Ankylosing spondylitis is a chronic inflammatory condition that affects the spine and sacroiliac joints. It can cause persistent back stiffness, reduced spinal flexibility, and gradual postural changes over time. Physical therapy helps maintain mobility, improve posture, and support long-term spinal health.
Do you wake up with stiffness in your lower back that improves as you start moving? Have you noticed your posture gradually changing or your flexibility decreasing over time? These symptoms may be related to ankylosing spondylitis, a chronic inflammatory condition that primarily affects the spine.
At Rose Physical Therapy in Washington, DC, physical therapists work with individuals who have ankylosing spondylitis to improve posture, reduce stiffness, and maintain mobility through personalized, one-on-one care.
What Is Ankylosing Spondylitis?
Ankylosing spondylitis (AS) is a form of axial spondyloarthritis, an autoimmune condition that causes inflammation in the spine and sacroiliac (SI) joints.
Over time, chronic inflammation can lead to the formation of new bone along the spine. This process may cause sections of the spine to gradually fuse together, reducing flexibility and sometimes leading to a forward-leaning posture.
Although AS often begins in the lower back and pelvis, it may also affect:
• The thoracic spine (mid-back)
• The neck
• The hips
• The ribs and chest wall
• The shoulders in some cases
Early recognition and consistent management are important for preserving mobility and preventing long-term complications.
What Causes Ankylosing Spondylitis?
Ankylosing spondylitis develops due to a combination of genetic and immune system factors.
Common contributors include:
Genetic predisposition
Many individuals with AS carry a genetic marker called HLA-B27, which increases the risk of developing the condition.
Chronic inflammation
The immune system mistakenly attacks structures in the spine and SI joints, leading to inflammation and stiffness.
Postural adaptations
As stiffness progresses, the body may gradually shift toward a forward-flexed posture.
Age of onset
Symptoms commonly begin between the late teens and early 40s.
Delayed diagnosis
Early symptoms can resemble mechanical low back pain, which sometimes delays proper diagnosis.
What Does Ankylosing Spondylitis Feel Like?
Symptoms can vary widely and often occur in cycles of flare-ups and periods of improvement.
Common symptoms include:
• Persistent low back pain and stiffness, especially in the morning
• Pain that improves with activity but worsens with rest
• Reduced spinal mobility and flexibility
• Difficulty standing fully upright
• A gradual forward-flexed posture
• Pain or stiffness in the hips, shoulders, or rib cage
• Fatigue during inflammatory flare-ups
Unlike many mechanical back conditions, ankylosing spondylitis symptoms typically improve with movement and worsen with prolonged rest.
How Is Ankylosing Spondylitis Diagnosed?
Diagnosis is usually made by a rheumatologist and involves a combination of clinical findings, imaging, and laboratory testing.
This may include:
• Medical history and symptom evaluation
• Imaging studies such as X-rays or MRI to identify joint inflammation or structural changes
• Blood testing for markers such as HLA-B27
At Rose Physical Therapy, physical therapists do not diagnose autoimmune diseases, but they work closely with your healthcare team to support your long-term management plan.
Your physical therapy evaluation may include:
• Spinal mobility testing (neck, thoracic spine, and lumbar spine)
• Postural assessment
• Strength and flexibility screening
• Gait analysis
• Rib cage expansion testing
• Functional movement assessment
How Physical Therapy Helps Ankylosing Spondylitis
Regular movement and exercise are among the most effective strategies for maintaining mobility and managing symptoms.
Treatment at Rose Physical Therapy may include:
Postural training
Exercises and education to support upright spinal alignment.
Spinal mobility exercises
Targeted movements that help maintain flexibility and reduce stiffness.
Strengthening of postural muscles
Focusing on spinal extensors, glutes, and core muscles to support spinal stability.
Breathing and rib mobility exercises
Improving chest expansion and maintaining rib cage mobility.
Manual therapy techniques
Gentle hands-on treatment to reduce stiffness and improve comfort.
Personalized home exercise program
Daily exercises designed to maintain flexibility and support long-term spinal health.
Consistent movement and guided therapy can play a major role in maintaining function and preventing long-term stiffness.
Support for Ankylosing Spondylitis at Rose Physical Therapy
Ankylosing spondylitis is a lifelong condition, but proactive care can help you stay active and maintain mobility. At Rose Physical Therapy, treatment focuses on improving posture, preserving spinal flexibility, and helping you continue doing the activities that matter most.
If spinal stiffness or pain related to ankylosing spondylitis is affecting your daily life, Rose Physical Therapy is here to help. Schedule an evaluation at one of our Washington, DC locations:
Farragut North
Friendship Heights
Navy Yard
Early and consistent care can help maintain mobility, improve posture, and support long-term spinal health.