Self-care Tips for Ankylosing Spondylitis

Ankylosing spondylitis is a type of arthritis that causes pain, swelling, and stiffness in the joints. The pain and stiffness that is associated with ankylosing spondylitis is usually in the back and the pelvis and tends to worsen at the base of the spine at the sacroiliac joints, which link the spine with the pelvis. Treatment for ankylosing spondylitis involves therapies and medication that help your condition from worsening over a period of time. These medications and therapies also work to prevent the loss of range of motion and flexibility. However, in between treatment, the many doctor’s appointments, work, family commitments, and other daily chores, it is often easy to forget to take care of yourself. Self-care is one of the most critical components of treating and managing the condition of ankylosing spondylitis. Here are some self-care tips for ankylosing spondylitis that will help you retain your range of motion and also prevent your disease from getting worse with time.

Self-care Tips for Ankylosing Spondylitis

Exercising Regularly

Regular physical activity and exercising are essential to your health and to any healthy lifestyle plan that you draw up. In patients of ankylosing spondylitis, in spite of the pain and stiffness that they experience, it is essential to get some form of exercise and that too regularly. (1)

Regular movement of the joints helps maintain their flexibility and also decreases pain and stiffness. Even exercising for just a couple of minutes at home daily can also help immensely.

Your doctor, physical therapist, or even your occupational therapist might design specific exercises based upon the severity of your symptoms and pain.

If, however, you are looking to do some exercises at home by yourself, then it is essential to focus on workouts that are low impact. This can include walking and swimming. Aquatic exercises are known for boosting the range of motion in your joints, minus the effect of weight-bearing. When these exercises are performed in warm water, it further increases the blood flow, helping lower inflammation.

Exercises that improve flexibility should also be considered, including yoga and tai chi. (2) (3) Furthermore, if you need to lose weight to improve your condition, then regular exercises will be very important for you.

Following an Anti-inflammatory Diet

Medical experts firmly recommend that patients who have ankylosing spondylitis should try to have an anti-inflammatory diet or a Mediterranean diet for maintaining their health. Anti-inflammatory diets are known to help reduce inflammation in the body and, at the same time, also lower the risk for heart disease. (4)

Many studies have shown that eating more anti-inflammatory foods have helped improve patients’ symptoms of ankylosing spondylitis in the long term. (5)

An anti-inflammatory diet is made up primarily of plant-based foods such as fruits and vegetables, and moderate amounts of lentils and some grains. (6) This type of diet also places a lot of emphasis on seafood rather than on dairy and meat. Mediterranean diets are also known to include a lot of olive oil, which is known to be extremely beneficial for your heart health.

Some anti-inflammatory foods you should try to include in your diet are:

Leafy Green Vegetables: Spinach, kale, collard greens, Swiss chard are all leafy greens that contain high levels of magnesium. Magnesium helps to reduce the inflammatory markers in the body. Cooking the greens with olive oil and garlic will further boost their benefit as garlic is also known to contain magnesium.

Broccoli: Broccoli is part of the cruciferous family and is known to contain an anti-oxidant known as sulforaphane. Sulforaphane helps decrease levels of inflammatory compounds in the body. (7) A study published in 2013 in the Arthritis & Rheumatism journal (7) found that sulforaphane blocks the enzymes in the body that cause destruction of the joints by stopping the production of a critical molecule that causes inflammation.

Onions: Leeks, garlic, shallots, and onions are all from the allium family. These foods are powerhouses of sulfuric compounds, which are known for their anti-inflammatory properties. Onions are also very rich in quercetin, which is a flavonoid that helps prevent inflammation-causing agents in fats. All types of onions are healthy for those who have ankylosing spondylitis, but red onions, yellow onions, and shallots are known to contain the highest amounts of quercetin, the inflammation-fighting compound. (8)

Berries: Berries are great fruits to include in your diet if you have ankylosing spondylitis. Raspberries, blueberries, strawberries, and even blackberries are rich in antioxidants, which are great for reducing inflammation and also fight against the damaging effects of free radical in the body. Berries get their inflammation-fighting power from the antioxidant flavonoid anthocyanin, which is what gives berries their distinctive color. You should ideally aim for including a variety of berries in your daily diet as different types of berries contain different and varying levels of antioxidants.

Wild Salmon: Wild salmon is a type of fatty fish, and fatty fishes are known to contain omega-3 fatty acids that are the superstar of anti-inflammatory diets. Omega-3 fatty acids are one of the well-researched parts of any anti-inflammatory or Mediterranean diet. While until now most of the research done on omega-3 fatty acids focused on how they are beneficial in rheumatoid arthritis, a recent Swedish study has also shown that omega-3 fatty acids can indeed help relieve the symptoms and also decrease disease activity in people who have ankylosing spondylitis. The research was carried out by the Gällivare Hospital in Sweden, and it has laid the foundation of further research to find out exactly how omega-3 fatty acids help in ankylosing spondylitis. (9) According to the Arthritis Foundation, it is believed that omega-3 fatty acids may help decrease the chemicals that lead to inflammation within the body. While wild salmon is one of the top fatty fishes on this list, there are many other fishes as well that are known for the anti-inflammatory properties. These include the Atlantic cod, mackerel sardines, and the rainbow trout.

