Ankylosing spondylitis is a type of arthritis that causes a lot of pain and stiffness. Sufferers can try alternative care, such as chiropractic, for relief.
What is Ankylosing Spondylitis?
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 fuse, the spine can become rigid. In severe cases, the posture of the patient becomes stooped. The people most affected are men in their teens and early adulthood. Women may experience a milder version. 0.1-0.5% of adults are affected. Symptoms of ankylosing spondylitis include pain in the tendons and ligaments (i.e., tendonitis), and stiffness, especially with low back pain, hip pain, and the sacroiliac joints (SI joints) that join the sacrum (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 activities, including breathing. There are additional symptoms throughout the body, including fatigue, fever, eye inflammation, appetite loss, and, rarely, heart and lung problems. The cause of this disorder isn’t known, but 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. Steroid injections may also be advised. For those with advanced knee and hip joint diseases, artificial joint replacement may be a surgical option. Patients with ankylosing spondylitis are advised to avoid smoking, and to 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). Propping the legs with pillows should also be avoided (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 treatments 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 physical therapy 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