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We hope you find the information on these pages helpful. Our team is working tirelessly to provide up to date advice in relation to the COVID-19/Coronavirus pandemic. Record numbers of people are now turning to NASS for support, and we hope to be here for everyone. Our helpline and advice service are only possible thanks to donations from people like you.

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Your Pain

This information is for anyone with axial spondyloarthritis (axial SpA), including people with ankylosing spondylitis (AS)

What causes pain in axial SpA (AS)?

Pain can be caused by your axial SpA (AS) for a number of different reasons, including:

  • Inflammation around the joints or muscles
  • Shortening or tightening of muscles or tendons
  • Protective muscle spasms

When should I speak to my doctor?

You should speak to your GP or rheumatology team if:

  • Your pain is not managed by medication or your usual self-management techniques
  • Your flares are becoming more frequent, more severe and lasting longer
  • You’re experiencing night pain that isn’t improved with self-management techniques
  • You feel your axial SpA (AS) is generally poorly controlled

How can I manage my pain?

There are lots of ways to help manage your pain.


There are lots of different medications available for axial SpA (AS). You can discuss these medications with your rheumatology team or GP.


Exercise can be helpful to reducing pain, particularly if the pain is related to joint stiffness, muscle tightness or muscle spasms. If you’re new to exercising, speaking to a physiotherapist for specialised advice can be helpful.

Your Pain Toolkit

There are many different tools you can use to reduce or manage your pain. Watch this video with Colin Beevor, Matron and Senior Clinical Nurse Specialist at Portsmouth Hospital, to learn about what you can keep in your pain ‘toolkit’:

You can also get more detailed advice about TENS machines:

Read more