Ankylosing spondylitis (AS) is a chronic inflammatory disease. It usually affects the spine and sacroiliac joints, where the spine meets the pelvis. AS is part of a group of diseases known as spondyloarthritis. It is characterized by inflammation, which leads to severe, chronic pain and discomfort. 

As time passes, the inflammation can cause the vertebrae in the spine to fuse, resulting in reduced flexibility and a hunched-forward posture. Sometimes, it can also affect other joints, eyes, and organs. It is crucial for individuals and their caregivers to manage this condition effectively.

The exact cause of ankylosing spondylitis remains unclear, but it is assumed to be a combination of genetic and environmental factors. The presence of the HLA-B27 gene is a significant risk factor, although not everyone with this gene will develop the condition. Symptoms typically begin in early adulthood, often before age 30, and can vary in severity and progression from person to person.

This blog aims to provide practical tips and strategies for managing pain and improving mobility for those with Ankylosing Spondylitis. So, keep reading to learn more.

Understanding Ankylosing Spondylitis

Ankylosing Spondylitis (AS) is a long-term inflammatory condition predominantly targeting the spine and sacroiliac joints, which results in persistent pain and stiffness. This inflammation can progressively cause the vertebrae to fuse, leading to decreased spinal flexibility and potentially a forward-curved posture. Beyond the spine, AS can also impact other areas of the body, such as the hips and shoulders, and may even extend to various organs, including the eyes and heart.

Common Ankylosing Spondylitis Symptoms Include:

  • Persistent pain or stiffness felt in the lower back and hips, especially in the morning or after durations of inactivity.
  • Fatigue and general malaise.
  • Decreased flexibility and motion in the spine.
  • Pain and swelling in other joints, such as the shoulders and knees.
  • In severe cases, eye inflammation (uveitis), heart issues, and lung complications.

Risk Factors Include:

  • Genetics: A family history of AS or other spondyloarthropathies.
  • Age: Symptoms typically begin in late adolescence or early adulthood, often between 17 and 45.
  • Gender: Men are more commonly affected than women.
  • Ethnicity: Some ethnic groups, including Caucasians, have a higher prevalence of the HLA-B27 gene.

Diagnosis and Medical Evaluation

Diagnosing AS can be difficult due to its gradual onset and the variability of symptoms. A thorough medical evaluation typically includes:

  • Medical History and Physical Examination: The doctor will review the patient’s symptoms and family history. Then, the doctor will check for pain, stiffness, and limited range of motion through physical examination.
  • Imaging Tests: X-rays, MRIs, and CT scans can reveal changes in the spine and joints indicative of AS, such as inflammation and fusion.
  • Laboratory Tests: Blood tests to check for inflammation markers (like ESR and CRP) and the presence of the HLA-B27 gene.

Pain Management Strategies

Medications

  • Nonsteroidal Anti-Inflammatory Drugs (NSAIDs):

NSAIDs are often the first line of treatment for Ankylosing Spondylitis (AS). These medications, such as ibuprofen, naproxen, and diclofenac, help reduce inflammation, pain, and stiffness by blocking the enzymes that cause inflammation. While effective, long-term use of NSAIDs can lead to side effects like gastrointestinal issues, so it’s important to use them under medical supervision.

  • Disease-Modifying Antirheumatic Drugs (DMARDs):

DMARDs are used to manage severe symptoms and prevent disease progression. Medications such as methotrexate and sulfasalazine work by suppressing the immune system to reduce inflammation. DMARDs are particularly useful when AS affects peripheral joints, such as arms and legs. Regular monitoring by your doctor is essential due to potential side effects and the need for dosage adjustments.

  • Biologics and Other Advanced Ankylosing Spondylitis Therapies:

Biologic drugs target specific immune system components, including TNF and IL-17 inhibitors. These advanced therapies are highly effective in reducing symptoms and slowing disease progression in patients who do not respond to NSAIDs and DMARDs. Biologics are usually administered via injection or infusion and require regular monitoring for effectiveness and side effects.

Physical Therapy

  • Importance of Regular Exercise:

Regular exercise is crucial for managing ankylosing spondylitis. It helps maintain flexibility, strength, and overall mobility. Consistent physical activity can alleviate pain, reduce stiffness, and prevent the progression of spinal fusion. Exercise also enhances cardiovascular health and overall well-being.

