Physical Therapy for Ankylosing Spondylitis : A Path to Wellness

Ankylosing Spondylitis (AS) is a chronic inflammatory condition that primarily affects the spine. While there’s no cure for AS, there are various treatment options available to manage the symptoms and improve the overall well-being of individuals living with this condition. One of the most important aspects of managing AS is physical therapy. In this blog, we will explore the role of physical therapy in the management of Ankylosing Spondylitis.

Understanding Ankylosing Spondylitis

Ankylosing Spondylitis is a type of arthritis that mainly affects the spine, causing inflammation of the vertebrae. Over time, this inflammation can lead to the fusion of the spinal joints, resulting in reduced flexibility and mobility.

AS tends to manifest in early adulthood, typically between the ages of 17 and 45. It affects more men than women and is often genetically linked.

Symptoms of AS may include chronic back pain, stiffness, fatigue, and limited range of motion. Early diagnosis is crucial to prevent severe joint damage.

Diagnosing AS involves medical history, physical examinations, and imaging tests like X-rays and MRI. Early detection can help in timely intervention.

The Role of Physical Therapy for Ankylosing Spondylitis

The goal of physical therapy in AS is to help patients manage their symptoms, improve function, and maintain a good quality of life. Here are some key aspects of the role of physical therapy in the management of AS:

1. Pain Management:
   • Physical therapists can use various modalities such as heat, cold, ultrasound, or electrical stimulation to help alleviate pain and reduce inflammation in affected joints.
   • They can also teach patients techniques for managing pain through proper body mechanics and posture.
2. Stretching and Range of Motion Exercises:
   • AS can cause the spine to become stiff and less flexible. Physical therapists can design specific stretching and range of motion exercises to help improve spinal mobility.
   • Exercises may target the spine, hips, and other affected joints to maintain or increase flexibility.
3. Strengthening Exercises:
   • Strengthening exercises are important to maintain muscle strength and joint stability.
   • Physical therapists can develop personalized exercise programs to target muscle groups that support the spine and affected joints. Strengthening these muscles can help reduce pain and improve function.
4. Posture Training:
   • Proper posture is essential for individuals with AS to minimize the risk of developing a forward-bent posture (kyphosis) and maintain an upright posture.
   • Physical therapists can educate patients about correct posture and provide exercises to promote good posture habits.
5. Breathing Exercises:
   • AS can affect the chest wall and lung function. Physical therapists can teach breathing exercises to maintain lung capacity and function.
   • These exercises can also help improve rib cage mobility and reduce chest pain.
6. Education and Self-Management:
   • Physical therapists play a crucial role in educating patients about their condition, including its progression, flare-ups, and management strategies.
   • They can guide ergonomic modifications for daily activities and work environments to minimize stress on the spine.
7. Assistive Devices: Physical therapists can recommend and provide guidance on the use of assistive devices such as braces or walking aids to support mobility and reduce strain on affected joints.
8. Pain Relief Techniques: In some cases, physical therapists may use manual therapy techniques such as joint mobilization or soft tissue manipulation to relieve pain and improve joint function.

Benefits of Physical Therapy

Here are some of the benefits of physical therapy for Ankylosing Spondylitis:

• Improved Mobility: AS can lead to stiffness and reduced range of motion in the spine and other joints. Physical therapy focuses on improving flexibility and mobility through stretching and range of motion exercises. These exercises can help maintain or increase joint mobility and prevent further fusion of the vertebrae.
• Posture Correction: AS often causes changes in posture due to the gradual fusion of spinal joints. Physical therapists can teach individuals proper posture techniques and exercises to help maintain good posture, reducing the risk of deformities and pain associated with poor alignment.
• Education and Self-Management: Physical therapists can educate individuals about AS, its progression, and how to manage symptoms effectively. They can guide adaptive techniques, ergonomics, and lifestyle modifications to reduce the impact of AS on daily activities.
• Pain Reduction without Medications: Physical therapy can offer non-pharmacological pain management strategies, reducing the reliance on pain medications that may have side effects or long-term risks.
• Prevention of Complications: By addressing mobility limitations and postural issues early on, physical therapy can help prevent complications associated with AS, such as spinal deformities and decreased lung capacity.

Types of Physical Therapy for Ankylosing Spondylitis

Here are some types of physical therapy interventions commonly used for individuals with AS:

Passive vs. Active Physical Therapy

The choice between passive and active physical therapy for Ankylosing Spondylitis (AS) often depends on the individual’s current condition, pain levels, mobility, and overall treatment goals. Here’s how passive and active physical therapy can be applied in the context of AS:

Passive Physical Therapy for Ankylosing Spondylitis:

• Manual Therapy: Hands-on techniques like joint mobilization and soft tissue massage may help improve joint mobility and alleviate pain in affected areas.
• Assistive Devices: In some cases, assistive devices such as braces or lumbar supports may be recommended to help stabilize the spine and reduce pain during periods of rest or activity.
• Passive Stretching: Passive range of motion exercises may be used to gently stretch and maintain joint mobility in cases where active movement is limited due to pain or stiffness.

