Updated: 11/17/23
Are you dealing with the effects of Ankylosing Spondylitis (AS) and seeking to find relief that is not only effective but also free from long-term consequences? If so, then this blog post is for you! Exploring the best treatments for AS will not only help decrease inflammation associated with it, but may even assist in easing its negative symptoms. Furthermore, natural supplements can be a great ally in your quest for healing. Here we’ll dive into the specifics of each treatment option available so that you can make an informed decision about what works best for your body.
What is Ankylosing Spondylitis?
Ankylosing spondylitis, also known as AS, is an autoimmune disease that causes inflammation and pain in the spine. The exact cause of AS is unknown, but researchers speculate that genetics play a role in the condition’s development. Ankylosing spondylitis (AS) is a type of arthritis that primarily affects the spine, but can also affect other joints. This chronic inflammatory disease causes the ligaments and tendons that attach to the bones in the spine to become inflamed, leading to pain and stiffness in the back. The spine can also become fused, making it difficult to move and causing a stooped posture. AS can also cause eye inflammation, bowel inflammation, and fatigue.
When it comes to back pain, ankylosing apondylitis is in a category all its own. It’s in the spondyloarthropathy family of inflammatory rheumatic diseases that cause arthritis. Ankylosing spondylitis is also referred to as AS, Bechterew’s disease, Marie Strumpell disease, and rheumatoid spondylitis.
In most individuals, the gene HLA-B27 is identified if there is a close family member diagnosed with AS. However, not everyone carrying the gene will develop the disease. Environmental factors like smoking may also contribute to the onset of AS symptoms. Ankylosing spondylitis is a condition that affects roughly 1 out of every 200 people worldwide. However, with the right understanding of the condition, diagnosis, and treatment, you can still live an active and fulfilling life.
Symptoms of Ankylosing Spondylitis
Pain and Stiffness in the Lower Back
One of the common symptoms of AS is pain and stiffness in the lower back that gradually progresses over time. The pain may be severe and can last for more than three months. The stiffness can be more prominent in the morning or after long periods of sitting or resting. The inflammation that occurs in the spinal joints makes it difficult for individuals to bend or twist, making simple activities like getting out of bed a challenge.
Hip and Joint Pain
AS can also affect the hips and other joints in the body. Hip pain can be felt on one or both sides and can be severe, making it difficult to walk or stand. Inflammation in other joints like knees, shoulders, and ankles can also cause similar symptoms and affect mobility.
Fatigue and Anemia
People with AS can also experience fatigue and anemia. Fatigue can be a result of the body trying to defend itself against inflammation and can negatively impact an individual’s daily routine. Anemia is a result of reduced red blood cells in the body, which can cause individuals to feel tired and weak.
Eye and Skin Symptoms
AS-related inflammation can also affect other parts of the body. Eye inflammation, known as uveitis, can cause redness, pain, and blurred vision. Skin rashes, like psoriasis, can occur in individuals with AS as well.
Reduced Flexibility
With ankylosing spondylitis and its progression, parts of the spine may fuse, reducing the spine’s flexibility, leading to decreased mobility. This can have consequences such as a more advanced hunched back, especially if you’re not seeking treatment.
Difficulty Sleeping
One of the earliest symptoms of ankylosing spondylitis is difficulty sleeping. People with AS often experience pain and stiffness that make it challenging to get comfortable in bed. People may wake up several times each night to find a more comfortable position or even get out of bed to stretch. As a result, the quality of sleep is reduced, and people may feel daytime fatigue and irritability.
Reduced Range of Motion in the Spine
Another hallmark symptom of ankylosing spondylitis is reduced range of motion in the spine. As the disease progresses, the vertebrae in the neck and back may fuse together, limiting the spine’s movement. Activities that require bending, twisting, and turning can become increasingly difficult, which can interfere with work, hobbies, and exercise.
Difficulty Walking and Performing Daily Activities
People with ankylosing spondylitis can also experience difficulty walking and performing daily activities such as getting dressed, carrying groceries, or climbing stairs. AS can cause weakness in the lower extremities and impair the body’s ability to move. In severe cases, people may need mobility aids, such as a cane or walker.
