking about something else. It’s not unusual to get home and realize you forgot to mention an important symptom or concern.

Keeping an AS journal can help. Bring it to every appointment to track questions, changes in symptoms, treatment updates, and your doctor’s recommendations.

Before each visit, update your journal with:

  • Current medications: Include prescription and over-the-counter medications you take, including dose and frequency. Don’t forget to list dietary supplements.
  • Medical records: If this is your first visit, bring any medical records and test results relating to your medical history.
  • New or worsening symptoms: List anything unusual, even if it seems unrelated, since it could affect your treatment plan.
  • Side effects or concerns: Note any reactions to medications or therapies.
  • Questions about test results or next steps: Write them down so you don’t forget during the appointment.

A little prep can help you leave each visit feeling clearer, more confident, and ready for what comes next.

Regular check-ins, honest conversations, and small daily habits can make a big difference in managing ankylosing spondylitis. Preparing questions and tracking changes helps you and your doctor work as a team, so your treatment plan keeps pace with your life and goals.