Lifestyle Changes

Reviewed by: HU Medical Review Board | Last reviewed: June 2022 | Last updated: July 2022

Receiving a diagnosis of ankylosing spondylitis (AS) can turn someone’s world upside down. In addition to finding a healthcare team that you trust and can work with, learning about the disease and its treatments, many people find they must make changes to their lifestyle to manage AS and its symptoms. While these lifestyle modifications may take many different forms for each individual, some common lifestyle changes are described below.

Quitting Smoking

Smoking negatively impacts a person’s health in a number of ways, and in addition to increasing your risk for lung cancer and heart disease, smoking worsens AS. Research has found that people with AS who smoke have more spinal damage than nonsmokers. In one study, smokers had damage that was 5.5 times greater than nonsmokers with the same level of disease activity.1 Smoking can also worsen the pain of AS and impact how well medications like biologics work.2Stopping smoking significantly improves disease activity in people with AS, and quitting smoking is also associated with improvements in physical mobility and quality of life.3


Living with a chronic condition like AS increases the importance of healthy habits, including diet. While there is not a specific diet that has been proven to impact AS, it is important to try and maintain a weight that is healthy for you. Being very overweight can place stress on joints, which may worsen symptoms of AS. Additionally, in some people with food sensitivities, certain foods may increase their symptoms. The anti-inflammatory diet may reduce symptoms in some people. Some foods have been shown to increase inflammation in the body while other foods may reduce inflammation.4

Physical activity

Regular physical activity is critical to managing the pain and stiffness of AS. Pain and stiffness caused by AS are worse in the morning after a night’s sleep or after periods of inactivity, and these symptoms improve with movement and activity or a warm shower.5 Although exercise and physical therapy have not been demonstrated to prevent the progression of AS, getting regular movement in the joints can help manage the symptoms of the disease and help people living with AS maintain their flexibility and mobility.6 Each individual should work with their doctor and physical therapist to determine which exercises are appropriate and safe for their unique situation.

Daily stretching

Stretching is an important part of an exercise regimen and should be included to help manage AS. Some forms of exercise can help with stretching, such as yoga, but simple stretches can be incorporated throughout the day to help maintain joint flexibility.

Posture exercises

Because AS commonly affects the spine, exercises that focus on good posture can help support the back and help maintain an upright bearing. While sitting or standing, you should aim to keep the spine tall and straight. Another posture exercise can be done by standing with the heels about 4 inches from a wall and focusing on touching the shoulders and buttocks to the wall for at least 5 seconds at a time. Posture exercises can also be done lying prone (face down) for several minutes.7

Stress management

Stress can worsen symptoms like inflammation and chronic pain. Finding ways to manage stress can help people with AS take an active role in managing their health and their life. Stress management may include meditation, support groups, counseling, breathing techniques, massage, or being in nature.8

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