Ankylosing Spondylitis and Chiropractic

Ankylosing Spondylitis is in inflammatory disease which affects more men than women. In this, the vertebrae in your back tend to fuse together causing a hunched posture and lack of flexibility. In some cases, ribs may also get affected causing difficulty in breathing.

More than 1 million cases per year (India)


Early signs and symptoms of ankylosing spondylitis might include pain and stiffness in your lower back and hips, especially in the morning and after periods of inactivity. Neck pain and fatigue also are common. Over time, symptoms might worsen, improve or stop at irregular intervals.

The main presenting complaints in the early stages are lower back pain with morning stiffness that often wares off during the day with activity. In some cases the inflammation can be so severe that the pain is constant and severely disabling, but this is rare.

The pain and stiffness can progress to affect the mid back and neck, and in about a quarter of people with AS it affects the joints in the limbs, with the hips being the most common, affecting half the people with AS.

If the chest and ribs are affected, it can make it difficult to take a deep breath. The legs can become weak and numb if certain nerves are pinched or trapped but this is very rare.

The  areas most commonly affected are:

The joint between the base of your spine and your pelvis (sacroiliac)
The vertebrae in your lower back
The places where your tendons and ligaments attach to bones (entheses), mainly in your spine, but sometimes along the back of your heel
The cartilage between your breastbone and ribs
Your hip and shoulder joints

Things That May Be Making Your Ankylosing Spondylitis Worse

Sedentary lifestyle : When you’re living with chronic back pain, exercise may seem impossible, but leading a sedentary lifestyle could aggravate symptoms. Physical activity can help improve joint flexibility and lessen the pain and stiffness caused by AS.

Poor posture  : Poor posture can also worsen AS. Keep your body properly aligned to strengthen your back muscles, help prevent anterior flexion deformity (where your spine is fixed in a stooped position), and alleviate pain.

Smoking  : Studies such as this one have found a link between smoking and disease activity in people with AS. This study followed nonsmokers and smokers living with AS (a total of 30 people). According to researchers, smokers with AS reported longer bouts of morning stiffness, higher disease activity, and a poorer quality of life compared with their nonsmoking counterparts.

Doing too much  : Because this condition can cause inflammation, stiffness, and joint pain, it’s important that you don’t overdo it and learn how to recognize your limitations. Failure to pace yourself could result in burnout, or you might engage in activities that put too much strain on your joints. This can make it harder for your body to recover and trigger long-term stiffness and joint immobility.

Being overweight  : Being overweight may also worsen symptoms of AS. Excess weight can put too much pressure on your joints and raise your pain level. As well, obesity is associated with increased inflammation. Adding physical activity to your schedule can help you shed excess pounds. You should also modify your diet.

Lack of sleep  : Sleeping is hard when you\’re in pain. You may have trouble falling asleep, or you may wake up frequently throughout the night. Sleep is how your body repairs itself, so lack of sleep may worsen AS symptoms.

Chronic stress  : Stressful situations may also unknowingly worsen symptoms of AS. Stress triggers the release of stress hormones like cortisol and adrenaline, which send your body into fight-or-flight mode.

This increases your blood pressure and heartbeat, and stress hormones stimulate your immune system to release cytokines (a chemical in your body that causes inflammation). Chronic stress can keep your body in an inflammatory state and worsen AS.

Indulging in alcohol  :  “There are a few reasons alcohol is bad for people with ankylosing spondylitis,” Dr. Mir says. “For one, it disrupts the ratio of good to bad bacteria in the gut, and a lot of autoimmune diseases tend to be related to gut health.” Second, many alcoholic beverages contain gluten, \”and many people with ankylosing spondylitis are sensitive to gluten,” he says. A good alternative is green tea, which has anti-inflammatory properties, according to the Arthritis Foundation.

Eating too much sugar  : “Sugar disrupts insulin levels, which are connected to the hormone activity that affects flares in people with ankylosing spondylitis,” Mir says. “Processed and canned foods contribute to our overall inflammation levels as well.” Instead, he recommends eating plenty of fresh fruits and vegetables and taking fish oil supplements, all of which haveanti-inflammatory effects on the body. “Probiotics to help heal the guts of people with ankylosing spondylitis,” he says. You can get probiotics in yogurt and other dairy products, juices, powders, and capsules, according to the American Gastroenterological Association. Talk with your doctor about choosing the right probiotics for you.

About Chiropractic Care for Ankylosing Spondylitis

The traditional hands-on manipulations used in chiropractic care involve moving the joints around in order to achieve therapeutic goals, such as easing pain and correcting alignment problems.

Safer Chiropractic Approaches for Ankylosing Spondylitis

For a person with AS, the spine may have become fused, and this makes it more susceptible to injury, Dr. Fox says. That’s why people with ankylosing spondylitis who are interested in chiropractic care should find a chiropractor who has experience specifically with AS and using gentler techniques, “A skilled chiropractor can use non-forceful techniques that are respectful of the spine and other joints,”

Instead of forcibly adjusting joints, for people with ankylosing spondylitis, chiropractor focuses on keeping soft tissues around a joint mobile and on helping people learn exercises that get them moving more smoothly when they get out of bed in the morning.

As an example of a non-forceful approach to keep the pelvis in line, instead of directly pushing the bones and joints, chiropractor uses the body’s own weight and the placement of specialized blocks to ease alignment.

Although chiropractors are best known for their bodywork, the goal of chiropractic therapy is to address the whole person. Chiropractors might also suggest diet changes and identify specific nutritional deficiencies. However, research about diet and inflammatory diseases such as AS is still limited, so suggestions for such changes shouldn’t be considered as proven medical advice for ankylosing spondylitis treatment.

The chiropractor will show you exercises designed to strengthen your back, improve posture, increase flexibility, range of motion, and techniques to improve your breathing. We normally also use spinalmanipulation of a kind that is safe and comfortable for you.

Because chiropractors specialise in treatment of lower back pain and usually have X-ray facilities on-site we often pick up when patients have AS early on.

Unfortunately, in some cases patients in past have been told by their medical practitioner that chiropractic treatment is not appropriate for them. But it is important to know that chiropractic treatment is a very helpful, safe and effective way of managing your AS.

We have had several patients over the years that have found that chiropractic treatment has maintained their mobility, improved their function and therefore helped to control their pain.

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