Healthy Oils: You can try to replace butter or margarine with a healthy dose of olive oil or any other healthy oil such as avocado oil. Extra virgin olive oil is one of the least processed and refined types of olive oil available in the market, and it is known to contain many anti-inflammatory and antioxidant compounds. According to a research done by the Deakin University and published in 2014 in the International Journal of Molecular Sciences (10), found that a compound known as oleocanthal found in olive oil is very similar to NSAIDs (non-steroidal anti-inflammatory drugs) that we take for getting relief from pain. The similarity lies in its ability to reduce inflammation and pain. This is why including olive oil in your day to day cooking can prove to be highly beneficial.

But just as how including anti-inflammatory foods in your diet will help you with your symptoms, at the same time, you also need to avoid inflammatory foods. These include:

  • Sugar
  • Red meat
  • Processed foods
  • Trans fats
  • Fast food items

Getting Adequate Sleep

Sleep is one of the most critical factors of good health for anybody, and especially so for people who are suffering from any type of medical condition. When you are in a sleep-deprived state, inflammation is going to increase, making stiffness, pain, and overall fatigue even worse. Furthermore, lack of sleep is also going to cause you to make poor eating choices, cut back on your exercise or forego it altogether, and also increase your stress levels.

According to the US Centers for Disease Control and Prevention (CDC), it is recommended that adults get at least seven hours of sleep every night.(11) This increases to seven to nine hours of sleep each night if you are over the age of 60 years.

If you find that your present sleeping pattern is falling short of this recommended amount, then you should seriously consider making some changes to your lifestyle so that you can achieve the goal of sleeping for at least seven hours. Try going to bed a little bit earlier each night until you manage to reach seven to eight hours of sleep each night.

Keep in mind that having a disease such as ankylosing spondylitis is going to leave you feeling fatigued even in the middle of the day, especially if you are in constant pain and feeling stiff. So while it might be very tempting, try an avoid taking naps in the daytime. These naps will throw off your sleeping schedule at night, and the cycle will only continue the next day, making you feel even more tired.

Sleeping when you have ankylosing spondylitis is not an easy task, especially if you have pain and stiffness. Many people have said that they find relief from the symptoms of this disease by sleeping on their back. You should also avoid using a large head pillow as elevating the neck will distort your spine, provoking joint pain. Sleeping without a pillow is the best option, but if you are uncomfortable without a pillow, then using a slim pillow or even a folded towel will be better.

Reduce Your Stress

When you have ankylosing spondylitis, any factors that cause stress, be it related to your work, school, childcare, or any other commitments, is going to make your symptoms worse.

Stress is also known to increase inflammation. Research carried out by the Second Military Medical University in China (12) showed that prolonged inflammation and stress is also going to increase the likelihood of developing chronic illnesses later on in life. Since inflammation is one of the major precursors to ankylosing spondylitis, it is, therefore, all the more critical that you reduce the level of stress in your life. (13)

While it is not possible to skip out on all your responsibilities and commitments, you can always try to look for some ways in which you can reduce a little bit of your stress every day. Some simple ideas that will help you de-stress each day include:

  • Going for a walk outside, even if for just ten minutes
  • Meditating daily for 5 to 10 minutes
  • Try doing yoga
  • Spending time in nature alone
  • Taking a warm bubble bath
  • Reading a book
  • Delegating assignments and chores to friends and family

Stop Smoking and Drinking

Consumption of alcohol is not at all advisable for people who have ankylosing spondylitis because it is only going to increase inflammation.

Smoking is also known to pose challenges for patients of ankylosing spondylitis. As the disease progresses, you are going to develop weaker ribs, a factor that is going to affect your breathing. If on top of this, you smoke, you will find that your breathing difficulties are only going to get worse. Smoking is also a trigger for inflammation.

Another factor that you should consider quitting smoking if you have ankylosing spondylitis is the increased risk of stroke and heart disease. The fact is that people who have ankylosing spondylitis are already at an increased risk of heart-related conditions such as stroke, blood clots, and heart disease.

An analysis of health data from 300,000 Swedish adults carried out by the Sahlgrenska Academy at the University of Gothenburg in Sweden and published in the 2017 issue of Arthritis Research and Therapy journal (14) found that people with ankylosing spondylitis have a much higher risk of developing heart-related conditions including stroke, heart attack, atherosclerosis, etc., and smoking is only going to increase this risk further.

Furthermore, the American Heart Association (AHA) (15) states that smoking nearly doubles your risk of developing heart disease regardless of any other chronic condition that you might be having. The AHA also emphasizes that anybody who is concerned about their heart health should quit smoking and also avoid exposure to second-hand smoke.

