4 Habits That Can Make Ankylosing Spondylitis Worse
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:
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.”
Dr. Cardozo is an assistant professor of Rehabilitation Medicine at Icahn School of Medicine at Mount Sinai.
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In ankylosing spondylitis, we know that although inflammation
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is a large part of the disease,
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there's also other factors that come into play,
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whether it's fatigue or limits in their function,
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so by looking at it from all different angles
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and really trying to optimize the different parts of your lifestyle,
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whether it be your diet, your sleep, your exercise during the day,
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we know that that's gonna improve different parts of the disease.
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The main bad habit for a patient that has AS is gonna be smoking.
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So I always counsel my patients on stopping smoking
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if they do smoke, and even if they've tried to quit before
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and they haven't been successful, I counsel them on the fact
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that it can take many attempts to successfully quit smoking,
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and it will make a world of difference in their pain and function.
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In addition to that, being sedentary is another thing
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that you want to avoid in ankylosing spondylitis.
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That's because inactivity actually can cause increased pain
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and stiffness, so we want patients to stay as active as possible.
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One of the simplest things you can start doing is walking.
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That's a great form of exercise.
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If for some reason that is painful for you,
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or you're not sure of other things you can do,
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my best advice is to be referred to a physical therapist.
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Since ankylosing spondylitis really affects your spine primarily,
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bad posture can exacerbate the symptoms of it already.
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So you really wanna be very cognizant of your posture
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both when you're working during the day,
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if you are at a desk job sitting and things like that,
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but then in your, just your day-to-day activity.
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The best way to go about that is by really strengthening
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your postural muscles, whether it be through a
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physical therapy program or on your own,
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and also making sure that the ergonomics of your situation
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during the day are as optimized as possible.
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I would say sleep hygiene is so important for anyone,
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whether they have AS or not, but especially in AS,
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because we know that fatigue is a large issue with the disease,
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and sleep hygiene is very important
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to combat fatigue and tiredness.
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Usually I start off with asking the patient a little bit
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about their sleep and where they're having trouble.
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I also want to know what their sleep environment is like.
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If it's as optimal as possible with darkness, sound,
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if they're going to sleep around the same time every night,
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if they're using phones or TVs before they go to sleep,
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things like that are all gonna be important in their sleep hygiene
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and the quality of the sleep that they're getting.
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In addition to that, the fatigue itself can also be exacerbated
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by underlying conditions such as depression and anxiety.
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So I always tell patients, if they are feeling a lot of fatigue with that,
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they should be evaluated and treated for those conditions.
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In ankylosing spondylitis, it's a multifactorial disorder
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based on inflammation, but also affecting
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different systems in your body.
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As we know, it can cause stiffness in the joints,
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it can cause pain, it can cause fatigue,
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so because of that, we really want to have
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a multifaceted treatment approach that addresses
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all of those things, but at the root cause,
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it's gonna be controlling the inflammation from the disease.
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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)