What to Know About Massage Therapy for Ankylosing Spondylitis
Ankylosing SpondylitisConquering the Invisible: Living With Ankylosing Spondylitis

What to Know About Massage Therapy for Ankylosing Spondylitis

What to Know About Massage Therapy for Ankylosing Spondylitis
iStock
By
Updated on May 1, 2025
by
Life with ankylosing spondylitis (AS) often means managing stiffness, pain, and fatigue.

 While medication and exercise are the mainstays of ankylosing spondylitis treatment, adding massage therapy to your treatment plan can also be beneficial.
During a massage, a trained therapist uses their hands to apply pressure to muscles and soft tissue. There are many types of massage techniques.

 Swedish massage, which involves long, flowing strokes, is one widely used technique.

 Some therapists also practice myofascial release, which focuses on stretching and releasing the connective tissue (fascia) that surrounds your muscles.

Not all massage techniques are safe for AS, though, so it’s important to talk to your doctor before booking a session.

Benefits of Massage Therapy for Ankylosing Spondylitis

AS causes inflammation where your tendons and ligaments attach to your bones, especially in your spine.

 This can lead to stiffness, tightness in your muscles, and significant discomfort.

Since muscles work together with your tendons and joints, massage therapy may help manage some of the pain and tension you experience with AS, says Aly Cohen, MD, a rheumatologist and integrative medicine practitioner based in New Jersey, and the author of Detoxify: The Everyday Toxins Harming Your Immune System and How to Defend Against Them.

 “Massage has also been shown to decrease inflammation,” adds Dr. Cohen.
Massage may also target the areas where people with AS often feel the most discomfort. With AS, most of the pain comes from the muscles around the vertebrae, says Grace Leger, a licensed massage therapist at Elite Massage and Injury Rehab in Boulder, Colorado.

 Relaxing muscles around the vertebrae may relieve pain and stiffness.
Massage therapy can also reduce stress levels by helping your body relax and calming your nervous system.

 The combined physical and emotional effect of massage can be helpful since high stress levels can trigger or worsen AS symptoms.

Still, certain massage techniques can be risky for people with AS. If you have AS and are considering massage therapy, discuss it with your rheumatologist first.

Will a Massage Chair Help AS Pain?

A massage chair is a type of chair that provides an automated massage. While these chairs may reduce stress and pain, there’s no research that suggests they help with ankylosing spondylitis specifically.

Leger doesn’t typically recommend investing in a massage chair for AS. “Massage chairs can’t adjust based on your pain levels the way a trained massage therapist can,” she says. They may apply too much pressure in affected areas and potentially cause injury.

If you’re interested in a massage chair, consider borrowing or testing a few models first, and think about cost, how much space you have at home, and read customer reviews, says Leger, who also recommends consulting with your rheumatologist before you invest in one.

Risks of Massages for Ankylosing Spondylitis

Massage isn’t right for everyone with AS, and whether or not it’s beneficial depends on the individual, says Cohen. Some people find that massage increases their pain rather than relieves it.

 For example, deep tissue massage or aggressive massage around fused vertebrae can cause discomfort or be painful, says Leger.
These types of massages can also cause injury and even be dangerous. As AS progresses, the bones in your spine can grow together, fuse, and become weak and brittle (known as osteoporosis).

 This makes them fragile, and deep tissue massage or strong pressure can potentially contribute to breaks. Your vertebrae can also slip out of place, potentially causing nerve damage.
In some cases, massage may even cause AS symptoms to flare up.

Can You Massage Yourself to Soothe AS Pain?

Massaging yourself may help manage AS pain, as it can provide relief exactly where and when you need it. Self-massage involves using your hands, elbows, or tools like foam rollers to apply pressure to tight or painful areas.

If you’re interested in self-massage for AS, these tips can help you get started safely:

  1. Apply a heating pad or take a warm shower before massaging to help relax your muscles.
  2. Use massage oil or lotion to help your hands glide more smoothly over your skin.
  3. Begin with gentle, broad strokes to warm up the area before working on tight spots.
  4. Use slower, smaller circles to work out knots.
  5. Avoid pressing directly on painful or fused vertebrae or areas that feel inflamed.
For hard-to-reach areas, like your back, try using tools to extend your reach. Leger suggests using a baseball or tennis ball against a wall to work specific muscle areas.

