Ankylosing spondylitis (AS) is an advanced form of axial spondyloarthritis. AS causes inflammation and new bone growth in the spine. This can cause chronic pain and stiffness in the low back, rib cage, and neck.
As the body responds to increased inflammation by producing more calcium around the spine, more bone grows, causing further pain and stiffness. Over time, some of the bones in the spine may fuse into immobility, sometimes forcing the spine to curve forward.
Neck pain is a common symptom of AS and a frequently discussed topic on MySpondylitisTeam. Here, we’ll explore some of the most popular treatment options for managing neck pain on a daily basis.
Neck pain and stiffness due to ankylosing spondylitis often appears when lower back pain progresses up the spine into the neck, which can take several months or years. It’s important to note, however, that the symptoms of AS can present atypically — pain may start in the neck instead of the lower back. This presentation occurs in women more often than men.
Neck pain caused by ankylosing spondylitis is inflammatory rather than mechanical (created by stress and strain on the muscles of the back, such as from lifting heavy objects). AS neck pain may feel muscular in nature, and the neck may stiffen, reducing its range of motion. This combination of neck pain and stiffness can significantly impact daily life.
AS neck pain and stiffness may make it difficult to fall or stay asleep. People with AS also report having difficulty walking with their heads up, due to stiff and painful joints.
Out of the nearly 14,000 members of MySpondylitisTeam with ankylosing spondylitis, more than 1,200 report having neck pain. One member shared the intensity of their pain: “Neck pain brings tears to my eyes. The pain is so bad it feels like my head’s going to rip off my neck. I can’t hold my head up.” Another member wrote, “I also have extreme tenderness in my head and neck, which brings up some scary symptoms. I can’t even walk a mile because of this. I also can’t walk a lot when my neck is subluxated [partially dislocated].”
Members of MySpondylitisTeam frequently discuss their experiences with neck pain. “If I sit for more than an hour,” one member wrote, “my tailbone and neck hurt.” Others say the pain can be exhausting and discouraging. “Extreme back and neck pain,” one member wrote. “[I’m feeling] depressed.” Another said, “Chronic neck and back pain is exhausting.”
If you’re experiencing neck pain as a result of ankylosing spondylitis, there are many ways to manage it. Treatment options include home remedies like using a heating pad, exercises, and medications. Meditation may even help manage neck pain by reducing emotional and mental strain.
The first line of treatment for AS pain is usually over-the-counter pain relievers, such as the nonsteroidal anti-inflammatory drugs Aleve (Naproxen) and Ibuprofen. These NSAIDs can help relieve neck pain, stiffness, and inflammation in the short term.
Your doctor may also prescribe steroids to reduce inflammation for short-term relief of AS neck pain flare-ups. Steroids are often given as injections administered directly into the swollen joint or as a slow-release injection into a muscle. The steroid Prednisone may also be administered in the form of a tablet for short-term relief of neck pain in AS.
Most people with AS don’t need surgery. However, in rare cases, surgery can help eliminate pain and improve neck movement. A procedure known as an osteotomy may be used to fuse curved vertebrae and straighten the spine. Another option, known as a laminectomy or decompression surgery, may be performed to relieve pressure on the spinal cord or nerve roots.
Deciding whether to have surgery for AS pain is entirely personal. This process should involve your doctor and a specialist, such as a spinal surgeon. Your rheumatologist can help you understand whether you might be a good candidate for surgery.
Regular exercise can help increase or maintain your range of neck movement, helping to manage your pain. Exercise has a number of added benefits that may improve your pain and stiffness, including improved posture, better sleep, and muscle strengthening.
A routine of a few easy exercises each day — such as simple stretching exercises in the morning after a hot shower — may be a good place to start. You can also take pain medication before exercising, if it helps you stay comfortable.
There are several types of exercise that may be appropriate for people with ankylosing spondylitis, such as swimming, yoga, Pilates, and tai chi. The National Axial Spondyloarthritis Society offers online exercises tailor-made for people with ankylosing spondylitis.
As always, talk to your doctor before beginning a new exercise routine. It’s also a good idea to start slowly, gradually building up the frequency and intensity of your exercise. If you ever experience pain or find it hard to perform an exercise, stop immediately and consult your doctor or physical therapist.
Physical therapy can be an important part of managing neck pain caused by ankylosing spondylitis. A physical therapist can create a suitable program of exercises to build strength and keep your neck flexible. They can also help you maintain good posture to take pressure off your neck and offer some special exercises, such as hydrotherapy (also called aquatic therapy), to help improve your pain.
Meditation may help with neck pain relief when done consistently. Several members of MySpondylitisTeam regularly use meditation to ease their symptoms. One member shared, “All it is, really, is deep thought and learning to control thoughts as they come into your head.” They also added a bit of advice: “For meditation, look online at guided meditations on YouTube.”
Another MySpondylitisTeam member said, “I started seeing a therapist, and she recommended taking a mindfulness class. I’m on week three now, and it has really been helping me change my mindset and love myself and my body more.”
It may take some time to get used to the practice of meditation, and it may not work for everyone. As one MySpondylitisTeam member recalled. “I laughed my tail off every time I listened to a recording my doctor gave me. It did not work for me!”
Some of the most popular forms of meditation for ankylosing spondylitis include active meditation, mindfulness, and yoga breathing.
Active meditation is about focusing on the present moment, acknowledging and letting go of any thoughts, feelings, and sensations that arise. You can do this while walking, standing in line, or doing chores around the house.
Like active meditation, mindfulness involves being tuned into the present moment. This helps you address negative thinking, which can add to the emotional and mental stress of living with a chronic condition like AS. Instead of thinking or worrying about your neck pain, mindfulness can help you acknowledge it, accept it, and let it go.
To practice yoga breathing, sit comfortably in a relaxed position and focus on each breath as you inhale and exhale. Try to hold your breath, slowly letting it go: inhale for four seconds, and exhale for six seconds. Do this for at least two minutes.
A simple home remedy for neck pain and stiffness is heat therapy. You can use an electric heating pad, hot water compress, or microwavable heating pad. A warm bath or shower are also options. Take care not to overheat compresses or use water that is too hot.
When you join MySpondylitisTeam, you become part of a community of more than 54,000 people who understand life with spondylitis. More than a quarter of MySpondylitisTeam members have ankylosing spondylitis, and many share ways to deal with neck pain.
Take a look at some discussions about neck stiffness and pain on MySpondylitisTeam:
Have you felt neck pain and stiffness from ankylosing spondylitis? What have you found that eases your symptoms? Share your experience with neck pain in the comments below or on MySpondylitisTeam.
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