What is Ankylosing Spondylitis?
Ankylosing spondylitis is a type of arthritis that creates the onset of a lot of pain and stiffness in those who are unfortunate enough to have it. Sufferers can try alternative care, such as chiropractic, as a natural and safer form of relief from the effects of arthritis. In ankylosing spondylitis, the arthritic condition affects the spine. It can cause “pain and stiffness from the neck down to the lower back”. If the vertebrae become fused, the spine will become rigid, creating further difficulties in the patient’s quality of life. In severe cases, the posture of the patient becomes stooped. The people who are most likely to be susceptible to the condition are men in their teens and early adulthood. Women are more likely to experience a milder version. Ankylosing spondylitis affects about 0.1-0.5% of adults.
Symptoms of the arthritic condition could include pain in the tendons and ligaments, also known as tendonitis, and stiffness, especially with low back pain, hip pain, and the sacroiliac joints (SI joints) that join the sacrum, which is the lowest part of the spine, to the ilium bone (of the pelvis). Bony fusion, where the bones are overgrown and abnormally joined, can also occur. This can affect many regular activities, including breathing. There are additional symptoms that will probably occur throughout the body. These include fatigue, fever, eye inflammation, appetite loss, and, rarely, heart and lung problems. The cause of this disorder is not fully known. However, there is a family link, and there may be a relationship to the HLA-B27 gene as well.1
Ankylosing spondylitis can be treated with exercises, occupational therapy, and physical therapy, and doctors may prescribe NSAIDs (ibuprofen, naproxen, aspirin) and DMARDs (methotrexate). To reduce pain, inflammation, and stiffness, doctors may prescribe the new biologics (Enbrel, Humira, etc.) or even the antidepressant Cymbalta. Doctors may also advise steroid injections.
For those with advanced knee and hip joint diseases, artificial joint replacement may be a surgical option. Surgeries and medications, though they might be effective, are not options that should be taken lightly, as they both also come with potential risks. Unless absolutely necessary, these expensive and potentially dangerous options may not have to be the first and only forms of treatment. Patients with ankylosing spondylitis should avoid smoking. They should also be careful about jumping or falling, as the impact can lead to injury in those with a rigid back. Patients should consider sleeping on their back on a firm mattress, making sure not to use large pillows (as it may contribute to neck fusion). Avoid propping the legs with pillows (as it may lead to knee or hip fusion).2
For those patients wishing to avoid costly prescriptions and surgery, or for adjunct therapy, alternative treatment options may be another answer for ankylosing spondylitis. Massage, yoga, acupuncture, and chiropractic care can all provide relief.
Chiropractors may employ TENS (transcutaneous electrical nerve stimulation).3 Patients can learn exercises to strengthen the back, and they can work to increase flexibility and range of motion. Improving posture and breathing are also important. Chiropractors may employ aspects of physical therapy routines in their treatment.4 Patients need to have mobility in their joints and spine. Very often chiropractors will work with rheumatologists or other medical specialists to co-manage care for patients with this disorder.5 Case studies have shown chiropractic care to be beneficial in patients with ankylosing spondylitis. Further research is recommended.6,7 The most important thing is to keep patients moving and exercising, but in a safe way that limits the risk of fractures.8
Massage for Ankylosing Spondylitis
Another option for alternative treatment is massage therapy. It is very common for massage to be used as a complementary treatment option to chiropractic care. A lot of offices run by chiropractors feature a room for massage therapy. The chiropractor themselves could also recommend a local massage therapist to the patient. Ankylosing spondylitis often makes the patient very sensitive to pressure. Patients should clear with their primary care practitioner before they go in for massage therapy as a treatment option.
Therapists should massage the muscles and not the joints. Patients should be sure to mention any discomfort that they experience. Soft tissue massage, which involves stretching, circular and long strokes, kneading, and mild sacral rocking, are generally used for treating the arthritic condition. Though styles may vary depending on the patient’s situation and how far along in the condition’s progression they are. Those who are in the later stages of the ankylosing spondylitis are more likely to experience a decrease in pain but an increase in stiffness and immobility. So the techniques used in the massage therapy must be catered individually. Also, the Arthritis Foundation recommends that the patient mentions any other conditions that they might have, such as osteoporosis, high blood pressure, or varicose veins to their therapist.9