 To do this, stand with your back against a wall, place the ball behind you, and roll it gently to target tight spots near (but not directly on) affected vertebrae.
At-home cupping sets are also available, Leger says. Cupping involves placing suction cups along the back to draw blood to the area. “You or a partner can apply suction cups along your back. The cups hold onto the fascia tight, and you keep them on for a few minutes. When you take off the cup, it releases all the fascia in that area, and you can get pain relief from it.”

While cupping hasn’t been found to be harmful, the evidence showing its effectiveness in treating AS symptoms is weak; it also causes bruising.

Depending on how advanced your AS is, check with your rheumatologist before starting any self-massage routine to make sure it is safe in your case.

Choosing a Massage Therapist for AS

Here are tips for choosing a massage therapist for AS.

  • Start by asking your rheumatologist or physical therapist for a recommendation.
  • Look for a licensed massage therapist experienced with AS who specializes in myofascial release, says Leger. Therapists often list their specialties on their website, so try searching “myofascial release massage” along with your city to see who’s nearby, she adds.
  • Search for qualified massage therapists through the American Massage Therapy Association (AMTA) online directory. For a board-certified massage therapist, check the National Certification Board for Therapeutic Massage and Bodywork.
  • Consider bringing your X-rays or imaging reports to your appointment to help your therapist better understand your condition, says Cohen.

Communication with your massage therapist is important, notes Cohen. Before your session, make sure to tell your therapist about your condition, where your pain is located, and about any fused joints you may have. Be specific about how much pressure feels comfortable and speak up if anything hurts during the massage, she adds. This will allow the therapist to adjust their technique based on your feedback.

Insurance coverage for massage therapy can be limited, but a referral from your rheumatologist might improve your chances of getting coverage, notes Leger.

Other Ways to Manage AS Symptoms With Integrative Medicine

Other integrative therapies that may help manage symptoms of ankylosing spondylitis include:

  • Acupuncture This involves inserting thin needles into specific points on the body to help reduce pain and inflammation.
  • Transcutaneous Electric Nerve Stimulation (TENS) A TENS unit is a device that uses mild electrical currents through the skin to help relieve pain.

  • Relaxation Techniques Meditation and other soothing activities, like music therapy, may help manage stress.
  • Movement Yoga poses can improve flexibility, reduce pain, and promote relaxation.

     Tai chi and similar low-impact activities may also help.
  • Diet and Nutrition Anti-inflammatory diets like the Mediterranean diet and supplements such as omega-3 fatty acids or turmeric may help reduce inflammation.
Regular self-care routines, such as staying physically active and getting enough sleep, can improve your overall well-being.

 While some people try chiropractic care, experts warn against spinal manipulation if you have AS because of the risk of injury.

The Takeaway

  • Massage therapy may help manage ankylosing spondylitis (AS) symptoms by relieving muscle tension, improving flexibility, and reducing stress levels. But it can’t stop or reverse the progression of the disease and is not a replacement for medical treatment.
  • Some forms of massage may help manage AS pain. Deep tissue massage and other types of more aggressive modalities, however, may worsen symptoms or cause injury.
  • It’s important to work with a qualified and experienced licensed massage therapist who understands AS and can adjust their approach according to your needs.
  • Before trying massage therapy or any integrative treatment, talk with your rheumatologist.

Resources We Trust

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Ankylosing Spondylitis. Cleveland Clinic. December 19, 2023.
  2. Everything You Need to Know About Massage Therapy. Cleveland Clinic. November 11, 2021.
  3. Massage Therapy: What You Need to Know. National Center for Complementary and Integrative Health. May 2019.
  4. Myofascial Release Therapy. Cleveland Clinic. August 15, 2022.
  5. Wenkler KJ et al. Ankylosing Spondylitis. StatPearls. June 20, 2023.
  6. Ankylosing Spondylitis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. May 2023.
  7. Martin A et al. Nonpharmacologic Pain Management in Inflammatory Arthritis. Rheumatic Disease Clinics of North America. May 2021.
  8. Liew JW et al. Patient-Reported Disease Activity in an Axial Spondyloarthritis Cohort During the COVID-19 Pandemic. ACR Open Rheumatology. September 6, 2020.
  9. de Souza TPB et al. The Effectiveness of Chair Massage on Stress and Pain in Oncology. International Journal of Therapeutic Massage & Bodywork. September 2, 2021.
  10. Integrative Medicine. Spondylitis Association of America.
  11. Sharif K et al. The Risk of Osteoporosis in Patients With Ankylosing Spondylitis — a Large Retrospective Matched Cohort Study. Medicina Clinica. May 12, 2023.
  12. MacLennan M et al. Self-Massage Techniques for the Management of Pain and Mobility With Application to Resistance Training: A Brief Review. Journal of Strength and Conditioning Research. November 1, 2023.
  13. Bernstein S et al. Types of Massage. Arthritis Foundation.
  14. Furhad S et al. Cupping Therapy. StatPearls. October 30, 2023.
  15. Ma SY et al. Cupping therapy for treating ankylosing spondylitis: The evidence from systematic review and meta-analysis. Complementary Therapies in Clinical Practice. August 2018.
  16. Transcutaneous Electrical Nerve Stimulation. StatPearls. March 20, 2024.
  17. Acharya NN et al. Comparison of Yoga with Exercise in Ankylosing Spondylitis on Mobility and Functional Capacity. International Journal of Rheumatic Diseases. June 14, 2024.
  18. Ward MM et al. 2019 Update of the American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis. Arthritis & Rheumatology. August 22, 2019.
Meet Our Experts
See Our Editorial PolicyMeet Our Health Expert Network
beth-biggee-bio

