Many of these increase pain, stiffness, and risk of complications.
Treating ankylosing spondylitis—a type of inflammatory arthritis that primarily affects the spine or the back—takes a multifactorial approach. One important factor is to follow the treatment plan prescribed by your doctor. Another is to make (and stick to!) lifestyle adjustments that can help you manage your ankylosing spondylitis symptoms.
“Although inflammation is a large part of the disease, there are also other factors that come into play—whether it’s fatigue or limits in [the patient’s] function,” says Eliana Cardozo, DO, assistant professor of rehabilitation medicine at Icahn School of Medicine at Mount Sinai. “So by looking at it from all different angles and really trying to optimize different parts of your lifestyle, whether it be your diet, your sleep, your exercise during the day, we know that that’s going to improve different parts of the disease.”
Incorporating lifestyle changes to manage ankylosing spondylitis doesn’t always mean taking on a new healthy hobby. Depending on your treatment plan and current lifestyle, this may include limiting or adjusting certain bad habits that may be making your condition worse, such as:
Smoking can reduce the effectiveness of your medications and increase inflammation in the body. “I always counsel my patients on stopping smoking if they do smoke,” says Dr. Cardozo. “It can take many attempts to successfully quit smoking, [but] it will make a world of difference in their pain and function.”
2. Lack of physical activity
“Inactivity can actually cause increased pain and stiffness, so you want patients to stay as active as possible,” says Dr. Cardozo. Exercising regularly can help prevent permanent stiffness, preserve the range of motion in your neck and back, and keep your chest and rib cage flexible.
“One of the simplest things you can start doing is walking,” says Dr. Cardozo. “If for some reason that is painful for you, or you’re not sure of other things you can do, my best advice is to be referred to a physical therapist.”
3. Bad posture
Since ankylosing spondylitis primarily affects your spine, bad posture can exacerbate your symptoms, says Dr. Cardozo. “You really want to be very cognizant of your posture, both when you’re working during the day…and in your day-to-day activity.”
Not only can bad posture cause pain and stiffness, but it may also increase the risk of your joints fusing in an undesirable position. Learn more about spinal fusion, a complication of ankylosing spondylitis, here.
4. Lack of sleep
If you have ankylosing spondylitis, you may experience fatigue and pain at night. These may be due to the inflammation itself, but may also be caused by lack of sleep. “Sleep hygiene is very important to combat fatigue and tiredness,” says Dr. Cardozo.
“Ankylosing spondylitis [is] a multifactorial disorder based on inflammation but also affecting different systems in your body. We know it can cause stiffness in the joints, it can cause pain, [and] it can cause fatigue,” says Dr. Cardozo. “So because of that we want to have a multi-faceted approach that addresses all of those things, but at the root cause it’s going to be controlling the inflammation from the disease.”
Dr. Cardozo is an assistant professor of Rehabilitation Medicine at Icahn School of Medicine at Mount Sinai.
00:00:00.233 --> 00:00:03.332
00:00:03.333 --> 00:00:06.099
In ankylosing spondylitis, we know that although inflammation
00:00:06.100 --> 00:00:08.199
is a large part of the disease,
00:00:08.200 --> 00:00:10.699
there's also other factors that come into play,
00:00:10.700 --> 00:00:13.532
whether it's fatigue or limits in their function,
00:00:13.533 --> 00:00:15.899
so by looking at it from all different angles
00:00:15.900 --> 00:00:19.099
and really trying to optimize the different parts of your lifestyle,
00:00:19.100 --> 00:00:23.399
whether it be your diet, your sleep, your exercise during the day,
00:00:23.400 --> 00:00:28.432
we know that that's gonna improve different parts of the disease.
00:00:28.433 --> 00:00:31.632
00:00:31.633 --> 00:00:35.632
The main bad habit for a patient that has AS is gonna be smoking.
00:00:35.633 --> 00:00:38.932
So I always counsel my patients on stopping smoking
00:00:38.933 --> 00:00:42.299
if they do smoke, and even if they've tried to quit before
00:00:42.300 --> 00:00:45.299
and they haven't been successful, I counsel them on the fact
00:00:45.300 --> 00:00:47.832
that it can take many attempts to successfully quit smoking,
00:00:47.833 --> 00:00:51.766
and it will make a world of difference in their pain and function.
00:00:51.767 --> 00:00:54.499
In addition to that, being sedentary is another thing
00:00:54.500 --> 00:00:57.266
that you want to avoid in ankylosing spondylitis.
