(1) Treatment should be individualized: medication selection needs to be based on the patient’s clinical presentation, disease activity, function, disability, spinal and hip injuries, general condition, and patient wishes and expectations. (2) Condition monitoring should include history, clinical measures, laboratory tests and imaging, all clinical manifestations, etc. The frequency of monitoring depends on symptoms, severity and drug therapy. (3) Optimal treatment is a combination of pharmacologic and non-pharmacologic treatments. (4) Non-pharmacological treatment includes patient education and regular exercise. (5) Non-steroidal anti-inflammatory drugs (NSAIDs) are recommended as first-line medications for patients with pain and morning stiffness. For patients at high risk of gastrointestinal injury, non-selective NSAIDs plus gastroprotective agents or selective COX-2 inhibitors are available. (6) Analgesics such as acetaminophen and opioids may be used for pain control in patients with poor efficacy, contraindications, and/or intolerance to NSAIDs. (7) Corticosteroids can be injected directly into the localized skeletal muscle inflammation, but there is no evidence to support systemic corticosteroid treatment of mid-axis lesions. (8) There is no evidence to suggest that disease-relieving antirheumatic drugs (DMARDs), including salazosulfapyridine and methotrexate, are effective for mid-axis lesions, and salazosulfapyridine may be used to treat patients with peripheral arthritis. (9) In patients with persistent and markedly active disease, anti-tumor necrosis factor (TNF) therapy should be given in addition to the conventional therapy recommended by the ASAS. However, patients with no evidence of mid-axis involvement must be treated with DMARDs prior to or concurrently with anti-TNF therapy. (10) Patients with refractory pain or disability and structural damage on imaging, regardless of age, should undergo total hip arthroplasty. Spine surgery such as corrective osteotomy or fixation may be of value in some patients.