Beth Biggee, MD

Medical Reviewer
Member of American College of Lifestyle Medicine, Castle Connolly Top Doctor

Beth Biggee, MD, is medical director and an integrative rheumatologist at Rheumission, a virtual integrative rheumatology practice for people residing in California and Pennsylvania. This first-of-its-kind company offers whole person autoimmune care by a team of integrative rheumatologists, lifestyle medicine practitioners, autoimmune dietitians, psychologists, and care coordinators.

Dr. Biggee also works as a healthcare wellness consultant for Synergy Wellness Center in Hudson, Massachusetts. Teamed with Synergy, she provides in-person lifestyle medicine and holistic consults, and contributes to employee workplace wellness programs. She has over 20 years of experience in rheumatology and holds board certifications in rheumatology and integrative and lifestyle medicine. Dr. Biggee brings a human-centered approach to wellness rather than focusing solely on diseases.

Dr. Biggee graduated cum laude with a bachelor's degree from Canisius College, and graduated magna cum laude and as valedictorian from SUNY Health Science Center at Syracuse Medical School. She completed her internship and residency in internal medicine at Yale New Haven Hospital, completed her fellowship in rheumatology at Tufts–New England Medical Center, and completed training in integrative rheumatology at the University of Arizona Andrew Weil Center for Integrative Medicine. Following her training, she attained board certification in rheumatology and internal medicine through the American Board of Internal Medicine, attained board certification in integrative medicine through the American Board of Physician Specialties, and attained accreditation as a certified lifestyle medicine physician through the American College of Lifestyle Medicine. She is certified in Helms auricular acupuncture and is currently completing coursework for the Aloha Ayurveda integrative medicine course for physicians.

In prior roles, Dr. Biggee taught as an assistant clinical professor of medicine at Mary Imogene Bassett Hospital (an affiliate of Columbia University). She was also clinical associate of medicine at Tufts University School of Medicine and instructed "introduction to clinical medicine" for medical students at Tufts. She was preceptor for the Lawrence General Hospital Family Medicine Residency.

Dr. Biggee has published in Annals of Rheumatic Diseases, Arthritis in Rheumatism, Current Opinions in Rheumatology, Journal for Musculoskeletal Medicine, Medicine and Health Rhode Island, and Field Guide to Internal Medicine.

See full bio
Maggie-Aime-bio

Maggie Aime, MSN, RN

Author

Maggie Aime is a registered nurse with over 25 years of healthcare experience, who brings medical topics to life through informative and inspiring content. Her extensive nursing background spans specialties like oncology, cardiology, and pediatrics. She has also worked in case management, revenue management, medical coding, and as a utilization review nurse consultant. She leverages her unique insights to help individuals navigate the U.S. healthcare system and avoid financial pitfalls.

Maggie applies her extensive clinical expertise to create empowering education for readers at all stages. She is passionate about illuminating issues from disease prevention to health and wellness to medical personal finance. Her work can be found in GoodRx Health, Next Avenue, HealthNews, Insider, Nursing CE Central, Nurse Blake, AllNurses, and BioHackers Lab.

An active member of several professional nursing and journalism associations, Maggie founded The Write RN to fulfill her calling to teach.

When she's not crafting the next great article, you can find Maggie volunteering, reading, playing the piano, or savoring sunrise views at the beach.

See full bio
See Our Editorial PolicyMeet Our Health Expert Network