Effective Treatments for Ankylosing Spondylitis

1. Medicines

   • NSAIDs (e.g., Ibuprofen, Naproxen):

     • Purpose: To reduce pain and inflammation.

     • Duration: Can be taken for short periods as needed to manage flare-ups.

     • Typical Dose:

       • Ibuprofen: 200-400 mg, 3 times a day.

       • Naproxen: 250-500 mg, 2 times a day.

     • Choices: Other NSAIDs (e.g., diclofenac or celecoxib) may be prescribed, depending on your needs.

   • Tofacitinib (Xeljanz):

     • Purpose: Used when other treatments aren’t working to block inflammation.

     • Dose: 5 mg twice a day.

     • Role: Helpful for additional conditions like psoriatic arthritis, or when biologics and NSAIDs are ineffective.

   • Biologic Drugs (e.g., TNF inhibitors like Infliximab, Adalimumab or IL-17 inhibitors like Secukinumab):

     • Purpose: For moderate to severe AS. They target specific immune system pathways to reduce inflammation.

     • Dose (for TNF inhibitors):

       • Infliximab: Given by infusion (usually 5 mg/kg) at the start, then every 6-8 weeks.

       • Adalimumab: 40 mg every 2 weeks by injection.

     • Dose (for IL-17 inhibitors):

       • Secukinumab: 150 mg every 4 weeks after an initial loading dose.

     • Role: Effective at reducing inflammation and improving joint function.

2. Exercise and Physical Therapy

   • Regular exercise is crucial for managing AS. It helps improve flexibility, reduce pain, and prevent stiffness.

   • Types of exercises recommended:

     a) Stretching Exercises:

     • These help improve flexibility and reduce stiffness in your spine, hips, and shoulders.

     • Key stretches:

       • Cat-Cow stretch (for spinal mobility).

       • Chest opener stretch (for chest and upper back flexibility).

     b) Strengthening Exercises:

     • Strengthening muscles around your spine and joints helps support them.

     • Key exercises:

       • Bridges (strengthen hips and lower back).

       • Planks (strengthen core muscles for better posture).

     c) Aerobic Exercises:

     • Improve cardiovascular health and overall fitness, and help keep joints mobile.

     • Examples: Swimming, walking, cycling, or using an elliptical machine.

     d) Posture Exercises:

     • Help prevent a “hunched” posture, which is common in AS.

     • Examples: Chin tucks, wall angels, and shoulder blade squeezes.

   • For more exercise ideas, check out these helpful websites:

     • Versus Arthritis Exercise Tips: Exercise for Ankylosing Spondylitis

     • Arthritis Foundation: Exercise for Ankylosing Spondylitis

     • National Spondylitis Foundation: Exercise and Physical Therapy

3. Posture and Lifestyle Modifications

   • Good posture is essential for preventing a hunched back or spinal deformities.

     • Practice standing tall and keeping your shoulders back. Regular posture exercises can help maintain an upright posture.

   • Smoking cessation:

     • Why it’s important: Smoking worsens AS symptoms, contributes to faster progression of the disease, and increases the risk of complications like osteoporosis.

     • What to do: Quitting smoking can have a big positive impact on managing your AS. Support and resources like smoking cessation programs, counseling, and nicotine replacement therapies (e.g., patches, gum) can help.

     • Useful resources:

       • Smokefree.gov for tips and support.

       • NHS Smoking Cessation

   • Limit alcohol: Drinking alcohol can trigger flare-ups and interact with medications, so it’s best to limit your intake.

   • Healthy Diet:

     • A balanced diet with plenty of fruits, vegetables, and whole grains can help reduce inflammation and improve overall health.

     • Omega-3 fatty acids (found in fish like salmon or supplements) are especially beneficial for reducing inflammation.

     • Avoid processed foods and foods high in sugar, as they can increase inflammation.

   • Weight management:

     • Maintaining a healthy weight helps reduce the stress on your joints, especially the spine and hips. This can reduce pain and improve mobility.

   • Stress management:

     • Stress can worsen symptoms, so find ways to manage it effectively. Consider practices like yoga, deep breathing, mindfulness, or meditation to help relax.

4. Surgery

   • In severe cases, surgery may be needed to replace damaged joints (e.g., the hip) or straighten the spine if it becomes rigid.

5. Ongoing Monitoring

   • Regular check-ups with your doctor are essential to assess how well the treatment is working and make adjustments as needed.

6. Self-Management

   • Learn about your condition: The more you understand AS, the better equipped you’ll be to manage it.

   • Support groups: Joining a support group for AS can provide emotional support and practical tips from others who understand what you’re going through.

Key Takeaways:

• NSAIDs: Help manage pain and inflammation, usually for short periods.

• Tofacitinib: Used when other treatments aren’t effective, typically 5 mg twice a day.

• Biologics: Given for moderate to severe AS, typically via injection or infusion.

• Exercise: Focus on stretching, strengthening, aerobic, and posture exercises.

• Posture & Lifestyle: Quit smoking, limit alcohol, eat a healthy diet, and stay active to reduce stress on joints.

• Surgery: Can be considered for severe joint damage or spinal deformities.

For exercise guidance, smoking cessation help, and more, be sure to check out the websites mentioned.