How to exercise with ankylosing spondylitis

Written by Guan Jing Tao
Orthopedics
Updated on September 25, 2024
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In the early stages of ankylosing spondylitis, when the impact on the sacral and other joints is minimal, normal activities such as swimming and jogging are acceptable. However, in the later stages of ankylosing spondylitis, as the disease progressively affects the sacral, hip, and knee joints, it becomes necessary to adjust the exercise regimen, mainly focusing on walking. It is important to avoid localized exposure to the cold and to take oral medications that nourish the joint cartilage. Daily local heat therapy for the joints or appropriate acupuncture can also help to some extent in delaying the erosion and damage of the joints by ankylosing spondylitis.

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Written by Na Hong Wei
Orthopedics
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What is Ankylosing Spondylitis?

Ankylosing Spondylitis (AS), where "A" stands for fusion and "S" for spine, refers to the condition where the bones and joints of the spine are fused together. Ankylosing Spondylitis is defined as a chronic inflammatory disease primarily affecting the axial skeleton and major limb joints. It is characterized by fibrosis and ossification of the intervertebral discs’ annulus fibrosus and nearby connective tissues, as well as ankylosis (stiffening) of the joints. It presents as a sterile inflammation occurring in the spine. However, it is not solely limited to the spine as it also involves the axial bones and major limb joints. The pathological hallmark of the disease includes inflammation mainly at the sacroiliac joints and points of attachment to the spine, leading to joint stiffness and calcification of the spinal ligaments and joints. The disease progression begins at the sacroiliac joint, spreading upwards through the entirety of the spine, and eventually stops at the cervical vertebrae. Symptoms start with pain in the early stages, followed by restricted mobility in the intermediate phase, and ultimately leading to deformities of the abdomen and back, culminating in severe hunchback. The exact cause of Ankylosing Spondylitis remains unclear, with various theories proposed but none universally accepted. Additionally, it is categorized under rheumatologic and immunologic disorders.

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Written by Yang Ya Meng
Rheumatology
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How to control ankylosing spondylitis

The treatment of ankylosing spondylitis mainly consists of three parts: The first part is the use of non-steroidal anti-inflammatory drugs, such as sustained-release diclofenac sodium tablets; the second is the choice of disease control medications, which may include sulfasalazine or methotrexate tablets, especially for patients with peripheral joint pain, immunosuppressive drugs can be chosen. The most effective for ankylosing spondylitis are biologics, but before using biologics, it is necessary to exclude hepatitis, tuberculosis, and cancerous diseases, and the cost of biologics is relatively high. (Please use medications under the guidance of a professional physician and do not self-medicate.)

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Written by Li Jing
Rheumatology
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Ankylosing Spondylitis Diagnosis Methods

Ankylosing spondylitis is primarily characterized by involvement of the elbow joints, but it can also be accompanied by extra-articular manifestations such as iritis and pain in the heel, and severe cases may present with spinal stiffness and deformity. The cause of the disease is unclear, but studies suggest it is related to genetic and environmental factors, with a significant familial aggregation. Diagnosis requires a combination of clinical symptoms, blood tests including HLA-B27, and imaging such as CT or MRI of the sacroiliac joints to confirm inflammation or damage to these joints. To diagnose ankylosing spondylitis, these three criteria must be met. The most important factor is the presence of clinical symptoms that persist for more than three months, improve with activity, and do not significantly improve with rest. This is a typical characteristic of ankylosing spondylitis.

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Written by Li Jing
Rheumatology
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Does ankylosing spondylitis have a genetic component?

Firstly, ankylosing spondylitis is a chronic disease that primarily affects the axial joints, and this disease is incurable. It can only be managed with medications to control the progression of the disease, delay the appearance of joint deformities, and reduce disability. This is the main purpose of its treatment. The cause of the disease is also unclear, and it is somewhat related to genetics. If parents have it, the incidence in their children is significantly increased, and there is a phenomenon of familial aggregation. It cannot be considered a hereditary disease, but there is indeed a phenomenon of familial aggregation. Moreover, the incidence of the disease in children is much higher than in families without a history of the disease.

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Written by Li Jing
Rheumatology
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How to exercise with ankylosing spondylitis?

Once diagnosed with ankylosing spondylitis, after ruling out contraindications such as hepatitis B infection and tuberculosis, it is necessary to administer standard medications to improve rheumatic conditions. At the same time, it is necessary to develop good living habits, such as abstaining from alcohol, quitting smoking, and avoiding carbonated drinks and coffee, as these can exacerbate osteoporosis. Secondly, it is important to exercise regularly; one can walk slowly, run, or swim. Swimming is the best form of exercise for patients with ankylosing spondylitis as it can enhance the coordination of limb muscles while also delaying joint wear. Thirdly, it is important to maintain good posture and sleep on a hard bed.