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Physical Therapy for Ankylosing Spondylitis

Posted on November 29, 2021
Medically reviewed by
Ariel D. Teitel, M.D., M.B.A.
Article written by
Liz Aguiniga, Ph.D.

Physical therapy is an effective treatment option for people living with ankylosing spondylitis (AS). Also known as ankylosing spondyloarthritis, AS is an inflammatory disease that causes stiffness in the spine and sacroiliac joints, typically leading to low back pain, joint pain, and poor posture that can make balance difficult. Increased pain may be triggered by long periods of inactivity, and morning stiffness is a common symptom.

Although movement and exercise may seem difficult when you’re living with AS, it turns out that physical activity is a key part of pain management. Unlike most personal trainers or other trainers at a gym, a physical therapist can help guide you through exercises that account for your AS.

How Does Physical Therapy Help People With AS?

Physical therapy — in which a trained physical therapist creates a tailored routine of exercises for your specific needs — can help improve range of motion and promote good posture while reducing stiffness to decrease pain. Studies have shown that exercise programs that combine stretching, strengthening, spinal mobility, and cardiovascular exercises may increase the quality of life for people with AS by improving mobility and function.

Stretching

Stretching exercises can help improve the range of motion and flexibility and reduce the risk of joint fusion. The Spondylitis Association of America recommends that people with AS do stretching or range-of-motion exercises daily to minimize the risk of joint fusion and loss of mobility.

A physical therapist will help determine which stretching exercises are best to help improve your range of motion based on your current physical function.

Learn about some guided stretching and exercises for joint paint from a rheumatologist.

Eyes, joints, and muscles: how ankylosing spondylitis affects your body

Strengthening

Strengthening exercises improve muscle strength with the use of weights or resistance. People with AS should focus on doing exercises that help build up the core muscles (the abdominal and back muscles) to help support the spine. People with strong core muscles tend to have less back pain. A physical therapist can provide individualized guidance on which muscles need to be prioritized based on your needs.

Cardiovascular and Aerobic Exercises

AS has been shown to harm cardiorespiratory function, meaning it can affect breathing and the heart. People with AS benefit from doing cardiovascular or aerobic exercises that increase the heart rate for a sustained period of time. A physical therapist will be able to assess which exercises are best for your individual needs. Often, adding regular and consistent fast-paced walking to your routine can help improve breathing function, lung capacity, and endurance.

Your physical therapist may also teach you deep breathing exercises to promote better chest expansion, which may be limited if AS affects your ribs and thoracic spine (mid-back).

Functional Training Exercises

Functional training is aimed at helping you perform regular activities that are necessary for everyday life. The physical therapist will likely guide you through spinal mobility exercises to help promote good posture, as well as coordination exercises to help improve balance and minimize the risk of falls or injury.

A physical therapist can work with you to determine when to begin to incorporate other movements depending on your specific flexibility, spinal mobility, endurance, chest expansion, and overall physical function. It is important to find a physical therapist that can monitor and assess your specific needs consistently to determine when your exercise regimen needs to be adjusted.

How To Access a Physical Therapist

If you have health insurance, your insurance database will likely include a complete list of physical therapists within your network who you can contact. Your rheumatologist is also a good resource — they may be able to recommend a physical therapist who specializes in working with people who have AS or other types of inflammatory arthritis.

Although all physical therapists have received training on how to treat people who have problems with their spine, you may get the most benefit from working with a physical therapist who specializes in AS or who already has experience working with people who have the condition. The Find a PT tool built by the American Physical Therapy Association can help you find a physical therapist near you with the right background.

If you do not have access to health insurance or have difficulty accessing a physical therapist, the Arthritis Foundation and the Spondylitis Association of America have exercise programs for people with AS. Research has shown that exercises done at home can also help improve disease severity.

Talk With Others Who Understand

MySpondylitisTeam is the social network for people with spondylitis. More than 73,000 members come together to ask questions, give advice, and share their stories with others who understand life with ankylosing spondylitis.

Have you tried physical therapy for ankylosing spondylitis? Share your experience in the comments below, or start a conversation by posting on MySpondylitisTeam.

All updates must be accompanied by text or a picture.
Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Liz Aguiniga, Ph.D. is a freelance medical writer with a doctorate in life sciences from Northwestern University. Learn more about her here.

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