Numbness and Weakness in the Legs
In rare cases, ankylosing spondylitis can cause nerve damage that leads to numbness and weakness in the legs. This condition is called cauda equina syndrome and can be a medical emergency. If you experience numbness, tingling, or weakness in your legs, seek immediate medical attention.
Bowel and Bladder Problems
Ankylosing spondylitis can cause inflammation and scarring in the intestines, which can lead to bowel problems such as diarrhea, constipation, or abdominal pain. AS can also affect the bladder, causing difficulty in urination. If you experience any changes in bowel or bladder habits, speak to your doctor.
Loss of Appetite
Finally, ankylosing spondylitis can cause a loss of appetite, which can lead to unintentional weight loss. Chronic inflammation caused by AS can alter the body’s metabolism, leading to a decrease in appetite and weight loss.
Causes of Ankylosing Spondylitis
This chronic inflammatory condition affects approximately 1% of the population and tends to develop in early adulthood. Although the exact cause of AS is unknown, researchers have identified several risk factors that increase the likelihood of developing the condition.
Age
Ankylosing spondylitis typically develops in people between the ages of 17 and 45, although it can occur at any age. It is rare for children under the age of 16 to develop Ankylosing Spondylitis, but it is possible. The earlier the onset of the disease, the more severe it tends to be.
Gender
As mentioned earlier, Ankylosing Spondylitis occurs more commonly in men than in women. However, women who carry the HLA-B27 gene are at a higher risk of developing ankylosing spondylitis than women who do not carry this gene.
Genetics
Studies have found a genetic link to ankylosing spondylitis. Specifically, several genes are associated with AS development. These genes help to regulate the immune system and inflammation responses. If a person has specific variations of these genes, their immune system is more likely to overreact, leading to inflammation in the joints and spine, which eventually could develop into AS. Having a family history of AS increases the chances of an individual developing the condition significantly. However, inheriting the gene alone is not enough to cause the development of AS.
Other Medical Conditions
People with other autoimmune diseases, such as psoriasis, inflammatory bowel disease, or reactive arthritis, are at a higher risk of developing ankylosing spondylitis. These conditions share some of the same genetic and environmental risk factors as ankylosing spondylitis.
Environmental Factors
Environmental factors may play a role in the development of ankylosing spondylitis. Certain environmental factors, such as infections, can trigger an immune response, leading to inflammation. People who have experienced an infection before AS diagnosis may likely have a higher risk of AS. The intestinal bacterial pathogen Klebsiella pneumoniae has been linked to AS in some studies. So far, there is limited evidence as to what microbes might trigger and exacerbate AS.
Posture
Poor posture may cause vertebral and joint misalignment, increasing the risk of AS development. When the spine’s natural curvature is disturbed, it may lead to spinal stress, inflammation, and possible spinal fusion. For instance, people who sit or work on computers for extended periods face a higher risk of developing AS. People with poor posture patterns should practice good posture and ergonomic guidelines to help prevent and alleviate AS symptoms.
Risk Factors of Ankylosing Spondylitis
Inflammatory Bowel Disease (IBD)
Inflammatory bowel disease (IBD) refers to chronic inflammation of the digestive tract, with two main types: Crohn’s disease and ulcerative colitis. A person with IBD is more likely to develop AS, and AS patients often have IBD as well. The possible explanation for this is that both AS and IBD share common genetic and immunological features, including an overactive immune system.
Psoriasis
Psoriasis is a chronic autoimmune disorder that affects the skin, causing red, scaly patches on the skin’s surface. A person with psoriasis is at a higher risk for developing inflammatory arthritis such ankylosing spondylitis. Similar to IBD, there is a genetic overlap between psoriasis and AS, which can explain the association between the two diseases.
Ulcerative Colitis and Crohn’s Disease
Apart from genetics, several other factors can increase the likelihood of developing ankylosing spondylitis. Certain inflammatory bowel diseases like Crohn’s disease and ulcerative colitis, and skin condition psoriasis increase the risk. Individuals who have any of these conditions need to be extra cautious, and although the risk is low, they need to maintain good spinal health by avoiding positions that strain the lower back.
