(JIA ERA) Ankulosing spondylitis 18Y/old

I am an 18-year-old student diagnosed with Juvenile Idiopathic Arthritis (Enthesitis-related) and Ankylosing Spondylitis, (it's been 4 years) My HLA-B27 is positive and my ESR has been raised. I have constant pain in my shoulders, whole spine (including scapular region), neck, back, and inner/lateral thighs, which makes it very hard to study or sit for long. I have already tried physiotherapy, exercises, Ayurvedic therapy, homeopathy, and allopathy. I have taken many painkillers, including Nucoxia 60mg and 90mg, but they don’t give lasting relief. The pain is severe and affects my daily life and mobility. What should be my next step for safe and effective long-term pain management, considering my age and student life?”