I have recently checked the systematic literature reviews for the ACR and EULAR recommendations, and there was no mention of evidence for any natural remedies in the treatment of axial spondyloarthritis.

NSAIDs and bDMARDs are the currently approved treatments. Non-pharmacological treatments such as physical therapy may also be useful.

Dear Nasiba Binte Bahar , If you would consider swimming and exercising as natural remedies then that would be a great base line treatment.

This article may also give you an overview:

https://www.healthline.com/health/ankylosing-spondylitis-natural-treatment

The approach to ankylosing spondylitis (AS), indeed to any of the inflammatory arthritides, does not stop with medication.

Most guidelines do advise lifestyle interventions, and indeed I believe the latest EULAR guidelines concerning Rheumatoid Arthritis made a clear emphasis on this.

I disagree with all previous answers to this question above, and I proceed to explain why.

NSAIDs and bDMARDs are not the only treatment modalities used, not by a far margin.

Even if they were, we should be on the lookout for solutions, not take a quick look at guidelines and dismiss all else that might exist outside guidelines.

Guidelines guide the clinician, but guidelines do not always contain all the evidence-based options out there.

Indeed most times guidelines specifically ask the clinician to use guidelines with caution, and not to base clinical decision-making purely on guidelines, but to treat each individual patient on a case-by-case basis.

Case in point about guidelines, the EULAR guidelines on RA specifically require the decisions on treatment to be decisions that are shared with the patient and reflect patient preferences.

There are various pharmaceutical-grade botanical medicines that are of utility to our patients suffering from rheumatological conditions.

NSAIDs, to maintain my point, target COX-2 in the inflammatory pathway.

Curcumin, one of the primary anti-inflammatories in Ayurveda, has over 100 molecular targets, among them COX-2.

Omega 3 fatty acids are crucial in balancing out the inflammatory eicosanoids and chemokines produced through the Omega 6 fatty acid pathway, and there is evidence that patients with chronic inflammation do better when the ratio of Omega 3 to Omega 6 fatty acids is optimised.

The advice given above with regards to exercise is rudimentary, the sort of "in-passing" summary advice we are used to hearing at the end of medical consultations.

"Stretching" for instance, is quite arbitrary advice - a common reaction in response to MSK complaints - "stretch more" - to which I ask - "what for? what kind? static? dynamic? which body parts?"

There are exercises one can do - I have coached people with AS, and, depending on pain, disability, function, and spinal limitations in the sagittal and frontal planes, one can consider doing posterior chain work in order to support posture and spinal health both at the level of the vertebrae and the disks, with a primary focus on the posterior compartment of the thigh, sacrotuberous ligaments, erector spinae, latissimus dorsi, and trapezius territories.

Targeted exercises should be executed under supervision by qualified personnel, in regular liaison with the caring specialist and physiotherapist, who jointly can safely and effectively gauge and facilitate the necessary training for the patient.