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Exercises and Other Home Treatments for Ankylosing Spondylitis

Ankylosing spondylitis is a type of arthritis that causes inflammation in the joints where the pelvis and spine meet. The condition also impacts other parts of the body where ligaments and tendons join to the bones. Most people with ankylosing spondylitis have pain and stiffness in their lower back, with the pain fluctuating in severity. As the disease progresses, the pain also progresses into the upper spine. Many people with ankylosing spondylitis think that exercising is not for them as it will only aggravate their pain further. However, being physically active is one of the best ways to manage the symptoms of this condition. Read on to find out more about exercising and other home treatments for ankylosing spondylitis.

What is Ankylosing Spondylitis and What are its Symptoms?

Ankylosing spondylitis is a type of inflammatory arthritis that causes some of the bones in the spinal cord to fuse together. This can make the spine less flexible and even lead to a hunched-over posture. Ankylosing spondylitis is a progressive condition, and it mostly affects the joints at the place where your spine meets the pelvis. The condition can also impact places in the body where ligaments and tendons attach to the bones, causing inflammation. Inflammation may also occur in other parts of the body, such as:(1, 2, 3, 4)

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  • Ribs
  • Hips
  • Shoulders
  • Feet
  • Knees
  • Eyes
  • Jaw
  • Bowel

Most people with ankylosing spondylitis experience pain and stiffness in the lower back. The pain varies in severity and is also sporadic. These symptoms can also progress to the upper spine. Most symptoms differ from person to person and can include the following:(5, 6)

Not everybody with ankylosing spondylitis experiences severe complications or spinal fusion.

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There are natural treatments, exercises, as well as traditional remedies to help relieve the symptoms of ankylosing spondylitis. Here’s how exercising and some other home treatments can help ankylosing spondylitis.

Why Exercising is Good for Ankylosing Spondylitis?

Exercise is important for everybody. When you have ankylosing spondylitis, the last thing you may feel like doing is exercise. However, the fact is that exercise is a critical part of the treatment plan for ankylosing spondylitis as it helps maintain joint function and motion. It can also help reduce the pain, help with muscle imbalances, improve overall posture, make it easier to breathe, and also improve your overall quality of life. There are many options for which exercises are best for people with ankylosing spondylitis.

Though it is important to ensure that you exercise properly and you are careful while exercising, especially if you are experiencing a flare-up, to prevent an aggravation of your symptoms.(7, 8, 9, 10)

Best Exercises for Ankylosing Spondylitis

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Here are some of the best exercises for ankylosing spondylitis:

  • Walking: For those with ankylosing spondylitis who are able to exercise, it is best to practice low-impact activities like walking. Walking is also the safest bet for people with arthritis who are afraid of getting hurt due to joint deformities, fused joints, and misinformation. Walking is the best way to start exercising. Even short five to ten-minute walks can help. From ten-minute walks, try to build up to walking for at least half an hour at a time. However, again, always consult your doctor first before you begin any kind of physical activity with ankylosing spondylitis.(11, 12)
  • Swimming and Water Aerobics: Low-impact exercises like water aerobics and swimming are also ideal for people with ankylosing spondylitis. While it keeps your muscles and joints moving, it also helps your heart and muscles while also reducing the risk of developing joint pain. Swimming is especially great for people with ankylosing spondylitis because it puts almost no pressure on your joints. It is best to join twice-a-week classes for people with arthritis. Many community pools offer such programs. And if you can find an indoor or heated pool, it will provide an added comfort to your joints.(13, 14)
  • Strength Training Exercises: Strength training exercises help strengthen your muscles and take off some strain from the joints. Start off by using light free weight or even household items like canned goods or exercise machines. Strengths training exercises like plank exercises help work out several muscle groups at the same time, including the back, chest, and abdominal muscles. However, the key to doing strength training is to start out slow and then gradually increase the amount of time you hold each position, as well as the number of repetitions. It is a good idea to have a personal trainer or physical therapist show you how to perform these strength training exercises properly and safely.(15, 16)
  • Yoga: If you are just starting out exercising for the first time after getting your diagnosis of ankylosing spondylitis, it is a great idea to start out with yoga. Yoga is a great form of exercise as it can help reduce pain and inflammation and also increase your joint mobility and flexibility. At the same time, yoga is great for your mental health as well. People with ankylosing spondylitis should start out slow with yoga and familiarize themselves with the poses and movements first before moving on to more challenging poses. You should practice yoga at least a couple of times in a week.(17, 18)
  • Cycling: Another great aerobic exercise for people who have ankylosing spondylitis is cycling. You can either go out to cycle or use a stationary cycle at the gym. Cycling is a great exercise for the heart and your muscles while also not putting strain on your joints. You can also use a day of cycling outside to change up your daily routine.