  • Specific Ankylosing Spondylitis Exercises for Pain Relief:
  • Stretching: Gentle, daily stretching exercises, particularly those focusing on the spine, hips, and shoulders, can help maintain flexibility and reduce stiffness. Yoga and Pilates are excellent options.
  • Strength Training: Building muscle strength supports the spine and reduces joint strain. Focus on core-strengthening exercises and use resistance bands or light weights.
  • Aerobic Activities: Low-impact aerobic exercises, such as swimming, walking, and cycling, improve cardiovascular health, help manage weight, and reduce joint pressure.
  • Role of a Physical Therapist:

A therapist can develop a personalized exercise program tailored to your needs and limitations. They can teach techniques to avoid injury, provide hands-on treatments to relieve pain, and recommend assistive devices to enhance mobility.

Alternative Therapies for Ankylosing Spondylitis

  • Acupuncture:

Acupuncture therapy involves inserting thin needles into particular points on the body to relieve pain and improve overall wellness. This traditional Chinese medicine practice can help reduce pain and inflammation in AS patients. Many people find acupuncture to be a beneficial complementary treatment alongside conventional therapies.

  • Massage Therapy:

Massage therapies help relieve muscle tension, reduce pain, and improve circulation. They can be particularly effective for managing AS symptoms.

  • Hydrotherapy:

Hydrotherapy, or water therapy, involves exercises performed in warm water. The buoyancy of the water supports the body, reducing stress on the joints and allowing for a greater range of motion. Hydrotherapy can help improve flexibility, strength, and overall well-being. It’s especially beneficial for individuals with significant pain and stiffness.

Improving Mobility

Daily Exercise Routines

  • Stretching Exercises:

Stretching is crucial for maintaining flexibility and reducing stiffness. Daily stretching routines can help alleviate pain and improve range of motion. Focus on stretches that target the back, hips, and legs. Yoga and Pilates are excellent for gentle stretching, which can be easily incorporated into your daily routine.

  • Strength Training:

Strength training helps build muscle strength and support the spine. Exercises such as weight lifting, resistance band workouts, and bodyweight exercises like squats and lunges are beneficial. Strengthening the core muscles is particularly important for supporting spinal health.

  • Aerobic Activities:

Regular aerobic exercise improves cardiovascular health, reduces inflammation, and boosts overall well-being. Activities like walking, swimming, cycling, and low-impact aerobics are ideal. You must aim to exercise moderately for at least 150 minutes weekly.

Lifestyle and Self-Care

Diet and Nutrition

  • Anti-Inflammatory Foods:

To help manage ankylosing spondylitis symptoms, try adding anti-inflammatory foods to your diet. Some examples include fatty fish, leafy green vegetables, nuts, seeds, and fruits like berries.

  • Importance of a Balanced Diet:

A balanced diet is essential as it provides the much-needed nutrients that support overall health. Focus on whole foods, including lean proteins, whole grains, vegetables, and fruits.

  • Supplements and Vitamins:

Some supplements, including omega-3 fatty acids, vitamin D, and calcium, can be beneficial. Always consult your healthcare provider before incorporating any new supplement.

Stress Management

  • Relaxation Techniques:

Some relaxation techniques, such as deep breathing, progressive muscle relaxation, and guided imagery, can help decrease stress and alleviate pain.

  • Mindfulness and Meditation:

Mindfulness and meditation can help manage pain, reduce stress, and improve mental well-being. Beginners can learn these practices through apps and other online resources.

  • Importance of Mental Health Support:

Managing a chronic condition like ankylosing spondylitis can take a toll on mental health. So, you can seek help from mental health professionals and support groups. Moreover, counseling can provide emotional relief and coping strategies.

Sleep and Rest

Tips for Better Sleep Quality:

  • Routine: Stick to a regular sleep schedule.
  • Relaxation: Develop a pre-sleep routine that promotes relaxation, such as reading or a warm bath.
  • Avoid Stimulants: Limit caffeine and electronic device use before bed.

Managing Fatigue:

  • Rest: Take short naps if needed, but avoid long naps that can disrupt nighttime sleep.
  • Pace Yourself: Break tasks into smaller, manageable steps and rest between activities.
  • Stay Active: Regular, moderate exercise can help improve energy levels.

Conclusion

Living with AS requires a balanced approach, including medical management, physical activity, and self-care. Adapting your lifestyle to accommodate your condition while still pursuing your passions and interests is important. With the right strategies and support, you can live an active life despite the challenges posed by AS.

If you’re experiencing symptoms and seeking the best orthopedic doctors in Patiala, consider visiting the Patiala Heart Institute and Multispecialty Hospital. Our orthopedic specialists in Patiala are there to provide comprehensive care and personalized treatment plans to help you manage your condition effectively.

Don’t let AS define your life—seek expert treatment and take the first step towards a better quality of life with the help of Patiala Heart Institute.

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