Ankylosing Spondylitis Self-Care Strategies

AS affects about 1% of people. While there’s no cure, self-care strategies like regular exercise, a nutritious diet, and stress management can help reduce symptoms and improve quality of life.

Engage in Regular Exercise

Research has shown that a combination of aerobic, strength, stretching, and balancing exercises can significantly improve physical function and quality of life for people with ankylosing spondylitis. Regular physical activity helps:²

• Maintain flexibility
• Improve posture
• Reduce pain
• Improve breathing capacity
• Improve overall function

One small study investigated the effects of home exercise and workplace exercise on physical function, depression, and work-related disability in patients with AS. This non-randomized study involved 52 participants divided into three groups:³

• Home-and-workplace combined exercise (17 participants)
• Home exercise only (18 participants)
• Control group (17 participants)

The study assessed the effects of these exercise regimens and evaluated spinal mobility, pulmonary (lung) function, activity levels, depression, and work-related disability.³

The home-and-workplace combined exercise group experienced improvements in spinal mobility and pulmonary function. This group also reported significantly less work absence and reduced effects from overwork. The study concluded that an exercise regimen significantly improves physical function and reduces work-related disability in AS patients.³

Types of Exercise

Beneficial types of exercise for someone with ankylosing spondyloses include:²

• Range of motion
• Stretching or yoga
• Cardio
• Weight and resistance training
• Core strengthening
• Swimming⁴

Lack of movement can lead to loss of mobility and increase the risk of joint fusion in people with AS. When a joint is inflamed, the surrounding muscles tighten to control motion, resulting in even more stiffness and pain.²

Consistency is key. For maximum benefits, aim for at least 30 minutes of moderate exercise 3-5 days a week.²

Practice Good Posture

Maintaining good posture is crucial for people with ankylosing spondylitis. It helps prevent spinal deformities, maintains mobility, and reduces discomfort. Proper spinal alignment can reduce joint and muscle strain, easing pain and stiffness.

Tips on how to practice good posture throughout the day include:⁵⁶⁷

• Align your body: Keep your head aligned with your hips and ankles when standing. Keep your back straight when sitting, and avoid sitting in cramped positions.
• Keep your head level: If your chin tends to jut forward, tuck it a bit. Avoid looking down at your phone (“texting neck”).
• Move regularly: Alternate between sitting and standing versus sitting for long periods of time. If that’s not possible, incorporate seated stretches or exercises.
• Practice posture in bed: Align your head, neck, and spine as much as possible. Sleep on your back with a thin (or no) pillow. Place a pillow between your knees if you sleep on your side. Avoid sleeping on your stomach.
• Work with a physical therapist (PT): They can teach you exercises to help you maintain good posture.

You can practice standing against a wall with your shoulders, heels, bottom, and head touching the wall.⁷ Ergonomic adjustments at work and home, such as supportive chairs and adjustable desks, can also make a significant difference.

Finally, incorporate posture checks throughout your day to ensure you are standing and sitting correctly, which may help reduce the long-term effects of AS.

Prioritize Sleep

In people with ankylosing spondylitis, sleep disturbances are common due to inflammatory pain and restricted spine mobility. Poor sleep can also worsen AS symptoms, leading to a vicious cycle of discomfort and fatigue.⁸

It is important to have a quality mattress that properly supports your back, neck, hips, and other joints. Look for one that:⁹

• Has a supporting foundation
• Evenly distributes your weight
• Doesn’t cause you to sleep in a distorted position

Research indicates that individuals living with chronic pain, such as those with AS, often experience disrupted sleep patterns due to pain and stiffness. This can significantly affect your overall quality of life.¹⁰

To improve sleep quality:⁹

• Establish a consistent bedtime routine
• Create a dark space
• If possible, avoid napping during the day
• Ensure your sleeping environment is comfortable and supportive
• Sleep on your back to maintain alignment of the spine
• Consider using pillows that promote spinal alignment

Practicing relaxation techniques such as deep breathing or meditation before bed can also help you fall asleep more easily and enjoy a more restful night.¹¹

Focus on Quality Nutrition

A balanced diet rich in anti-inflammatory foods can play a significant role in managing ankylosing spondylitis. Incorporating plenty of whole grains, fruits, vegetables, and lean proteins can help reduce inflammation and support overall health.¹²

Individuals with AS have an elevated risk of osteoporosis, a condition characterized by bone thinning and a greater risk of fractures. A balanced diet rich in calcium and vitamin D can help lower osteoporosis risk.¹²