Other Home Treatments for Ankylosing Spondylitis

  1. Heat Therapy

    Heat therapy has been used for many decades to reduce the pain and stiffness of muscles. Applying a hot water bottle or an electric heating pad to the affected area can help reduce the pain and also stiffness. Using dry or moist heat can also help, such as a warm bath, especially if you take one before exercising.(19 , 20) However, it is not recommended to use heat therapy without asking your doctor if you have the following:

  2. Cold Therapy

    Some people prefer to use an ice pack, a bag of frozen vegetables, or a cold gel pack on their painful areas to help bring down the pain and swelling. Just like how heat therapy is helpful if applied before exercising, cold therapy can be more helpful if you apply it after exercising to help bring down the inflammation. However, do not apply the ice pack for more than 20 minutes at a time, and don’t apply it directly to your skin. Use a thin towel to wrap the ice pack in before applying it to the affected area. For those who have circulation issues, it is better to consult your doctor before using any form of cold therapy.(21)

  3. Stretching

    Stretching is the easiest and most natural remedy for ankylosing spondylitis. It not only helps increase your flexibility but also reduces pain. You should add some simple spine stretches and lower back stretches to your daily routine to help improve joint mobility and flexibility. Stretching is also a regular practice you should develop before exercising to lubricate joints and also increase and maintain your range of motion.(22)

  4. Massage Therapy

    Massage can help your entire body relax. It also helps your muscles loosen up to increase your flexibility. If you find that massaging certain areas of the spine causes pain, it is best to avoid those areas. If the pain is bearable, you can use light massage in those tender points until the pain goes away.

  5. Acupuncture

    Another highly recommended alternate therapy for ankylosing spondylitis is acupuncture. Acupuncture is a type of complementary therapy that is done by inserting very thin needles into specific locations on the skin. This is believed to help activate the pain-relieving hormones of the body. There have been many studies that have shown that acupuncture can help relieve pain associated with ankylosing spondylitis.(23)

    In 2019, a review of 70 clinical trials was carried out to discover that acupuncture was a generally safe and effective treatment to reduce pain associated with degenerative diseases like arthritis.(24) However, the specific research on acupuncture and ankylosing spondylitis remained inconclusive, so more studies are still needed.

    Nevertheless, most people who have tried acupuncture for ankylosing spondylitis have reported benefitting from this form of therapy.

Conclusion

Though most people will still need to take some type of medical treatment for the management of their ankylosing spondylitis, exercising and natural remedies such as the ones described here can help significantly in reducing the severity of symptoms. Of course, not all natural remedies and exercises are suitable for everyone who has ankylosing spondylitis, but with a trial and error process, you will eventually find one that works best for you. For example, most people find success with acupuncture and yoga, and others feel better after using heat therapy and massage. Remember that it is very important to consult your doctor before trying out any type of natural remedies as well. And do keep your doctor informed if you feel any change in your symptoms (both positive and negative outcomes) after trying out the natural treatments for ankylosing spondylitis.

References:

