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People with spondylitis often face such symptoms as joint pain and stiffness, and the thought of exercising can be intimidating. Many people avoid exercise because they’re afraid it might lead to more pain, or that it could trigger a flare. The reality is that exercise can improve mobility and help ease pain for most people with spondylitis.
“Any exercise I can do always improves my pain and stiffness,” one member of MySpondylitisTeam wrote. “I would say we must keep as active as we possibly can, no matter how slow we may be.” However, another wrote, “I understand that we have to exercise for the stiffness, but can someone tell me how I can exercise in pain?”
To find out more about this topic, MySpondylitisTeam sat down with Dr. Iris Navarro-Millán, a rheumatologist and assistant professor of medicine at Weill Cornell Medicine and the Hospital for Special Surgery in New York City.
“One of the things that exercise is really good at is preventing more stiffness,” Dr. Navarro-Millán said. “The way that we can keep our joints stable is by making the muscles around joints strong so that our muscles will protect our joints from damage and further injuries. We also want to make sure our joints aren’t too tight, and that’s why a combination of stretching and strengthening exercise is very important.”
Exercise won’t replace the treatment plan your doctors have created, but it can be an effective supplement to that plan. “A combination of the treatment and medications that your doctors might be giving you, alongside exercise and stretching, can alleviate pain and stiffness. So you don't want to tackle joint pain only with medications — you also want to do your own part,” she said.
She stresses the importance of talking to your doctor before trying any new exercise program. Work with them on the exercise plan that would be best for you.
Dr. Navarro-Millán recommends exercising daily when possible, because the benefits of exercise build up over time.
In fact, one study of 220 people with ankylosing spondylitis found that participants who exercised saw improvements in stiffness and pain, particularly when they exercised for at least 30 minutes daily. In addition, the researchers found that performing back exercises led to improvements in function and pain, especially when participants performed the exercises on at least five days each week.
The one exception to daily exercise involves people who are experiencing active flares, or worsening of their symptoms. “I do not recommend exercising if you’re having a flare,” Dr. Navarro-Millán said. “If you are flaring, hold on, listen to your body, and wait while you heal from your flare, and then go back to your exercise routine. It is important to go back to exercise after your flare from arthritis has resolved, because exercising can prevent the intensity and the frequency of those flares in the future.”
To get the benefits of exercise, you don’t need to push yourself hard or even join a gym. In fact, as Dr. Navarro-Millán explained, you can perform daily stretches and strengthening exercises while seated. You can use household items, such as cans of vegetables for weights and a belt for leverage. “I always tell my patients that the worst exercise is the one that is not done, so even if you can only do five repetitions, doing something is a lot better than doing nothing,” she said.
Even if exercising feels invigorating at first, be careful not to push yourself too hard during your workouts, Dr. Navarro-Millán noted. Start slowly, and listen to your body.
“If you're hurting while you’re actually doing the exercises, you may want to take it easy or stop for a little while. If you need more advice, ask your doctor for a referral to physical therapy so you can have a formal assessment about whether your reaction to the exercise is because of your joint pain, or if it’s because of your exercise — and those are very important things to know,” she said.
Keep in mind that once you start exercising, you may be a little bit slower the next day or the day after. That’s why it's also important to stretch properly before and after you work out and to stay hydrated. “You may feel a little bit of soreness, but it should not be something that limits your ability to do your activities of daily living,” Dr. Navarro-Millán said. “It may be uncomfortable, but it should not feel injured.”
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