Physical Therapy for a Ankylosing Spondylitis

AT EVOLVE

Physical Therapy for Ankylosing Spondylitis

HOW CAN PHYSICAL THERAPY HELP MY ANKYLOSING SPONDYLITIS?

Ankylosing spondylitis (AS) is a chronic inflammatory disease causing stiffness and discomfort in the pelvis, spine, and other joints such as the shoulders, hips and knees. Over time, pain and loss of joint flexibility can impact a person’s function and quality of life. Physical therapy is an excellent choice to manage symptoms of ankylosing spondylitis and to help maintain your level of function and functional mobility.

WHAT DOES PHYSICAL THERAPY FOR ANKYLOSING SPONDYLITIS LOOK LIKE?

While every case of AS is different, my staff and I will apply the best, evidence-based techniques to address your pain and functional limitations. We will start with an initial evaluation to better understand your medical history and the pattern of symptoms you are experiencing. We will discuss your goals for physical therapy and perform an examination to assess your spine, pelvis and any other areas of the body that may be contributing to your symptoms. With all of this knowledge in hand, we will create a custom program that may consist of hands-on techniques performed by our therapists combined with carefully prescribed movements and exercises performed by you in the clinic and at home.

WHEN WILL I BEGIN TO SEE RESULTS?

As AS is a chronic condition, physical therapy is not a cure, however, it can be helpful in reducing symptoms of pain and stiffness and improving your ability to perform daily tasks and participate in desired activities. In many cases, you should experience improvements in symptoms such as pain and discomfort within a couple of weeks but improvements in strength, flexibility and overall function may take longer. Achieving long lasting results may take some time, but dedication to your program will not only help you achieve these results but will help to maintain many of the benefits of your treatment.

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WHAT IS ANKYLOSING SPONDYLITIS?

Ankylosing spondylitis is an inflammatory condition that affects the joints and ligaments of the spine and pelvis and also can affect smaller joints like the shoulders, ankles, knees and hips. The National Institute of Health categorizes AS as a type of arthritis. The inflammation caused by this condition leads to feelings of stiffness. In severe cases the inflammation may cause the bones of the spine to fuse together, a condition called “bamboo spine.”

While anyone can get AS, certain factors may make developing this condition more likely. For example, most people with this condition develop it before the age of 45. Children and teens can also show early signs of this condition. Researchers believe there to also be a genetic component to AS meaning if a family member has AS, you have a higher chance of developing it as well. Finally, AS may be more common amongst individuals who have conditions like Crohn's disease, ulcerative colitis and psoriasis.

The inflammatory nature of AS typically results in discomfort and stiffness around the affected joints. Many people find their symptoms are worse after a period of prolonged rest or inactivity and that movement and exercise actually improve their symptoms. Patterns of pain can also vary from person to person. Some may experience periods of mild pain that comes and goes while others may experience severe pain that is chronic. Most people do report experiencing flares, periods of time in which symptoms suddenly increase, followed by periods of remission in which symptoms decrease.

The discomfort and stiffness caused by AS can impact individuals in many ways. Those with AS May experience

Worsening of their posture including stooping over
Pain or stiffness that is worse after resting or sleeping
Difficulty walking or standing for long periods
Disrupted sleep
Difficulty breathing if AS is affecting the mobility of the ribcage and spine
Impacted ability to perform daily tasks
Other less common complications associated with AS such as psoriasis, irritable bowel disease, uveitis of the eyes, cardiovascular disease, lung or kidney issues

HOW IS ANKYLOSING SPONDYLITIS MANAGED?

Medications to manage pain and inflammation may be prescribed by your physician and can be helpful in managing symptoms. Surgery to replace or repair joints that have become fused or affected by AS is recommended usually only in severe cases. Physical therapy is also one of the most important tools to manage AS as it can not only help decrease pain and discomfort but help preserve flexibility so joints are less likely to fuse.

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End Injury Progression

Physical therapy for Ankylosing Spondylitis has proven to prevent injury, slow and even stop pain issues, improve performance, and reverse injury progression in many cases.

**Improve Range of Motion**
Posture awareness is an important area to focus on due to the fact that certain positions may cause you further discomfort and pain.

**Relieve Pain**
The movements used in this technique can target your entire body helping you to manage discomfort and pain during the course of your physical therapy treatments.

**Restore Mobility**
You can regain mobility and flexibility by taking part in the stretches and exercises as prescribed by your physical therapist.

How Long Will Physical Therapy for Ankylosing Spondylitis Last?

If you decide to work with a physical therapist to help with Ankylosing Spondilitis, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your PT sessions yet in the comfort of your own home.

PHYSICAL THERAPY INTERVENTIONS FOR ANKYLOSING SPONDYLITIS

Physical therapy treatment for ankylosing spondylitis has several important goals:

Reduce sensations of pain and discomfort
Reduce feelings of stiffness
Preserve or improve joint flexibility
Prevent fusion of bones such as the spinal vertebrae
Increase overall health and fitness through physical activity such as aerobic, strength, endurance, balance and flexibility training
Preserve or improve the ability to walk
Preserve or improve the ability to participate in daily activities at home and in the community
Maintain good posture

Though your physical therapy plan will be individualized to your needs, these are common interventions physical therapists use in the management of ankylosing spondylitis:

Patient education: educating patients about AS and actions they can take to manage the condition over time

Stretching and joint mobilization: preserving or improving flexibility of the joint is essential for preserving function, reducing feelings of stiffness and helping to maintain a level of function. Self-stretching or passive stretching of muscles, joint mobilizations and mobility exercises are examples of interventions prescribed by PTs

Postural re-education and breathing exercises AS, especially in the spine, affects posture and it can cause a person to become stooped forward. Addressing postural muscle strength and length and joint flexibility can help improve posture and limit worsening over time. Training to maintain ribcage mobility and diaphragm and intercostal muscle function will help decrease the impact of AS on breathing.

Muscle strengthening: Muscle strengthening helps support joints in an optimal position and helps you perform functional tasks more easily. It can also prevent falls and keep you active in the community.

Aerobic conditioning: Participating in some low impact aerobic activity like swimming or bike riding can help maintain a healthy heart and lungs while also keeping joints lubricated and mobile, something that can help improve pain and stiffness

Living with a chronic condition like ankylosing spondylitis requires a team of great healthcare professionals. The physical therapists at Evolve are here to help care for you. If you have AS and are ready to take action on managing your condition and improving your function, call to schedule an evaluation today.