Medications for Neck Pain Caused by Ankylosing Spondylitis

The sharp, burning neck pain and stiffness caused by progressive ankylosing spondylitis can feel similar to other conditions, such as a muscle strain or herniated disc. However, knowing whether ankylosing spondylitis is causing painful inflammation in the neck can help guide the right treatment plan.

This page covers medications that may be helpful for neck pain caused by ankylosing spondylitis.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs help reduce swelling and pain. Some over-the-counter options include ibuprofen and naproxen. NSAIDs are also available as prescription medications in stronger doses or a separate class called COX-2 inhibitors, such as Celebrex. NSAIDs are usually the first type of medication used for treating ankylosing spondylitis.

Biologics

Unlike conventional drugs, which are manufactured from chemicals, biologics are manufactured from living cells. These medications work by reducing the immune system’s response in cases where it has become overreactive by mistakenly attacking healthy cells.

Read more about The Science Behind Biologics on Arthritis-health.com

While biologics, such as TNF inhibitors and IL inhibitors, can successfully reduce symptoms and possibly slow the progression of ankylosing spondylitis in some people, they also have side effects. For example, due to suppressing some aspects of the immune system, biologics can increase the risk for infection and other illnesses. As such, biologics are typically only tried for ankylosing spondylitis if NSAIDs are ineffective.

Read more about Biologics: Basic Facts for Patients on Arthritis-health.com

Currently, biologics are injected by needle for treating ankylosing spondylitis. In the future, oral options might become available.

Corticosteroids

In rare cases, oral corticosteroids, such as prednisone, might be used on a short-term basis for treating ankylosing spondylitis. Corticosteroids could be effective at lowering inflammation during a particularly bad flare-up that does not respond to other medications. However, corticosteroids are not recommended for long-term use because of the higher likelihood for serious side effects.

Medications Not Recommended

Some medications that should not be considered for neck pain caused by ankylosing spondylitis include:

• Disease-modifying antirheumatic drugs (DMARDs). DMARDs, such as sulfasalazine, are sometimes prescribed for ankylosing spondylitis pain in peripheral joints (located in arms or legs) but not the spine. DMARDs are not effective at treating neck pain that stems from the cervical spine.
• Corticosteroid injections. While corticosteroid injections may provide temporary relief for radicular pain that stems from the neck, they are not recommended for treating neck or other spinal pain caused by ankylosing spondylitis. For peripheral joints affected by ankylosing spondylitis, such as the hip or knee, corticosteroid injections may be helpful. ¹ Moon KH, Kim YT. Medical Treatment of Ankylosing Spondylitis. Hip Pelvis. 2014;26(3):129‐135. doi:10.5371/hp.2014.26.3.129

Read more about Ankylosing Spondylitis Medications on Arthritis-health.com

In addition, acetaminophen (Tylenol) is not typically recommended for ankylosing spondylitis, but it may be considered if other medications are ineffective at alleviating the pain.