Ankylosing spondylitis (AS) is arthritis of spine which usually is progressesive in nature, but the process may get arrested at anytime. AS is usually ascending type beginning from the lower back and creeping up. When HLA B27 is negative, HLA C 06 and HLA B 07 is also checked go rule out Psoriatic arthritis and juvenile arthritis or undifferentiated spondyloarthritis. These are usually recommended by an immunologist or a rheumatologist who will suggest you with appropriate tests and drugs. When disease activity is more, drugs can help reduce the progressive phase. Physiotherapy will help you to improve and maintain spinal mobility thereby increasing the joint function and muscle strength which is crucial for spinal health. Pain relief and local inflammation reducing physiotherapy will help you in managing your condition well. Based on your occupation, your physio will also help you in giving back care programme.