Rare Complications of Ankylosing Spondylitis
In most cases, AS symptoms occur in a predictable pattern. But in some rare cases, the following complications may occur
Uveitis
Uveitis is an inflammation of the middle layer of the eye, known as the uvea. It is a common autoimmune manifestation in patients with AS. Uveitis can cause redness, pain, and blurry vision. In severe cases, it can lead to permanent vision loss if left untreated. That is why patients with AS should regularly undergo an eye exam.
Cardiovascular Diseases
AS is associated with increased risk of developing heart disease. This is due to chronic inflammation, which can lead to the buildup of fatty deposits in the arteries. These deposits can cause blockages, leading to heart attacks, angina, and strokes. It is important to control blood pressure and cholesterol levels through medication and lifestyle changes such as regular exercise and a healthy diet.
Osteoporosis
Osteoporosis is a condition that results in weakened bones that are more susceptible to fractures. Patients with AS have an increased risk of developing osteoporosis due to inactivity and the use of corticosteroids. It is important to maintain a healthy weight-bearing exercise regimen and take calcium and vitamin D supplements to prevent this complication.
Pulmonary Diseases
AS may cause lung-related complications such as shortness of breath, chest pain, and coughing. It can lead to interstitial lung disease or pulmonary fibrosis, which is a chronic lung disease that damages the lungs and makes it harder to breathe. A chest x-ray or CT scan can detect this complication early and your doctor may prescribe medication to treat it.
Respiratory Issues
Respiratory issues of Ankylosing spondylitis are dangerous, seeing as it can cause inflammation and scarring that can impair lung function which can eventually lead to respiratory failure. It’s reported that 5% of patients with ankylosing spondylitis develop interstitial lung disease, which can hamper lung function and cause shortness of breath.
Neurological Disorders
Ankylosing spondylitis can lead to nerve damage that affects signals sent by the nervous system throughout the body. This may result in nerve compression syndromes such as lumbar spinal stenosis, cervical radiculopathy, cervical myelopathy, and polyneuropathy which causes numbness in the affected area.
Gut Issues
Ankylosing spondylitis can cause gut inflammation, intestinal fluid accumulation, and a range of abdominal pain. It’s been reported that a significant percentage of people with ankylosing spondylitis also show signs of other inflammatory bowel diseases, such as Crohn’s Disease, even though they may be asymptomatic.
Is Ankylosing Spondylitis An Autoimmune Disease?
The answer is yes. Researchers believe that ankylosing spondylitis is an autoimmune disease, which means it occurs when the immune system mistakenly attacks the body’s own tissues. With AS, this self-attack typically targets the synovial joints that attach the spine to the pelvis. This type of immune response triggers inflammation and ultimately leads to pain, stiffness, and joint damage.
Ankylosing Spondylitis in Females
Ankylosing spondylitis is a genetic condition. While the exact cause is unknown, having certain genetic markers increases the risk of developing AS. These genetic markers are more common in males, which is why AS is more prevalent in men. However, females who have these genetic markers are also at risk of developing the condition.
Ankylosing spondylitis can affect pregnancy outcomes. Women with AS have a higher risk of developing complications during pregnancy, such as preterm labor and cesarean delivery. However, with proper management, women with AS can have successful pregnancies. It is important for women with AS to discuss their pregnancy plans with their healthcare providers and to receive appropriate care throughout their pregnancy.
The symptoms of ankylosing spondylitis in females are similar to those in males. The most common symptom is back pain, which can be accompanied by stiffness and limited mobility. Other symptoms include pain and swelling in the joints, especially in the hips and knees. Fatigue is also common in people with AS. Women with AS may also experience pain and stiffness in the chest. These symptoms can be managed with medication, physical therapy, and lifestyle changes.
How Ankylosing Spondylitis is Diagnosed
Physical Exam
During the physical exam, your physician will look for signs of inflammation, such as swelling, redness, and warmth. They may also check your range of motion and feel for tenderness in the affected joints. In some cases, a doctor may perform a straight leg raise test and a spinal mobility assessment, which involves evaluating how well your spine can bend in different directions. These tests can help establish a diagnosis of AS.
