Each year, Americans spend about $1 billion on alternative treatments for the more than 100 types of arthritis, including ankylosing spondylitis. Little valid scientific evidence backs most of these treatments, which are considered outside the mainstream of arthritis therapy. But many people find relief when using them. If you are interested in trying an alternative treatment, talk with your health care provider first. He or she can help you understand how each therapy fits into your overall plan for managing ankylosing spondylitis. Some alternative therapies can interact with conventional treatments, requiring a different approach. Scientists continue to study alternative treatments, seeking evidence of their effectiveness. In the meantime, here’s what you need to know about the alternative approaches most often used to treat ankylosing spondylitis. Acupuncture In this ancient Asian therapy, practitioners insert small, thin needles into certain trigger points on your body. These trigger points are called meridians. Health care providers believe this may cause your brain to release natural, pain-relieving chemicals. Acupuncture has shown promise in relieving pain from other causes. The evidence that acupuncture relieves pain from ankylosing spondylitis is thin. Most studies suggest acupuncture has few risks when performed by qualified professionals. Consider asking your health care provider for a referral, or consult a national acupuncture organization. Before each treatment, make sure your practitioner uses a new set of disposable needles to decrease your risk for infection. Chiropractic care Practitioners of this therapy focus on how your body’s structure and alignment affect the way you move and function. Some people with ankylosing spondylitis make regular chiropractic visits. But many conventional health care providers warn against it. They cite a risk for neurological complications and spinal fractures, especially if your spine has fused. When interviewing chiropractors, ask how they modify their treatment approach for AS patients. Massage Besides easing stress and anxiety, massage may ease some of the pain and stiffness that come with ankylosing spondylitis. Increased blood flow, one of the key benefits of massage, can also improve your flexibility. Work only with a physical therapist or a trained massage therapist who has experience treating ankylosing spondylitis. He or she will know techniques that don’t worsen your pain or harm your joints. Also, avoid massages during active flare-ups of your condition; reschedule for when you feel better. Key Takeaways Talk with your health care provider before starting an alternative therapy. It may interact with conventional treatments you’re receiving. Acupuncture may cause your brain to release natural, pain-relieving chemicals, although the evidence for ankylosing spondylitis is thin. Some people with ankylosing spondylitis make regular chiropractic visits, but many conventional health care providers warn against it. A small but growing body of research suggests that massage may ease some of the pain and stiffness of ankylosing spondylitis and improve your flexibility.