At this stage, the stiffness and deformity are fixed and cannot be mobilised. The most important aspect of management is regular mobilising exercises to all parts of the spine and the thoracic cage, in order to prevent fibrous ankylosis and most of all bony ankylosis . If started early and continued regularly, i.e. every day, the result is excellent with little restriction of movement or deformity. These exercises have to be done irrespective of the patient's lifestyle as they make sure that every part of the spine is mobilised. Sometimes we also include exercises to the shoulders and the hips which are the most frequently involved joints outside the spine.
Swimming is a good sport for patients with spondylitis as it moves the shoulders and hips.
On the other hand, prolonged periods of immobilisation such as sitting continuously for long periods, or being confined to bed for a number of days are things that one should, as far as possible, refrain from if one has spondylitis. The anti-inflammatory medication that may be prescribed contributes to relieving the pain and inflammation but is not a substitute for the regular exercise programme.