4 Habits That Can Make Ankylosing Spondylitis Worse

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: 

1. Smoking

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.” 

Learn more about the importance of exercise for ankylosing spondylitis. 

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. 

Here are some doctor-approved ways to sleep better tonight. 

“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.”