Year: 2021

Exercise in Ankylosing Spondylitis Management

Living with Ankylosing Spondylitis can make you think that exercising is the last thing you should do. The gradually developing chronic pain in the lower back seems like the most common reason to stop you from exercising. On the contrary, it should be the reason for you to exercise.

Studies have suggested that Ankylosing Spondylitis is best managed with a combination of medication and physical therapy. Just like the right treatment is important, staying physically active is also equally necessary to live well with Ankylosing Spondylitis.^[1]

Exercises or physical therapy in Ankylosing Spondylitis serves 3 purposes:

1. Helps maintain posture:
   Ankylosing Spondylitis causes pain and stiffness, but, if left unchecked over a period, is known to cause spinal joints to fuse leading to formation of ‘bamboo spine’. A person with bamboo spine is typically bent forward and is unable to move freely.^[2][3]

Exercises designed to help initiate change in posture, especially during the early stages of Ankylosing Spondylitis are very crucial in maintaining the right posture.^[3]

2. Helps improve mobility:
   Mobility is directly related to pain, stiffness and improvement in physical function. Research has shown that regular exercises can reduce the immobility which is the hallmark feature of Ankylosing Spondylitis.^[3]
3. To improve respiratory functions:
   Fusion of spinal bones of the upper back may lead to limited movements of the chest wall, thus restricting the ability to breathe. Cardiorespiratory fitness, therefore, forms a very important part of the exercise routine.^[3]

Keeping these 3 parameters in mind, a physiotherapist can plan a routine exercise program that can improve posture, mobility and respiratory function for patients with Ankylosing Spondylitis.

Exercise now forms an essential part of Ankylosing Spondylitis management and has a great influence on the outcomes of the disease. Persons with Ankylosing Spondylitis are encouraged to exercise regularly and include different forms of exercise in their routine.

Ask your Physiotherapist to design an exercise routine that suits your specific needs.

Ask your Rheumatologist for biologics that slow down spinal fusion.

References

1. What is Ankylosing Spondylitis (AS)? Available [online] at URL: https://www.everydayhealth.com/ankylosing-spondylitis/guide/#duration. As accessed on February 11, 2020
2. Sieper J, et al. Ann Rheum Dis 2002;61(Suppl III):iii8–iii18
3. Nolte K and van Rensburg CJ. Int Spor Med J. 2001;2(4)

Simple tips to help you sleep better at night

Do you lie awake at night trying to coax your aching body into a comfortable position? You are not alone. Sleep disturbances have been observed in almost 80% of those diagnosed with Ankylosing Spondylitis and could be attributed to various factors like pain, stiffness and limited movement.^[1] Also, symptoms of Ankylosing Spondylitis may be triggered after prolonged periods of rest, which could further impact sleep.^[2]

Sleepless nights have a significant impact on your productivity during the day, so it’s essential that you get a good night’s sleep.

Try these simple tips to help you sleep better:

1. Effective medications to control pain:
   Be compliant to the medication schedule prescribed by your Rheumatologist.^[3]Newer therapies called biologics are available that can help you combat symptoms of Ankylosing Spondylitis effectively.^[4]Lesser pain and stiffness will help you get a restful sleep.^[3]
2. Maintain the natural curvature of your spine while sleeping
   Small changes in your sleeping position will help you.^[2]

• Sleep on your back:Sleeping on your back may provide temporary relief from pain and stiffness.^[2]
• Avoid a high pillow:Elevating your neck may alter the curvature of your spine and can aggravate pain. So, the best option is to sleep without any head support, but if you are uncomfortable, you can use a thin pillow to support your neck. Avoid tucking pillow under your back or legs.^[2]
• Invest in a good mattress:Mattresses are your new best friend so choose the right one. A sagging mattress provides an uneven sleeping surface and will cost you your sleep. The ideal mattress should be firm with an even surface. (You can check if your mattress is sagging by taping a taut piece of string along the length of the mattress.) Take pains to choose a comfortable, supportive mattress and it will serve you well.^[2]
• Get moving:Stretching exercises or a brisk walk early during the day will help you get better sleep at night.^[2][3]
• Keep track of pre-bedtime activities:Consumption of caffeinated beverages or exposure to blue light from television or mobile screens can make it harder to fall asleep. Consider a relaxing bedtime routine and gift yourself a restful sleep and a productive day that follows.^[2]

Remember, you deserve a good night’s rest so that you can tackle the day better.

Sleep well, live well. Fight The Fuse.

Ask your Rheumatologist for biologics that slow down spinal fusion.

References

1. Yolbas S, et al. Turk J Med Sci 2017;47:1198-1205
2. Deardoff WW.How to Sleep Better if You Have Ankylosing Spondylitis. Available [Online] at: https://www.arthritis-health.com/blog/how-sleep-better-if-you-have-ankylosing-spondylitisAccessed on 5 June 2019
3. Spriggs BB. 8 Tips for a Better Night’s Sleep When You Have Ankylosing Spondylitis. Available [Online] at: https://www.healthline.com/health/ankylosing-spondylitis/better-night-sleep#5Accessed on 5 June 2019
4. Sieper J, et al. Ann Rheum Dis 2002;61(Suppl III):iii8–iii18

Components of an Ideal Exercise Program

In addition to the medication, exercise is recommended as an integral part of the management of Ankylosing Spondylitis. Together they can help preserve mobility and delay spinal fusion.^[1]

An ideal exercise routine will compose of the following parts:

• Strength Exercises :Helps sustain and increase strength in your muscles so that it is easier to maintain the right posture.^[2]
• Breathing Exercises :Helps to keep your rib cage flexible.^[2]
• Mobility and Flexibility Exercises :Helps work out your joints through the available range of motion and stretches each muscle group for better balance and movement.^[2]
• Cardiovascular exercises:Helps your overall fitness and increases oxygen intake.^[2]

Another important factor that should be considered is the intensity, duration and frequency of the exercises. A study demonstrated that people with Ankylosing Spondylitis who did 4 to 6 hours of exercise every week, experienced fewer symptoms (like pain and stiffness) as compared to those who did not exercise at all.^[1]

Together with your Physiotherapist, you can plan a daily exercise routine that will combine these exercises and help you effectively fight spinal fusion.

In a nutshell, it is important to note that exercise forms an integral part of the Ankylosing Spondylitis management. However, it’s the consistency in exercise that counts the most. Regular exercises will ensure better results.

Join the movement, exercise regularly, take the right medication and Fight Spinal Fusion.

Ask your Rheumatologist for biologics that slow down spinal fusion.

References

1. Nolte K and van Rensburg CJ. Int Spor Med J. 2001;2(4)
2. Back to Action. NAAS. Available [Online] at: https://nass.co.uk/wp-content/uploads/2018/08/Back-to-Action-low-resolution-version.pdfAccessed on 7 May 2019