If you are unable to quit smoking and drinking on your own, you can always discuss ways to quit with your doctor. You will find that not only will quitting smoking and drinking improve the quality of your life, but at the same time, it will decrease the progression of ankylosing spondylitis. (16)

Conclusion

One of the best forms of self-care in ankylosing spondylitis is to follow your treatment plan strictly. You have to make sure that you are not missing out on any of your scheduled appointments with your doctor. Take your medication as your doctor has prescribed and also follow up with your medical team as and when required. If you find your symptoms getting worse or that there is no improvement in your condition following the treatment plan, then also you should get in touch with your doctor to let them know of the same.

Self-care is very important and only by following a healthy lifestyle and eating healthy will you be able to lead a better quality of life with ankylosing spondylitis and also be able to slow down the progression of the disease.

References

  1. Nass.co.uk. (2019). Exercise | National Ankylosing Spondylitis Society. [online] Available at: https://nass.co.uk/managing-my-as/exercise/ [Accessed 4 Aug. 2019].
  2. Yogauonline.com. (2019). Ankylosing Spondylitis: What Is It and How Can Yoga Help? | YogaUOnline. [online] Available at: https://www.yogauonline.com/yogau-wellness-blog/yoga-therapy-yoga-for-ankylosing-spondylitis [Accessed 4 Aug. 2019].
  3. Plus, S. (2019). Tai Chi. [online] Spondylitis Association of America. Available at: https://www.spondylitis.org/Spondylitis-Plus/tai-chi-exercises-for-spondylitis-1 [Accessed 4 Aug. 2019].
  4. Anon, (2019). Fight Inflammation to Help Prevent Heart Disease. [online] Available at: https://www.hopkinsmedicine.org/health/wellness-and-prevention/fight-inflammation-to-help-prevent-heart-disease [Accessed 4 Aug. 2019].
  5. Sundström, B., Wållberg-Jonsson, S. and Johansson, G., 2011. Diet, disease activity, and gastrointestinal symptoms in patients with ankylosing spondylitis. Clinical rheumatology, 30(1), pp.71-76.
  6. Spondylitis, A., Information, T. and Nutrition, D. (2019). Diet & Nutrition. [online] Spondylitis.org. Available at: https://www.spondylitis.org/Diet-Nutrition [Accessed 4 Aug. 2019].
  7. Davidson, R.K., Jupp, O., de Ferrars, R., Kay, C.D., Culley, K.L., Norton, R., Driscoll, C., Vincent, T.L., Donell, S.T., Bao, Y. and Clark, I.M., 2013. Sulforaphane represses matrix‐degrading proteases and protects cartilage from destruction in vitro and in vivo. Arthritis & Rheumatism, 65(12), pp.3130-3140.
  8. Living With Arthritis. (2019). Onions Can Help Prevent Inflammation – Living With Arthritis. [online] Available at: http://blog.arthritis.org/living-with-arthritis/onions-prevent-inflammation-arthritis-diet/ [Accessed 4 Aug. 2019].
  9. Sundström, B., Stålnacke, K., Hagfors, L. and Johansson, G., 2006. Supplementation of omega‐3 fatty acids in patients with ankylosing spondylitis. Scandinavian journal of rheumatology, 35(5), pp.359-362.
  10. Parkinson, L. and Keast, R., 2014. Oleocanthal, a phenolic derived from virgin olive oil: a review of the beneficial effects on inflammatory disease. International journal of molecular sciences, 15(7), pp.12323-12334.
  11. Cdc.gov. (2019). CDC – How Much Sleep Do I Need? – Sleep and Sleep Disorders. [online] Available at: https://www.cdc.gov/sleep/about_sleep/how_much_sleep.html [Accessed 4 Aug. 2019].
  12. Liu, Y.Z., Wang, Y.X. and Jiang, C.L., 2017. Inflammation: the common pathway of stress-related diseases. Frontiers in Human Neuroscience, 11, p.316.
  13. Zochling, J., Bohl-Bühler, M.H., Baraliakos, X., Feldtkeller, E. and Braun, J., 2006. Infection and work stress are potential triggers of ankylosing spondylitis. Clinical rheumatology, 25(5), pp.660-666.
  14. Bengtsson, K., Forsblad-d’Elia, H., Lie, E., Klingberg, E., Dehlin, M., Exarchou, S., Lindström, U., Askling, J. and Jacobsson, L.T., 2017. Are ankylosing spondylitis, psoriatic arthritis and undifferentiated spondyloarthritis associated with an increased risk of cardiovascular events? A prospective nationwide population-based cohort study. Arthritis research & therapy, 19(1), p.102.
  15. www.heart.org. (2019). 5 Steps to Quit Smoking. [online] Available at: http://www.heart.org/HEARTORG/HealthyLiving/QuitSmoking/QuittingSmoking/Why-Quit-Smoking_UCM_307847_Article.jsp#.Wv8WxIgvzct [Accessed 4 Aug. 2019].
  16. Zhang, S., Li, Y., Xu, X., Feng, X., Yang, D. and Lin, G., 2015. Effect of cigarette smoking and alcohol consumption on disease activity and physical functioning in ankylosing spondylitis: a cross-sectional study. International journal of clinical and experimental medicine, 8(8), p.13919.

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