Ankylosing spondylitis treatment guidelines, diet, and exercise tips

By: Dr. Victor Marchione | Arthritis | Thursday, March 17, 2016 - 03:00 PM

Ankulosing spondilitis treatment guidelinesAnkylosing spondylitis (AS) can be improved with a healthy body weight and exercise. Ankylosing spondylitis is a type of inflammatory arthritis that mainly affects the spine and can lead to pain, fatigue, and stiffness. But research has shown regular exercise can help improve it.

The American College of Rheumatology (ACR) outlined recommendations for patients with ankylosing spondylitis. Principal investigator Michael Ward said, “The ACR’s primary objective was to provide recommendations on optimal treatment for patients with AS and non-radiographic axial SpA [spondyloarthritis] that were based on quality evidence and took into consideration patient values and preferences. While the guideline does not cover all aspects of spondyloarthritis management, it provides a foundation based on the current best-available evidence.”

The guidelines not only discuss the broad spectrum of ankylosing spondylitis treatments. The investigators also included the Grading of Recommendations Assessment, Development, and Evaluation approach (called GRADE), which specifications for different patient groups, interventions, competing treatment alternatives and outcomes, grading the quality of evidence used, and basing recommendations on benefits and harm.

Recommendations are placed into one of five categories: recommendations for the treatment of patients with active AS (pharmacologic and rehabilitation), recommendations for the treatment of patients with stable AS (pharmacologic and rehabilitation), recommendations for the treatment of patients with either active or stable AS, recommendations for the treatment of patients with AS and specific impairments or comorbidities (such as advanced hip arthritis, severe kyphosis, acute iritis, and inflammatory bowel disease), education and preventive care recommendations; and recommendations for the treatment of patients with non-radiographic axial SpA.

Each category contains recommendations regarding pharmaceutical and non-pharmaceutical interventions followed by supporting evidence.

Treating ankylosing spondylitis: Healthy diet tips

Following a healthy diet has been shown to help relieve symptoms associated with ankylosing spondylitis. Here are the foods most beneficial for those with ankylosing spondylitis – and foods that you should avoid in your healthy diet.

  • Go for Omega-3 foods: flax seeds, walnuts, soybean, Brussels sprouts, kale, cold water fish.
  • Eat more fruits and vegetables.
  • Stock up on whole foods and grains.
  • Eat probiotic-rich foods: yogurt, fermented foods.
  • Stick with a low-starch diet.
  • Eliminate sugar, sodium, and fat: added sugars, processed foods, saturated fat, trans fat, preservatives.
  • Cut down on dairy – for some people, it triggers further inflammation
  • Limit or avoid alcohol.

Treating ankylosing spondylitis: Exercise tips

For many ailments, resting in bed is generally the go-to recommendation. But for those living with ankylosing spondylitis, laying still in bed and resting can worsen symptoms. Therefore, it’s important to exercise and keep moving.

Exercises should focus on the back, chest, and limbs. but be mindful and know your limits – overdoing it can cause more pain. Here are some useful exercises for those with ankylosing spondylitis:

  • Stand with your back flat against the wall. Slowly put your head into the wall, but do not tilt it forward. Hold for five seconds, release, and repeat.
  • Stand with feet shoulder width apart and place your hands on your waist. Turn your upper body as if you are looking to the side, but feet are still pointing ahead. Hold this position, release, and repeat. Make sure you do this on both sides and focus on your breathing.
  • Lay on your back, knees bent, feet flat on the ground. Place your hands on your ribs and breathe deeply so your ribs are pushing against your hands. Then place your hands on your chest and repeat.
  • Lay on your stomach, looking straight ahead, hands by your side. Raise one leg up and opposite arm up out in front at the same time and hold. Release. Switch arms and legs and repeat. When you’re laying on your stomach with hands by your side, attempt to raise your chest, shoulders, and head, but keep the legs on the ground.
  • On you hands and knees, lift your opposite leg and arm and extend out. Hold this position, release, and switch sides.

ankylosing-spondylitis-arthritis-inflammation-effects-increase-with-physically-demanding-workExercises to avoid ankylosing spondylitis

Although exercise can benefit patients with ankylosing spondylitis, some exercises should be avoided as they can cause more harm than good. Such activities include step aerobics, running, heavy weight lifting, kick boxing, burpees, cross training, jumping, sit ups, and leg lifts. These types of exercises put stress on the back and spine which can worsen symptoms and increase the risk of injury.

Speak with your doctor prior to starting on a workout routine to ensure it is safe for you. You may also want to begin with a visit to physiotherapist to get a good idea of how to perform certain movements. Lastly, let your body be your guide – if it doesn’t feel right, discontinue the exercise.

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