What to Expect in Ankylosing Spondylitis Physical Therapy

Medically reviewed by Amy Kwan, PT, DPT

Physical therapy is a common treatment used for ankylosing spondylitis. It helps to:

• Reduce pain

• Improve mobility

• Minimize stiffness

This article will cover the benefits of ankylosing spondylitis physical therapy and what to expect during ankylosing spondylitis physical therapy sessions. It will also discuss pain management techniques to stay comfortable.

Benefits of Ankylosing Spondylitis Physical Therapy

One of the primary treatments for ankylosing spondylitis is exercise. Exercise guided by a physical therapist (PT) has been shown to provide:

• Pain relief

• Spinal mobility

• Functional capacity

• Stiffness

A PT can help to prevent and/or correct postural deformities.

Learn More:How to Manage Pain With Ankylosing Spondylitis

What to Expect During Physical Therapy Sessions

When you work with a physical therapist, you will learn specific exercises and stretches to improve function. A physical therapist will assess your needs and determine your limitations. Once an assessment is complete, the physical therapist will guide you through the movements.

After the session, you usually are given a set of exercises and stretches to do at home.

A physical therapist will create an at-home plan individualized to your needs and goals. This plan is generally provided in a handout at the end of the physical therapy session. Don't hesitate to ask your therapist to clarify how to do the exercises.

If you have had surgery for ankylosing spondylitis, your healthcare provider may recommend seeing a physical therapist. The PT will work with the person to regain range of motion and strength in a safe way after surgery.

Posture Training

Ankylosing spondylitis causes inflammation in the spine that can also lead to bone formations that fuse the spine. People with the condition may have a stooped posture to compensate for the pain and stiffness.

A physical therapist may use posture training exercises to help restore mobility and proper posture in people with ankylosing spondylitis. These exercises will focus on strengthening the lower back and shoulder blades to help improve posture and movement.

Flexibility Exercises and Stretching

Stretching and flexibility exercises benefit you by supporting your mobility and range of motion. When you have ankylosing spondylitis, your ability to move may decline, increasing your risk of joint fusion. Also, when joint inflammation occurs, the nearby muscles tighten to control the motion. This causes even more pain and stiffness.

As a result, stretching and range of motion exercises should be done every day on joints that are still or can become stiff.

Learn More:Will Yoga Help Ankylosing Spondylitis?

Strength Exercises

In people with ankylosing spondylitis, strengthening exercises are key in supporting their core and maintaining overall muscle strength.

The core muscles, which include the abdominal and back muscles, support your spine. Having strong core muscles can reduce stress on the spine and pain. Strengthening exercises are ones in which you are moving against resistance or weight. These exercises should be done two to four times per week with the guidance of a physical therapist.

Aerobic Exercise

Aerobic exercises increase blood flow through the heart and improve lung and heart function as well as your overall health. Other ways that aerobic exercise benefits people with ankylosing spondylitis include:

• Improve breathing function

• Increase endurance

• Better mood

• Less pain and fatigue

The Spondylitis Association of America recommends performing aerobic exercises three to five times per week for an approximate total of 75 to 150 minutes each week.

Balance Exercises

Maintaining a strong core and proper balance are at the base of safe movements. In less active people, these stability exercises are extra important. Balance exercises reduce the chance of falls. A physical therapist can help design balance exercises that are both safe and effective while helping those with ankylosing spondylitis reach their physical goals.

Patient Education and Pain Management

Physical therapists are trained to educate patients on exercises to improve their condition. This education is completed through in-person appointments and handouts that can be reviewed at home.

A 2019 study showed that ankylosing spondylitis symptoms improved in people with an exercise program compared to those who did not exercise. Each person will have different needs; that is where a physical therapist can come in and create an exercise program for your individual needs.

Exercise and stretching are key to a holistic approach to ankylosing spondylitis. But medication and proper nutrition are also part of the equation. There are several medications available that can slow down the progress of the condition and help manage the symptoms.

They include nonsteroidal anti-inflammatory drugs (NSAIDs), TNF (tumor necrosis factor) inhibitors, and others. A healthcare provider will guide your through treatment options to provide the best results.

How to Find a Physical Therapist

One of the best ways to find a physical therapist is through a referral from your healthcare provider. They will know which physical therapists specialize in ankylosing spondylitis and are in the area. If your healthcare provider is unable to find a physical therapist for you, ask for a referral to a social worker. They can guide patients through the healthcare system and find the necessary assistance.

Summary

Ankylosing spondylitis is a chronic condition that causes back pain and stiffness. One of the recommended treatments is exercise and stretching. Exercise and stretching will help patients reduce symptoms and maintain their range of motion. A physical therapist is trained to guide patients through an exercise program to provide them with the best results.

Frequently Asked Questions

Do you need to work with a special type of physical therapist?

People with ankylosing spondylitis do not need to work with a special type of physical therapist, but it is helpful to work with a PT who is familiar with the disease's limitations and progression.

How long do you need to do physical therapy for AS?

How long someone with ankylosing spondylitis needs physical therapy will vary based on their healthcare provider's recommendations. Individual sessions generally last from 30 minutes and one hour.