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  1. Braun, J. and Sieper, J., 2007. Ankylosing spondylitis. The Lancet, 369(9570), pp.1379-1390.
  2. Sieper, J., Braun, J., Rudwaleit, M., Boonen, A. and Zink, A., 2002. Ankylosing spondylitis: an overview. Annals of the rheumatic diseases, 61(suppl 3), pp.iii8-iii18.
  3. Linden, S.V.D., Valkenburg, H.A. and Cats, A., 1984. Evaluation of diagnostic criteria for ankylosing spondylitis. Arthritis & Rheumatism, 27(4), pp.361-368.
  4. Calin, A., 1985. Ankylosing spondylitis. Clinics in rheumatic diseases, 11(1), pp.41-60.
  5. Gran, J.T., 1985. An epidemiological survey of the signs and symptoms of ankylosing spondylitis. Clinical rheumatology, 4(2), pp.161-169.
  6. van der Linden, S. and van der Heijde, D., 1998. Ankylosing spondylitis: clinical features. Rheumatic Disease Clinics of North America, 24(4), pp.663-676.
  7. Regnaux, J.P., Davergne, T., Palazzo, C., Roren, A., Rannou, F., Boutron, I. and Lefevre‐Colau, M.M., 2019. Exercise programmes for ankylosing spondylitis. Cochrane Database of Systematic Reviews, (10).
  8. Ince, G., Sarpel, T., Durgun, B. and Erdogan, S., 2006. Effects of a multimodal exercise program for people with ankylosing spondylitis. Physical therapy, 86(7), pp.924-935.
  9. Santos, H., Brophy, S. and Calin, A., 1998. Exercise in ankylosing spondylitis: how much is optimum?. The Journal of rheumatology, 25(11), pp.2156-2160.
  10. Analay, Y., Ozcan, E., Karan, A., Diracoglu, D. and Aydin, R., 2003. The effectiveness of intensive group exercise on patients with ankylosing spondylitis. Clinical rehabilitation, 17(6), pp.631-636.
  11. Mangone, M., Scettri, P., Paoloni, M., Procaccianti, R., Spadaro, A. and Santilli, V., 2011. Pelvis–shoulder coordination during level walking in patients with ankylosing spondylitis. Gait & posture, 34(1), pp.1-5.
  12. Mengshoel, A.M., Jokstad, K. and Bjerkhoel, F., 2004. Associations between walking time, quadriceps muscle strength and cardiovascular capacity in patients with rheumatoid arthritis and ankylosing spondylitis. Clinical rheumatology, 23(4), pp.299-305.
  13. Karapolat, H., Eyigor, S., Zoghi, M., Akkoc, Y., Kirazli, Y. and Keser, G., 2009. Are swimming or aerobic exercise better than conventional exercise in ankylosing spondylitis patients? A randomized controlled study. Eur J Phys Rehabil Med, 45(4), pp.449-457.
  14. Dundar, U., Solak, O., Toktas, H., Demirdal, U.S., Subasi, V., Kavuncu, V.U.R.A.L. and Evcik, D., 2014. Effect of aquatic exercise on ankylosing spondylitis: a randomized controlled trial. Rheumatology international, 34(11), pp.1505-1511.
  15. Hurkmans, E., van der Giesen, F.J., Vlieland, T.P.V., Schoones, J. and Van den Ende, E.C., 2009. Dynamic exercise programs (aerobic capacity and/or muscle strength training) in patients with rheumatoid arthritis. Cochrane Database of Systematic Reviews, (4).
  16. Häkkinen, A., 2004. Effectiveness and safety of strength training in rheumatoid arthritis. Current opinion in rheumatology, 16(2), pp.132-137.
  17. Haaz, S. and Bartlett, S.J., 2011. Yoga for arthritis: a scoping review. Rheumatic Disease Clinics, 37(1), pp.33-46.
  18. Sharma, M., 2014. Yoga as an alternative and complementary approach for arthritis: a systematic review. Journal of evidence-based complementary & alternative medicine, 19(1), pp.51-58.
  19. Oosterveld, F.G. and Rasker, J.J., 1994, October. Treating arthritis with locally applied heat or cold. In Seminars in arthritis and rheumatism (Vol. 24, No. 2, pp. 82-90). WB Saunders.
  20. Mainardi, C.L., Walter, J.M., Spiegel, P.K., Goldkamp, O.G. and Harris Jr, E.D., 1979. Rheumatoid arthritis: failure of daily heat therapy to affect its progression. Archives of Physical Medicine and Rehabilitation, 60(9), pp.390-393.
  21. Schlesinger, N., Detry, M.A., Holland, B.K., Baker, D.G., Beutler, A.M., Rull, M., Hoffman, B.I. and Schumacher, H.R., 2002. Local ice therapy during bouts of acute gouty arthritis. The Journal of rheumatology, 29(2), pp.331-334.
  22. Ytterberg, S.R., Mahowald, M.L. and Krug, H.E., 1994. Exercise for arthritis. Bailliere’s clinical rheumatology, 8(1), pp.161-189.
  23. Zhang, D., Liu, W., Yang, H. and Wu, Y., 2016. Clinical review of ankylosing spondylitis treated with acupuncture and medicine. Zhongguo Zhen jiu= Chinese Acupuncture & Moxibustion, 36(8), pp.893-896.
  24. Aquino, M.B.N., Pereda, C.A. and Muñoz-Ortego, J., 2019. Efficacy of acupuncture in rheumatic diseases with spine involvement: systematic review. Medicina Clínica (English Edition), 153(6), pp.250-255.

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