Imaging Tests
Iimaging tests, such as X-rays, CT scans, and MRI may be used to visualize inflammation and damage to the spine and other joints. These tests are useful in determining the extent of the damage by AS and to identify changes in the bone structure. It is common to get these tests done after visiting a doctor who suspects that you might have AS.
Blood Tests
There is no specific blood test for diagnosing ankylosing spondylitis. However, your doctor may order blood tests to rule out other causes of your symptoms, such as infections, rheumatoid arthritis, or lupus. Additionally, blood tests may reveal elevated levels of specific proteins in the blood, known as HLA- B27. While not everyone with AS has this protein, it is present in about 90% of people with the condition.
Treatment for Ankylosing Spondylitis
While Ankylosing Spondylitis is a painful and debilitating disease, there are a variety of treatments that can help manage the symptoms.
Medications
There are a variety of medications that can be effective in treating ankylosing spondylitis. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen or naproxen help to reduce inflammation and relieve pain. Disease-modifying antirheumatic drugs (DMARDs) slow down the process of the disease, preventing further damage to your joints. Corticosteroids are another type of medication that can help decrease inflammation and suppress the immune system. Keep in mind that some medication can cause side effects or may not be safe for pregnant women. Always make sure to speak with a doctor about the right option for you.
Surgery
In serious cases of ankylosing spondylitis, surgery may be required. Often, spinal fusion surgery, where two vertebrae fuse together, can help manage pain and increase flexibility. This type of surgery has a long recovery time and should be a consideration only after trying other treatment options. Surgery can be expensive and is not always covered by insurance. Always make sure to consult with a specialist before considering surgery.
Physical Therapy
One of the most effective ways to keep yourself flexible and pain-free is by receiving physical therapy. Physical therapists exhibit training to help you maintain range of motion and improve your posture. By doing a regular routine of exercises, you will be strengthening your joints and reducing pain. Always make sure to consult with a physical therapist first, and never attempt any exercises without the proper knowledge. In many cases, physical therapy is covered by insurance.
Acupuncture
Many people afflicted with ankylosing spondylitis swear by the effects of acupuncture. Acupuncture involves the use of needles that are have strategic placement to stimulate the body’s natural painkillers. Acupuncture can help alleviate the stiffness and pain with ankylosing spondylitis. Studies have shown that acupuncture can be an effective way to treat chronic pain in general, making it a plausible treatment option for ankylosing spondylitis.
Yoga
Yoga is an effective way to improve flexibility and strengthen joints, making it a great way to help relieve the symptoms of ankylosing spondylitis. Many studios offer yoga classes specifically tailored for people with limited mobility. Yoga also helps with improving balance and reducing anxiety, both of which can be extremely helpful when dealing with painful conditions.
Managing Ankylosing Spondylitis
Exercise
One of the most important things you can do to manage AS is to stay physically active. Regular exercise can help reduce pain, improve joint flexibility, and boost overall physical and mental wellbeing. Specifically, low-impact exercises like walking, swimming, or yoga can be particularly helpful for AS sufferers.
In some cases, you may need to work with a physical therapist or trainer who can help you develop a safe and effective exercise routine. However, with a little research and dedication, you can find the right exercise program that works for you and helps you maintain a healthy lifestyle.
Diet
Maintaining a healthy diet is another key component of managing AS symptoms. Some people with AS may benefit from following an anti-inflammatory diet that includes foods like leafy greens, fatty fish, nuts, and whole grains. Avoiding high-sugar and high-fat foods can also help reduce inflammation and improve overall health.
It’s important to work closely with a healthcare professional or registered dietitian to determine the best diet plan for your individual needs. Additionally, if you have any food allergies or sensitivities, it’s important to avoid those foods that may trigger inflammation or exacerbate AS symptoms.
Stress Management
Stress can be a major contributor to AS symptoms, so finding effective ways to manage stress is key. Some people find relief through practices like meditation, deep breathing, or massage therapy. Additionally, regularly engaging in hobbies or activities that bring you joy and relaxation is a great way to reduce stress and improve overall quality of life.
