Ankylosing spondylitis (AS) is a type of arthritis that affects the spine. Usually characterized by stiffness and pain in the lower back and sometimes swelling in large joints, this disease can seriously impair a patient’s quality of life. Rheumatologist Dr. Kelly Weselman offers these tips for relieving pain and living a healthy life with AS. 1. Exercise makes all the difference. Getting on a good exercise program is one of the most important components for an AS treatment plan. We can do great things with medicine, but exercise for an AS patient is just as important. Exercise helps improve posture, builds muscle strength, and increases mobility. This relieves pain and can help prevent the loss of motion of your spinal vertebrae, a potential, long-term consequence of AS. Finding an exercise plan is easier said than done, so I often recommend that my patients see a physical therapist. Usually a combination of a stretching routine, some cardiovascular exercise, and focal resistance exercise such as strength-building workouts, makes for a well-rounded plan to relieve stiffness and pain in your back and joints. 2. Your medicine is not just about relieving pain. For some patients, sticking with a prescribed treatment plan can be really difficult. I’ve had patients tell me that if they can tolerate the pain, they don’t need to take their medicine regularly. I always emphasize that taking your medications goes far beyond just relieving the pain caused by AS. Medications prescribed by your doctor for AS can prevent flare-ups from happening and can prevent the disease from affecting other parts of your body, like your knees, other joints, and even your eyes. AS patients are at increased risk for inflammation in the eyes, which can be prevented with medication. The drugs’ effects also make it more comfortable for you to exercise, which makes a big difference in controlling the disease. 3. Heat is a good remedy. Applying heat packs to your lower back or other affected areas can relax the muscles around the spine and reduce pain and discomfort. This is a simple remedy that can greatly improve your functional capacity—your ability to move and perform daily activities—and make it easier to start a work out. 4. Be careful with activities that can over-manipulate the spine. While exercise and stretching are really important to improve your quality of life with AS and stave off its progression into spinal fusion or curvature, I do advise caution with certain activities. AS makes your spine more fragile, meaning there is a higher risk of fracture from over-manipulation, or extreme movements. Extreme yoga poses, heavy massage and high impact activities should be approached with care because your spine isn’t able to bend as easily. 5. Watch for signs of inflammation or discomfort in other parts of the body. Ankylosing spondylitis is a systemic disease, which means that symptoms aren’t only limited to your joints. Some patients experience fatigue, swelling in their joints, and loss of appetite. If you’re experiencing difficulty breathing, your chest muscles and rib cage could be losing their capacity to expand and move air properly as a result of stiffness. More serious conditions like iritis, in which a part of the eye becomes inflamed, as well as heart conditions, can result from AS. Report any symptoms like eye pain, blurry vision, or difficulty breathing to your rheumatologist. He or she should be able to tell you if these issues are related to AS or not.