Spondylitis Treatment

Not all back pain needs surgery. If you've been diagnosed with spondylitis, the good news is that many people respond well to medications. The sooner treatment starts, the better the outcomes.

"Spondylitis treatment has changed dramatically in the past 15 to 20 years," said Marcia Johnson, MD, a board-certified rheumatologist at Franciscan Health Lafayette. "We now have medications that can reduce inflammation, relieve pain and even help prevent joint damage."

What Is The Goal Of Spondylitis Treatment?

Spondylitis is a chronic inflammatory condition. We work not only to relieve symptoms, but also to prevent inflammation from getting worse and potentially fusing the spine.

The goal of treatment is to:

• Improve daily function and boost energy levels
• Protect joints and prevent spinal damage
• Reduce stiffness and pain
• Support spinal mobility and posture

The best treatment for spondylitis depends on your unique symptoms. Early care offers the best chance to prevent long-term issues.

How Do You Treat Spondylitis?

Spondylitis treatment options range from simple medications to advanced immune-modifying drugs. Each patient's plan looks a little different, depending on their symptoms, other health conditions and how their body responds. Your care team will work with you to choose the best options for your lifestyle, symptoms and long-term goals.

A personalized plan may include a combination of the following:

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs, like ibuprofen or naproxen, are often the first step. They help reduce inflammation and ease pain.

"Many patients get relief just from anti-inflammatories, especially early on," Dr. Johnson said. "We usually start there to see how the patient responds."

Physical therapy and exercise

Physical therapy is a cornerstone of treatment, and when you work with a physical therapist at Franciscan Health, they'll teach you how to make movements safe and effective. Because movement plays a key role in managing spondylitis, a physical therapist can help strengthen the back and improve flexibility without causing flare-ups.

"If someone rests too much, they can actually become stiffer," Dr. Johnson explained. "Gentle activity helps keep the spine mobile."

Biologic medications

When NSAIDs aren't enough, your rheumatologist may recommend biologics for inflammatory spine disease. These advanced medications target and block specific proteins in the immune system to reduce inflammation. Biologics usually start with close monitoring. Your provider may recommend labs to track how well your body responds and make adjustments if needed.

Biologics include:

• TNF inhibitors like Enbrel®, HUMIRA® or Remicade®
• IL-17 inhibitors like Cosentyx® or Taltz®

"These medicines have been a game-changer for patients," Dr. Johnson said. "They don't just relieve symptoms; they may slow or even stop the damage."

Biologic medications for inflammatory arthritis are safe and often life-changing. We can give them as injections or infusions. Most people tolerate them well and use them safely for years.

JAK inhibitors and other therapies

For some patients, other immune-targeting treatments may help. JAK inhibitors, like upadacitinib (RINVOQ®), are oral medications that target different pathways. They are an option when TNF inhibitors for back pain or IL-17 blockers aren't effective.

"Sometimes it's a process of trying more than one option," Dr. Johnson said. "What works well for one patient may not work for another, but we almost always find something that helps."

Steroids and pain management

Short-term use of steroids (corticosteroids) may help during severe flare-ups. Some patients also benefit from local injections or additional supportive therapies for managing fatigue or sleep problems. Supportive therapies help manage discomfort and can include:

• Mindfulness
• Pain education
• Stretching

"If a patient has already tried anti-inflammatories and their symptoms fit, it may still make sense to try a medicine like HUMIRA, Remicade or Enbrel," said Dr. Johnson. "These medications are generally well tolerated, and many patients are really struggling by the time they reach us."

When To Start Spondylitis Treatment

Early treatment for spondylitis makes a difference. Once the spine starts to fuse, it becomes harder to reverse.

"I've seen people go from not being able to bend or sit comfortably to returning to work and normal activity," Dr. Johnson said. "The earlier we catch and treat it, the better the outcome."

Hope Starts With The Right Team

You don't have to live with chronic pain and limited movement. With personalized care and access to the latest medications, many people with spondylitis go on to live full, active lives.

To learn more about your treatment options for spondylitis or get a personalized care plan, visit Franciscan Health's rheumatology services to request an appointment. We're here to help you feel better, starting today.