5 Ways to Help Fight Ankylosing Spondylitis Progression
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If you are one of the approximately 1.5 percent of Americans who have been diagnosed with axial spondyloarthritis (axSpA)—a chronic inflammatory rheumatic disease that can cause pain, stiffness, and fatigue—you know the overwhelming feelings that arise when symptoms flare up. It can be equally distressing to consider that these issues could become worse in the future. The progressive nature of the condition can lead to a sense of helplessness and lack of control, says Harry Fischer, MD, a rheumatologist at Northwell Lenox Hill Hospital in New York City.
But there’s good news, too. “There are many steps you can take to manage symptoms effectively, and these strategies also have a tendency to slow progression of axSpA, aka ankylosing spondylitis,” Dr. Fischer says. “Conversely, if you aren’t on top of your treatment and management, it might speed up that progression.”
In terms of what hits the brakes instead of the gas pedal, here are the top five factors.
1. Get Physical Activity
“Movement is medicine” is a common adage, and that’s certainly the case with axSpA, says Dr. Fischer. “Getting exercise in various forms, including aerobic activity and strength training, is a foundational part of managing axSpA,” he adds. “This can have profound effects not just on progression, but on your current health.”
According to a research review of exercise’s effect on axSpA, movement has positive effects on pain, stiffness, mobility, cardiorespiratory function, and disease activity for individuals living with the condition. This is why regular exercise is included in international recommendations for the management of axSpA.
How long does it take to see results? Preliminary research published in the British Journal of Sports Medicine suggests that three months of high-intensity exercise may reduce pain, fatigue, and stiffness, as well as inflammation, in people living with axSpA. This is something that you will want to discuss with your doctor before adopting this type of workout routine, as your health history and disease progression should be considered.
2. Manage Stress
There are many forms of stress, from work obligations to family difficulties, and of course axSpA can on its own prompt psychological challenges that lower resilience. It isn’t uncommon for people living with the condition to feel a lost sense of self, lower self-esteem, and distress, as well as anxiety about anticipated progression of their symptoms, according to a report in the journal BMC Rheumatology. It also found that there’s a bidirectional relationship between negative emotions and inflammation. That is to say, feelings like these can cause your inflammation to surge, which in turn can make your emotional health (as well as your perception of pain) worse.
Finding ways to de-stress can help break this cycle, and what strategies are most effective will be different for each person, says Dr. Fischer. So it’s worth exploring various options to see what works for you. Consider meditation and mindfulness, deep breathing, yoga, gardening, daily walks outdoors, and any type of break that leaves you feeling refreshed. If tactics like these have minimal impact, talk with a mental-health professional, who can suggest more ways to reduce everyday stressors.
3. Strive For Restful Sleep
Another bidirectional relationship axSpA has is with sleep—when you struggle to get quality sleep or have poor sleep habits, that can increase inflammation, which then makes sleep even more difficult, according to research in Frontiers in Neurology.
Sleep issues can also make you more sensitive to pain and increase feelings of emotional distress. Because of this, it’s important to implement strategies including avoiding caffeine late in the day, getting regular physical activity, limiting screen time before bed, and taking medications as directed.
If problems persist even with healthy sleep habits, talk to your doctor about what else might help, says Dr. Fischer.
4. Consume A Whole Foods Diet
While there is no specific diet recommended to help manage axSpA, eating anti-inflammatory foods such as fruits and vegetables, fatty fish like salmon, whole grains, and extra-virgin olive oil, as popularized by the Mediterranean eating pattern, may help. Reducing consumption of red meat, sugar, and processed foods may also have a positive effect.
And healthy eating can also reduce fatigue, which is a common issue with axSpA, says Ruth Chan, DO, a specialist in immunology and rheumatology at The Ohio State University Wexner Medical Center in Columbus, Ohio. “When fatigue is better controlled, that creates a ripple effect on other healthy behaviors,” she adds. “For example, you’re more likely to sleep better, have more energy for physical activity during the day, and be less stressed overall.”
As healthy lifestyle habits stack up, she says, it becomes easier to manage symptoms, because you tend to feel more in control of your health.
5. Take Your Medications
One of the most essential aspects of managing symptoms and slowing the progression of axSpA will be medication. This includes both over-the-counter anti-inflammatories to control short-term pain and stiffness, and long-term management choices like disease-modifying antirheumatic drugs (DMARDs) and biologics, which can change how your body responds to inflammation.
“When it comes to pain with axSpA, staying ahead of your symptoms is crucial,” says Neel Anand, MD, director of spine trauma at Cedars-Sinai Spine Center in Los Angeles. “Once your pain becomes intense and chronic, it’s much harder to alleviate, and that’s when it can speed up the progression of your condition.”
So, if possible, it’s important to talk with your doctor before symptoms flare, he adds. Having an open and honest discussion with your health team about your symptoms is another crucial way to address progression. Whether you’re feeling distressed and overwhelmed or empowered to make more changes, discuss next steps for managing your axSpA with your doctor, so you can get ahead—and stay ahead—of the condition.
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