Active Physical Therapy for Ankylosing Spondylitis:

• Active Range of Motion (AROM) Exercises: These exercises encourage patients to actively move their joints and muscles within their pain-free range to improve and maintain mobility.
• Cardiovascular Exercise: Aerobic activities like walking, swimming, or stationary cycling can help maintain cardiovascular fitness and overall health. These activities should be low-impact to avoid putting excessive stress on the spine.
• Functional Training: Active physical therapy can include activities and exercises that are specifically tailored to help individuals with AS perform their daily tasks and activities more effectively and with less discomfort.

Exercises and Stretches

Here are some exercises and stretches that are commonly recommended for individuals with AS:

1. Deep Breathing Exercises:

• Deep breathing exercises can help improve lung capacity and reduce the risk of chest wall involvement associated with AS. Try diaphragmatic breathing, which involves inhaling deeply through your nose, expanding your abdomen, and exhaling slowly through your mouth.

2. Range of Motion Exercises:

• These exercises aim to maintain or improve joint mobility. Gentle range of motion exercises can help reduce stiffness in the spine and other affected joints.
• Neck stretches: Slowly tilt your head forward, backward, and to each side. Hold each stretch for a few seconds and repeat.
• Spinal stretches: Sit or stand with good posture and gently twist your upper body from side to side to maintain mobility in your spine.

3. Flexibility Exercises:

• Stretching exercises can help improve flexibility and reduce muscle tension. Hold each stretch for 15-30 seconds and repeat several times.
• Hamstring stretch: Sit on the floor with your legs extended, and reach for your toes. Don’t force the stretch; go only as far as you can comfortably.
• Quadriceps stretch: Stand and bend one knee, bringing your heel toward your buttocks. Hold your ankle with your hand to stretch the front thigh muscle.
• Chest opener: Stand with your arms at shoulder height and palms facing forward. Slowly move your arms backward, opening up your chest.

Hydrotherapy and Heat Therapy

Hydrotherapy involves the use of water for therapeutic purposes. It can be performed in various settings, including warm pools, hot tubs, or whirlpools. Water’s buoyancy reduces the impact on joints, making it a suitable option for individuals with AS.

Heat therapy involves the application of heat to specific areas of the body to alleviate pain and promote relaxation. Heat can be applied using various methods, including hot packs, warm towels, or heating pads.

Breathing Exercises

Here are some breathing exercises you can consider:

Diaphragmatic Breathing (Deep Belly Breathing):

• Sit or lie down in a comfortable position.
• Place one hand on your chest and the other on your abdomen.
• Inhale deeply through your nose, allowing your abdomen to rise as you fill your lungs.
• Exhale slowly and completely through your mouth or nose, feeling your abdomen fall.
• Focus on making your breaths slow, deep, and rhythmic.
• Repeat for several minutes, gradually increasing the duration as you become more comfortable with the technique.

Pursed-Lip Breathing:

• Sit comfortably with your back straight.
• Inhale slowly through your nose for a count of two.
• Exhale through pursed lips as if you are blowing out a candle, taking a longer count, such as four.
• Continue this rhythmic breathing pattern, ensuring that your exhalation is longer than your inhalation.
• Pursed-lip breathing can help improve oxygen exchange and reduce the work of breathing, especially during activities.

Finding the Right Physical Therapist

Finding the right physical therapist is crucial for receiving effective and personalized care, especially if you have specific conditions like Ankylosing Spondylitis (AS). Here are steps to help you find the right physical therapist:

• Ask for Referrals: Start by asking your primary care physician or rheumatologist for recommendations. They can often refer you to experienced physical therapists who specialize in treating AS or similar conditions.
• Check with Your Insurance: Contact your health insurance provider to understand your coverage for physical therapy services. They may have a list of in-network providers or specific requirements you need to follow when choosing a therapist.
• Seek Recommendations from Friends and Family: Friends, family members, or colleagues who have had positive experiences with physical therapy may be able to recommend a therapist. Personal recommendations can be valuable.
• Search Online: Use online resources like the American Physical Therapy Association’s (APTA) website or healthcare directories to search for physical therapists in your area. Many therapists have websites or online profiles that provide information about their specialties and credentials.

Conclusion

In conclusion, ankylosing spondylitis is a challenging condition, but with the right approach, including physical therapy, individuals can lead fulfilling lives with improved mobility and reduced pain. By staying informed, following a personalized treatment plan, and making necessary lifestyle adjustments, those with AS can find relief and regain control of their health.

Physical Therapy helps patients recover from pain. If you’re experiencing Back, Shoulder, Knee, Neck, Elbow, Hip, or Arthritis pain, a physical therapist at PhysioMantra can help: Book an online physical therapy session.