Comprehensive overview of alternative medicine in the treatment of ankylosing spondylitis: Symptoms, pathogenesis, diagnosis and treatments (Review)

Ankylosing spondylitis (AS) is an autoimmune disease characterized by chronic inflammation in the sacroiliac joints and cartilage, resulting in symptoms such as back pain, morning stiffness, sacroiliitis, and extra-articular manifestations. Several drugs reduce the inflammatory response, such as nonsteroidal anti-inflammatory drugs, and disease-modifying antirheumatic drugs. However, the adverse effects and high costs associated with drug therapy highlight the need for complementary treatments. In the present review, significant alternative and complementary remedies for the treatment of AS are examined to provide broader insight. PubMed and Google Scholar were searched for alternative and complementary treatments for AS, using the keywords 'ankylosing spondylitis', 'spondyloarthropathy', 'oriental medicine', 'herbs', and 'therapy'. The symptoms and underlying pathogenesis were described based on diagnostic methods, including principal criteria and radiographic findings. In addition, current remedies for AS, including exercise and pharmacological treatments, were reviewed alongside evidence indicating that alternative therapies, such as moxibustion, decoctions, herbal medicines, and plant-derived compounds, may regulate inflammation, oxidative stress, and abnormal osteogenesis in AS. Given the risks associated with drug use, herbal remedies, including decoctions, formulations, individual herbal extracts, and compounds isolated from herbs, may represent promising therapeutic options for managing the progression of AS. Further large-scale studies, building on cell- and animal-level research, are required to validate the efficacy of herbal medicines.