00:00:57.267 --> 00:01:00.199
That's because inactivity actually can cause increased pain
00:01:00.200 --> 00:01:03.399
and stiffness, so we want patients to stay as active as possible.
00:01:03.400 --> 00:01:06.099
One of the simplest things you can start doing is walking.
00:01:06.100 --> 00:01:07.866
That's a great form of exercise.
00:01:07.867 --> 00:01:11.366
If for some reason that is painful for you,
00:01:11.367 --> 00:01:13.832
or you're not sure of other things you can do,
00:01:13.833 --> 00:01:17.366
my best advice is to be referred to a physical therapist.
00:01:17.367 --> 00:01:21.732
Since ankylosing spondylitis really affects your spine primarily,
00:01:21.733 --> 00:01:26.232
bad posture can exacerbate the symptoms of it already.
00:01:26.233 --> 00:01:29.866
So you really wanna be very cognizant of your posture
00:01:29.867 --> 00:01:32.499
both when you're working during the day,
00:01:32.500 --> 00:01:35.599
if you are at a desk job sitting and things like that,
00:01:35.600 --> 00:01:37.566
but then in your, just your day-to-day activity.
00:01:37.567 --> 00:01:40.532
The best way to go about that is by really strengthening
00:01:40.533 --> 00:01:42.532
your postural muscles, whether it be through a
00:01:42.533 --> 00:01:44.732
physical therapy program or on your own,
00:01:44.733 --> 00:01:48.466
and also making sure that the ergonomics of your situation
00:01:48.467 --> 00:01:51.199
during the day are as optimized as possible.
00:01:51.200 --> 00:01:54.032
I would say sleep hygiene is so important for anyone,
00:01:54.033 --> 00:01:57.032
whether they have AS or not, but especially in AS,
00:01:57.033 --> 00:02:00.766
because we know that fatigue is a large issue with the disease,
00:02:00.767 --> 00:02:03.132
and sleep hygiene is very important
00:02:03.133 --> 00:02:05.732
to combat fatigue and tiredness.
00:02:05.733 --> 00:02:07.999
Usually I start off with asking the patient a little bit
00:02:08.000 --> 00:02:10.732
about their sleep and where they're having trouble.
00:02:10.733 --> 00:02:13.899
I also want to know what their sleep environment is like.
00:02:13.900 --> 00:02:18.332
If it's as optimal as possible with darkness, sound,
00:02:18.333 --> 00:02:21.466
if they're going to sleep around the same time every night,
00:02:21.467 --> 00:02:25.066
if they're using phones or TVs before they go to sleep,
00:02:25.067 --> 00:02:28.066
things like that are all gonna be important in their sleep hygiene
00:02:28.067 --> 00:02:30.832
and the quality of the sleep that they're getting.
00:02:30.833 --> 00:02:34.299
In addition to that, the fatigue itself can also be exacerbated
00:02:34.300 --> 00:02:37.266
by underlying conditions such as depression and anxiety.
00:02:37.267 --> 00:02:40.532
So I always tell patients, if they are feeling a lot of fatigue with that,
00:02:40.533 --> 00:02:43.866
they should be evaluated and treated for those conditions.
00:02:43.867 --> 00:02:48.499
In ankylosing spondylitis, it's a multifactorial disorder
00:02:48.500 --> 00:02:50.599
based on inflammation, but also affecting
00:02:50.600 --> 00:02:52.199
different systems in your body.
00:02:52.200 --> 00:02:54.566
As we know, it can cause stiffness in the joints,
00:02:54.567 --> 00:02:57.099
it can cause pain, it can cause fatigue,
00:02:57.100 --> 00:02:59.166
so because of that, we really want to have
00:02:59.167 --> 00:03:01.799
a multifaceted treatment approach that addresses
00:03:01.800 --> 00:03:04.232
all of those things, but at the root cause,
00:03:04.233 --> 00:03:08.066
it's gonna be controlling the inflammation from the disease.
00:03:08.067 --> 00:03:12.967
Axial Spondyloarthritis. Arthritis Foundation. (Accessed on April 28, 2020 at https://www.arthritis.org/about-arthritis/types/ankylosing-spondylitis)
Treatment of Spondyloarthritis. Spondylitis Association of America. (Accessed on April 28, 2020 at https://www.spondylitis.org/Treatment-Information)
Arthritis and Exercise (Beyond the Basics). UptoDate. (Accessed on April 28, 2020 at https://www.uptodate.com/contents/arthritis-and-exercise-beyond-the-basics)