At this stage in our patient-doctor relationship, we are past the whining syndrome. Gone are the days where I presumed the more symptoms I declared the more apt he will be able to find an answer to my woes. Not so, my friends. Instead I acquired mounds of paper work and extensive phone notes (so I can remember what to ask) that never seem to be answered. The sad rule of thumb I've learned is that no one knows why most of my symptoms occur especially him.
I now sit motionlessly the new keen observer of symptoms that can be actually measured and diagnosed. Those are the symptoms I share at this point. He initiates the dialogue now as I sit braced for impact. "Your recent MRI shows more degeneration in the lower vertebrates on your back, we now have bulging discs, more inflammation and the beginning of Ankylosing Spondylitis. One of your bulging discs is maneuvering its way a half inch up your spine and may have caused you that severe pain in your back last month that..........."
"Wait, hold up, anklo what?" I asked. This was a new term that I had not been privy to before.
"Ankylosoing Spondylitis is the fusion of your vertabrates in your back from inflammation. Just a moment let me show you on the skeletale vertabrate I have here....., " he begins.
Ankylosing spondylitis is an inflammatory disease that, over time, can cause some of the vertebrae in your spine to fuse. This fusing makes the spine less flexible and can result in a hunched-forward posture. If ribs are affected, it can be difficult to breathe deeply.
Ankylosing spondylitis affects men more often than women. Signs and symptoms typically begin in early adulthood. Inflammation also can occur in other parts of your body most commonly, your eyes.
There is no cure for ankylosing spondylitis, but treatments can lessen your symptoms and possibly slow progression of the disease.
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 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
When to see a doctor
Seek medical attention if you have low back or buttock pain that came on slowly, is worse in the morning or awakens you from your sleep in the second half of the night — particularly if this pain improves with exercise and worsens with rest. See an eye specialist (ophthalmologist) immediately if you develop a painful red eye, severe light sensitivity or blurred vision.
Natural treatments for Ankylosing Spondylitis
There isn’t a cure for AS. It’s a lifelong condition, but effective treatments are available. Treatment goals are to minimize pain and stiffness and reduce flares. Natural treatments may be used on their own or with traditional AS treatments.
These 10 natural therapies may help relieve symptoms:
Stretching helps build flexibility and may reduce pain. Consider adding the spine stretch or the low-back rotation stretch to your daily routine.
2. Heat therapy
Apply a hot water bottle or heating pad to the affected area to reduce stiffness and pain. You may also use moist or dry heat. A warm bath may also help, especially before exercise. Don’t use heat therapy without consulting your doctor if you have diabetes, deep vein thrombosis, vascular disease, an open wound, or a skin condition such as dermatitis.
3. Cold therapy
Applying an ice pack, cold gel pack, or a bag of frozen vegetables to painful joints can help reduce swelling. After exercise, cold therapy may help reduce inflammation. Don’t apply ice for more than 20 minutes at a time. Don’t use cold therapy without consulting your doctor if you have circulation problems.
Acupuncture is an ancient remedy for pain. It involves inserting thin needles into specific points in your skin. This is thought to activate your body’s pain-relieving hormones. Some people report acupuncture relieves AS pain.
5. Massage therapy
Massage helps you relax. It may also help you feel more flexible or “loose” so that you can exercise or stretch. Massage may cause pain at tender points around your spine. If this happens, avoid those areas and only use light massage techniques until the pain improves.
The more you sit, the stiffer you’re likely to feel. Get up, move around, and stretch regularly. If you have a desk job, take a “get up and move” break every hour.
Gentle exercise programs such as yoga and Pilates are great for AS because they incorporate stretching. Swimming may also be beneficial because it’s easy on your joints. Strengthening exercises with weights can help build muscle, which supports joints affected by AS. Talk with your doctor or a physical therapist to determine the best exercise plan for you.
8. Alexander Technique
AS often leaves you hunched over. Practicing good posture is critical. The Alexander Technique teaches you to be aware of your posture throughout your day. It also teaches you how to correct poor posture and may be helpful for people with AS. To find a qualified teacher, visit the official website.
9. TENS therapy
TENS stands for transcutaneous electrical nerve stimulation. This therapy uses electrical current to stimulate nerves through the body for pain control. Electrodes are usually applied at the pain site and connected to a TENS machine. It’s thought that when TENS stimulates nerves, it overrides pain signals. The TENS technique is usually taught by a physical therapist and may be continued at home.
10. Stop smoking
Smokers, especially men, are at risk for greater spine damage from AS than non-smokers. Quitting smoking not only helps reduce AS damage, but also improves your overall health.
Natural ways to improve sleep
A good night’s sleep can often be an elusive goal if you have AS. Pain may be worse at night due to inadequate bedding. Your mattress should keep your spine straight when you lie on your side. Your mattress should also allow your spine to have an “S-curve” when you lie on your back.
Try these tips for a good night’s sleep:
- Use a medium-firm mattress, which can mold to the shape of your spine.
- Use only enough pillows to keep your neck aligned.
- Use heat therapy before bed to help reduce pain.
- Don’t sleep with a pillow between your legs.
Traditional treatments are also used to manage pain, reduce stiffness, and help prevent flares. Several types of medications may be used.
NSAIDs are anti-inflammatories that reduce pain. Ibuprofen, naproxen, and aspirin are NSAIDs. Corticosteroids may be offered when AS symptoms are severe and don’t respond to other medications. They also help reduce inflammation and pain. Corticosteroids are usually injected into the affected joint for fast pain relief.
Disease modifying anti-rheumatic drugs are used to help slow down the inflammatory process. Examples include sulfasalazine and methotrexate. These drugs are used for long-term treatment.
Biologic agents are used to block proteins that cause inflammation. Seven different biologics are approved by the U.S. Food and Drug Administration to treat AS:
- adalimumab (Humira)
- etanercept (Enbrel)
- golimumab (Simponi)
- infliximab (Remicade)
- Certolizumab pegol (Cimzia)
- Secukinumab (Cosentyx)
- Infliximab-dyyb (Inflectra)
These drugs are injected or given intravenously.
Although most people require some type of medical therapy for AS, natural remedies may also help reduce symptoms.
Not all alternative treatments are right for everyone with AS. Some people may have success with yoga and acupuncture. Others may feel better using cold therapy and massage.