Excessive alcohol consumption—more than two drinks daily—is another risk factor for osteoporosis. Combining alcohol with specific medications can also lead to severe gastrointestinal (GI) and organ-related complications, affecting organs like the liver and kidneys.¹²

Here are a few nutritional recommendations:¹²

• Eat a variety of fruits and vegetables
• Drink 8-10 glasses of water per day (or whatever your healthcare provider recommends)
• Ask your provider if vitamin supplements might benefit you
• Eat anti-inflammatory foods rich in omega-3 fatty acids, such as flaxseed and salmon
• Avoid processed and fried foods

Maintaining a healthy weight is also important, as excess weight can put additional stress on the joints.¹²

Manage Stress

Living with a chronic illness can be challenging and stressful. It’s important to incorporate healthy stress management techniques that fit your lifestyle and bring you peace. This could include anything that helps you feel relaxed. Here are a few things to try:⁷

• Go for nature walks
• Try meditating
• Engage in yoga
• Spend quality time with your pets
• Listen to music
• Try a creative activity and focus on the process, not the product (e.g., writing or visual art)

Avoid Smoking

Smoking has been linked to increased disease activity in ankylosing spondylitis, leading to more severe symptoms such as pain, stiffness, and fatigue.¹³

Smoking is also known to weaken bones and is a risk factor for osteoporosis. Since AS already increases the risk of bone thinning and fractures, avoiding smoking can help preserve bone density and reduce the risk of fractures.¹³

AS is also associated with an increased risk of cardiovascular disease. Smoking further elevates this risk. Experts highly recommend that people with AS quit the habit and replace it with healthy lifestyle changes such as exercise.¹³

Optimize Physical Therapy

Physical therapy (PT) is a valuable self-care strategy for people with ankylosing spondylitis due to its numerous benefits in managing the condition and improving overall quality of life.

PT plays a vital role in maintaining and enhancing mobility. A tailored PT program can help improve joint mobility, reduce pain, and enhance functional abilities. It can enable individuals with AS to perform daily activities more comfortably.¹⁴

Here are some other potential PT benefits if you have AS:¹⁴

• Improves pain and inflammation management
• Improves core and abdominal strength
• Maintains joint flexibility
• Strengthens back and neck muscles
• Tailors exercise to help you improve your posture

Optimizing physical therapy may also empower individuals with AS to actively participate in their treatment and self-care. Education on proper body mechanics, posture, and home exercises provides you with tools to manage your condition effectively on a daily basis.

Why Flares Occur

A flare is the acute (sudden) worsening of ankylosing spondylitis symptoms. Flares are often attributed to increased disease activity and include symptoms like increased back pain, fatigue, and emotional distress.¹⁵

Flare causes may vary and include:¹⁵

• Unpredictable fluctuations (changes) in disease activity
• Emotional stress
• Overexertion
• Infections
• Disruptions in regular routines (such as during the COVID-19 pandemic)

Several contributing factors can lead to a flare. For example, studies suggest that people often associate AS flares with increased emotional stress or pushing themselves too far physically.¹⁵ Incorporating self-care practices into your daily routine may empower you to proactively manage your condition.

Always discuss your situation with your healthcare provider. They can guide you toward the lifestyle habits and self-care techniques that may benefit you.

When To Call a Healthcare Provider

Typical flares of ankylosing spondylitis are usually short-lived, lasting from days to weeks, and many people develop strategies to manage these episodes.¹⁵

Coping strategies for AS flares may include:¹⁵

• Re-starting non-steroidal anti-inflammatory drugs (NSAIDs) or adjusting the daily dosage
• Making changes to the exercise routine, such as focusing on gentle stretching and low-impact activities
• Taking long hot baths or showers for pain relief
• Utilizing other non-pharmacological interventions like heat or cold therapy, relaxation techniques, or acupuncture

Seek medical advice if AS symptoms during a flare are unusual or persist for an extended period. Consulting with a rheumatologist can help determine the underlying cause and appropriate management.

What Is a Rheumatologist?

A rheumatologist is a medical doctor who specializes in rheumatic diseases, including musculoskeletal diseases and systemic autoimmune diseases. Musculoskeletal diseases affect bones, joints, muscles, and connective tissues. Systemic autoimmune diseases are conditions where the body’s immune system attacks itself.¹⁶

Managing ankylosing spondylitis requires a holistic approach that integrates self-care strategies, medical guidance, and lifestyle adjustments. You can tailor these strategies to your individual needs and work collaboratively with healthcare providers.

Flares do occur, but reach out to a healthcare provider if your symptoms are unusual or persist for an extended period of time.