Community Support
Finally, seeking out community support is an important aspect of managing AS. Joining a support group or connecting with others who have AS can provide a sense of validation and understanding that can be invaluable in coping with this chronic condition. Online forums or social media groups can be particularly helpful for those who may not have access to in-person support groups.
Supplements for Ankylosing Spondylitis
Omega-3 Fatty Acids
Omega-3 fatty acids are essential fatty acids that our bodies need but cannot produce on their own. Studies show that Omega-3s can help reduce inflammation and joint pain associated with ankylosing spondylitis. Omega-3s are found in fatty fish like salmon, mackerel and sardines, but supplements like fish oil or krill oil are a great way to make sure you’re getting enough.
Vitamin D
Vitamin D deficiency is common in people with ankylosing spondylitis and can contribute to the severity of the disease. It helps regulate the immune system and plays a key role in bone health. Taking Vitamin D supplements can help reduce inflammation and joint pain symptoms associated with this condition. Vitamin D can also be found in sunlight exposure, fortified dairy products, and fatty fish, but doctors may suggest supplements to ensure you are getting the right amount.
Calcium
Calcium is a bone’s best friend. And since AS affects the vertebrae of the spinal cord, calcium could be an AS patient’s best friend, as well. Calcium promotes strong bones, including the bones of the spine. In addition to dietary and herbal sources of calcium, there are also a number of supplements that can help boost your intake. Calcium carbonate and calcium citrate are two of the most common, but you can also find calcium supplements that include vitamin D and other minerals that support bone health. The daily recommended intake of calcium is 1200 milligrams for women over 50 or men over 70. If you’re younger, take 1000 milligrams daily.
Ginger
Ginger is a natural anti-inflammatory and antioxidant. It shows to improve joint mobility and reduce pain and inflammation associated with ankylosing spondylitis. Ginger can be consumed fresh, dried or in supplement form.
Turmeric
The active ingredient in turmeric is a compound called curcumin, which has been shown to have anti-inflammatory and antioxidant effects. Turmeric has been arpund for centuries in Ayurvedic medicine to reduce joint pain and inflammation. It can be consumed as a spice in cooking or as a ginger root extract supplement.
Glucosamine
Glucosamine is a natural supplement that supports joint health by reducing inflammation and improving cartilage function. Some studies have shown that glucosamine can improve joint mobility and reduce pain associated with AS. Glucosamine also helps slow the progression of osteoarthritis, which can occur in people with AS.
Probiotics
Probiotics are beneficial bacteria that live in your gut and help improve digestion and boost immunity. People with AS often have gastrointestinal symptoms like diarrhea and abdominal pain, which can be improved with probiotics. Probiotics can also help reduce inflammation and boost your immune system, which can help manage the symptoms of AS.
The Bottom Line
Ankylosing spondylitis is a chronic inflammatory arthritic disease that causes pain and swelling in the spine and other areas of the body. While there is currently no cure for AS, research continues to determine likely causes and the best courses of treatment.
While living with Ankylosing Spondylitis can be challenging, there are many strategies that can help manage symptoms and improve overall quality of life. From exercise and diet to medication and stress management, finding the right combination of tools and resources can be a game-changer. Working closely with a healthcare professional and seeking out community support can also provide a sense of validation and understanding that can be invaluable in coping with this chronic condition. Whatever your situation, know that you’re not alone, and there are many resources available to help you manage AS and live your best life!
If you have Ankylosing Spondylitis, you’re probably familiar with the pain and stiffness that comes with this chronic inflammatory disease. While there’s no cure for AS, you can manage its symptoms and improve your quality of life with the help of certain supplements. Omega-3 fatty acids, vitamin D, glucosamine, turmeric, and probiotics are all excellent supplements for Ankylosing Spondylitis that can help reduce inflammation, improve joint mobility, and boost your immune system. Be sure to talk to your doctor before starting any new supplements, particularly if you’re taking other medications or have existing health conditions. With the right supplements and the right lifestyle choices, you can improve your overall health and manage the symptoms of AS.
These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease
