Ankylosing Spondylitis Flare-Up Relief Strategies

In the early days (especially before I had a diagnosis), dealing with Ankylosing Spondylitis flare-ups felt like they came out of nowhere. One day I’d be fine, and the next I’d wake up stiff, sore, and unable to move properly. And no matter what over-the-counter painkiller I reached for—aspirin, paracetamol, or even Nurofen or ibuprofen—none of them truly dealt with the underlying issue.

They would dull the pain to a degree, but they didn’t address the root cause. And often, the side effects just weren’t worth it. What I learned over time is that managing Ankylosing Spondylitis (AS) flare-ups effectively comes down to understanding and controlling inflammation. Once I began tackling that, everything changed.

Below are the four most important strategies that have helped me get on top of flare-ups.

1. Start With Diet — What You Eat Matters

One of my earliest breakthroughs came from an unexpected place: a small book I found in a Christian bookstore in Pietermaritzburg, South Africa. It was written by a lesser-known doctor who believed strongly that inflammation is tied directly to diet. The idea was to reset your system and then reintroduce foods gradually to find out what triggered flare-ups.

Here’s the general approach:

• Do a short fast (ideally water-only, or minimal foods for a few days) to allow the system to settle.

• Reintroduce foods slowly over the next week or two, starting with fruit (apples, oranges, berries, etc.), then vegetables, then grains and proteins.

• Listen to your body. If any food causes stiffness or discomfort, flag it as a trigger.

Over time, I built a personal list of “safe” foods and foods to avoid. While everyone’s list will be different, the process is worth trying.

Also important: avoid eating the same foods every single day.
Even foods that seem safe or beneficial can sometimes cause issues if consumed too regularly. I’ve found that varying my diet—not just in food types but also in frequency—helps my body stay balanced. It seems that too much of even a good thing can build up and cause problems.

2. Anti-Inflammatories Over Painkillers

The next major key came from a doctor who finally put me on an NSAID (non-steroidal anti-inflammatory drug) called Arthrexin (based on indomethacin). I took 25mg capsules, up to three or four a day during tough periods. This was a game-changer.

Unlike standard painkillers, which only dulled the pain temporarily, anti-inflammatories targeted the root inflammation.

That meant less pain overall — and none of the unwanted side effects like mood swings, stomach issues, or bladder problems that I experienced with the others.

Even when I have a flare-up now, I can temporarily increase the dose (as advised by my doctor) to bring it under control. That alone has made daily life far more manageable.

3. Supplements and Self-Experimentation

Supplements can play a role, but as with food, you have to be careful. Some vitamins and minerals can trigger flare-ups too. Here’s how I approach them:

• Test one at a time — add a new supplement and give it a few days to see how your body responds.

• Track what works — for me, high-strength cod liver oil has been very helpful for my general well-being and possibly inflammation too.

• Adjust dosage — even if a label says “take two three times a day,” I’ve often found that just one tablet three times a day works better for me.

• Cycle supplements — I’ve also found that taking the same supplement every day can sometimes cause a build-up and lead to issues. For example, vitamin C is helpful, but if I take it daily for too long, it seems to affect me negatively. So now I might take it for two days, then take two days off, or rotate with another supplement. It seems to help keep things in balance.

Again, everyone’s system is different, but this “trial and observe” approach really helped me personalise my supplement routine.

Bonus Tip: Hydration Matters

What you drink is just as important as what you eat. I’ve learned that staying hydrated helps reduce inflammation and keep my system running smoothly.

I aim for 1–2 litres of water or watered-down fruit juice per day, avoiding:

• Sugary or artificial fruit juices

• Fizzy drinks like Coke or Pepsi

• Excess caffeine from coffee or strong tea

Instead, I stick to 100% pure fruit juices (diluted), herbal teas, and plenty of water. Roughly three-quarters of what I drink each day is water or natural, no-added-sugar liquids.

4. Keep Moving — Even If It’s Hard

Finally, a piece of advice from the same doctor who prescribed me NSAIDs has stuck with me:

“The disease wants to freeze your joints. Your job is to keep them moving.”

Even simple movements — stretching fingers, rolling wrists, rotating your hips — help prevent stiffness and maintain flexibility.

I’ll go deeper into stretching and mobility in another post, but the main thing is this: movement helps pain melt away as you warm up.

Final Thoughts

These strategies won’t make AS disappear, but they’ve helped me go from feeling overwhelmed and powerless to feeling like I can manage the condition.

Everyone’s different — your flare-ups may look different from mine — but I hope some of these insights will give you a starting point.

If you’re just getting to grips with your own AS journey, hang in there. Relief is possible — and understanding your own body is the first step.

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