Exercise for Inflammatory Arthritis of the Spine (Ankylosing Spondylitis)
Ankylosing Spondylitis (AS) is an inflammatory condition that affects the spine and surrounding joints. Exercise is a very important part of your treatment program; starting early and at the right level is the key to success. In earlier stages of progression, people find that the stresses on the body in sports such as tennis or golf may cause pain. Instead of stopping activity to avoid pain, try modifying your exercise program so that you are giving enough attention to other fitness components, such as flexibility and core stability training, to allow appropriate recovery between exercise or sports sessions. Many people with AS find swimming an excellent cross training exercise for both mobility and strength, that also helps them stay active in their favorite sports.
AS primarily impacts one’s quality of life, mobility, and ability to be physically active. If you, or someone you know, could have AS then you may be aware that leading health authorities agree that the most effective thing you can do to manage AS is exercise.
Although AS has historically been thought to affect men more frequently than women, we now know that symptoms can be very different in women, making them much more difficult to diagnose. Moreover, diagnosis is not an easy process because there are many illnesses that share similar symptoms. Although further blood and imaging tests are required to diagnose AS, or rather to rule out other illnesses, it is important to seek medical consultation early – the average delay in diagnosis in Canada is 9 years.
Aside from experiencing pain, many people with AS can also feel uneasy during activities which makes them feel unsafe. These feelings can cause you to limit the exercises or sports that you enjoy. Despite these feelings it is important to keep active as being too sedentary can contribute to increased progression of the disease and stiffening of the spinal joints. A Therapeutic Fitness program will help you to find safe and effective exercises that maintain your flexibility and mobility. This program will allow you to continue to enjoy the activities you enjoy and help you to maintain your quality of life. Being active also has a positive psychological impact which can also be an important factor in managing AS.
In addition to exercise, medication is often important in the management of this condition. Despite recent cautions against using NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) before or after exercise, NSAIDs are an important first line of drug therapies to help control joint inflammation and swelling. This is because Ankylosing Spondylitis is an inflammatory condition that responds differently to these medications than normal muscle strains or overuse. These medications can help you to exercise and move with greater ease, so that you can delay or limit the stiffening and pain in your back. For more moderate to severe cases, cortico-steroids may be prescribed to manage the inflammation. More recently, drugs called “biologics” have been found to be particularly helpful and not only control symptoms but can reduce the progression of the disease. They work by controlling the uptake of TNF (Tumour Necrosis Factor), a certain hormone that has been found to increase inflammation in the tissues which is one of the causes of pain and stiffness.
Monitoring and follow-up are key to getting consistent results. While x-rays and blood work are important for diagnosis, your health practitioner may use one or more measurement scales such as the BASMI (Bath Ankylosing Spondylitis Measurement Index), BASDI (Bath Ankylosing Spondylitis Spine Disability Index), or BASFI (Bath Ankylosing Spondylitis Spine Functional Index) to track the progress of your condition. These tests provide meaningful measurements of your physical condition during treatment so that your program can stay on track.
Working with a team, such as at the Orthopaedic Therapy Clinic, provides allows consistent follow-up with a your primary health professionals to help you to track your mobility and any changes in your posture. Our integrated model of care ensures that we stay in contact with your rheumatologist or family physician so that everyone is playing on the same team - YOURS!
Did you know?
We are proud to be a clinical research partner with the Toronto Western Hospital to improve the diagnosis of Ankylosing Spondylitis.