Do you have these symptoms—stiffness, reduced mobility, or pain in your spinal cord or joints? Or are you fatigued and find it difficult to perform daily chores? These could all be symptoms of ankylosing spondylitis (AS). AS is a health condition that can diminish your quality of life. However, the good news is that the condition is manageable. Your physician can prescribe medication to alleviate the symptoms.

Physical therapy is another effective way to manage AS. At Suarez Physical Therapy, we gladly help AS patients with efficient physiotherapy services. Our registered physical therapists understand the difficulties ankylosing spondylitis presents and are available to help. We center our physiotherapy approach around customized care tailored to the patients’ goals and needs. Call us if you are looking to undergo physical therapy for AS in Las Vegas, and we will attend to you with compassion.

Ankylosing Spondylitis Overview

AS refers to an inflammatory type of arthritis primarily affecting the spine and large joints, such as the

  • Pelvis
  • Feet
  • Hips
  • Knees and
  • Shoulders

The disease causes the following effects:

  • Stiffness and pain, limiting mobility
  • Abnormal growth of bones
  • Fusing of joints in the vertebrae of the spine
  • Fusing of the sacroiliac joints. Sacroiliac joints are located between the pelvis and each hip and
  • Vital organs such as the eyes, lungs, and heart might also be affected.

Ankylosing spondylitis is a lifelong (chronic) disease. Most people with this condition have a gene known as HLA-B27. However, many individuals who have inherited this gene from a parent with the condition do not suffer from the illness. The AS’s onset is generally diagnosed in people between seventeen and forty-five years old. Men are usually diagnosed two to three times more frequently than women. Also, men tend to experience more severe symptoms than women.

Currently, ankylosing spondylitis has no cure. However, proper treatment will assist in decreasing the stiffness and pain related to the illness. Medication usually lowers localized swelling and inflammation. In rare, severe cases of hip joint destruction, doctors may perform a total hip replacement.

Ankylosing Spondylitis Symptoms

Pain is the initial and most prevalent symptom you will experience with the AS’s onset. You will experience pain in your lower back and sacroiliac joints. You might also gradually feel shoulder and hip pain. Pain often appears together with morning stiffness or stiffness after prolonged inactivity. The pain and stiffness generally improve after activity or exercise. Other prevalent symptoms are:

  • Generalized fatigue
  • Lost appetite
  • Fever
  • Ankylosis or bony fusion is typical of ankylosing spondylitis in spine joints. This causes progressive stiffness, reducing the capability to stand upright, bend, or turn the head.
  • Difficulty keeping good posture, which could lead to you stooping forward. Bad posture will make losing your balance easier. This will cause challenges in walking, making you likely to fall.
  • In advanced AS cases, osteoporosis may occur. Osteoporosis is the thinning of bones. Thus raises the likelihood of bone fractures.
  • Ankylosis spondylitis can also impact soft tissues in the eye, leading to swelling (uveitis). Patients might also experience eye pain, floaters, redness, and increased sensitivity to light.
  • Difficulty breathing. The lungs and joints where the spine and ribs attach stiffen. This limits chest expansion, leading to shortness of breath.
  • Inflammation. This is a very prevalent symptom. Patients often experience inflammation in the area where tendons and ligaments join bones. These areas are tender and are sometimes known as hotspots. The back and heel of the foot are prevalent sites where tender spots are. Hence, this can cause challenges in walking and standing.
  • Skin conditions such as psoriasis and inflammatory bowel disease can lead to abdominal pain, weight loss, or diarrhea.

Complications

In serious AS, new bone develops as the body's way to heal. The new bone slowly bridges the gap between spinal bones and ultimately fuses parts of those bones. Those sections of the spinal cord stiffen and become inflexible. Fusions can also stiffen the rib cage, limiting lung function and capacity. Other complications may include the following:

  • Eye inflammation, known as uveitis. This is among the most prevalent complications of AS. Uveitis can lead to rapid-onset eye pain, blurred vision, and light sensitivity. See your doctor immediately if you experience these signs.
  • Compression fractures. For some patients, bones weaken in the initial stages of AS. Weakened spinal bones can crumple, raising the seriousness of stooped posture. Fractures in the spinal bones can put stress on and potentially injure the spine, plus the nerves passing through it.
  • Heart-related problems. The AS disease can cause aorta-related problems. The aorta is the biggest artery in the body. It can become inflamed, enlarging to the extent that it distorts the shape of the aortic valve in the heart, impairing its function. AS-related inflammation generally increases the likelihood of heart disease.

When to Visit a Specialist

Seek medical care if you experience buttock or lower back pain that:

  • Appeared slowly,
  • Awakens you from your sleep in the second half of the night,
  • Worsens in the morning

It is cause for concern, particularly if the pain worsens with rest and improves with activity. Visit an eye specialist as soon as possible if you experience blurred vision, severe light sensitivity, or a painful red eye.

Ankylosing Spondylitis Diagnosis

If you visit a doctor for symptoms like chronic back pain, they may send you to a rheumatologist. The rheumatologist will review your medical history and need you to explain the following:

  • How the symptoms appeared
  • What symptoms appeared first
  • Whether they improve with activity or worsen with inactivity

The rheumatologist will then thoroughly evaluate your posture and movement of your knees, shoulders, hips, and spine. They will also assess whether there are any tender sites around your sacroiliac joints, hips, and spine. Then, they will gently evaluate your capability to bend backward or forward, walk, and squat.

If the rheumatologist suspects AS, they will also check how your chest expands when inhaling deeply and exhaling. This will show how the disease may have impacted your breathing function and rib joints. The rheumatologist will further observe your capability to walk and your movement from standing to sitting. Then, they will also assess your balance to establish whether you are at risk of falling.

If the rheumatologist suspects AS, they will consult your doctor for more tests. The tests may include an MRI or X-ray of the sacroiliac joints and spine. The rheumatologist may also recommend genetic testing and blood tests.

Treating Ankylosing Spondylitis

Treatment aims to relieve stiffness and pain and delay or prevent spinal deformity and complications. Ankylosing spondylitis treatment is most effective before the illness causes permanent damage.

NSAIDS (nonsteroidal anti-inflammatory drugs) like ibuprofen and naproxen sodium are medications doctors most prevalently utilize to treat AS. These drugs can relieve stiffness, pain, and inflammation. However, they may also lead to gastrointestinal bleeding.

If NSAIDS are not helpful, your healthcare provider may recommend beginning a TNF (tumor necrosis factor) blocker or an IL-17 (interleukin-17) inhibitor. Doctors inject these medicines via an IV line or beneath the skin. Another drug option is a JAK (Janus kinase) inhibitor. JAK inhibitors are administered by mouth. They can reactivate untreated tuberculosis and expose you to infections. Examples of TNF blockers are:

  • Humira (adalimumab)
  • Cimzia (certolizumab pegol)
  • Enbrel (etanercept)
  • Simponi (golimumab)
  • Remicade (infliximab)

Interleukin-17 inhibitors utilized to treat AS include Cosentyx (secukinumab) and Taltz (ixekizumab). Janus kinase inhibitors available for treating AS include Rinvoq (upadacitinib) and Xeljanz (tofacitinib).

How Physical Therapy  Can Help

Physiotherapy provides a clinical means for patients with AS to remain active and know various exercise techniques. Physical therapists assist patients in leading productive lives. They work with these patients to increase their muscle flexibility, joint mobility, and strength and enhance their posture. Exercise is crucial in treating AS, and specialists prioritize it for individuals suffering from this condition. A significant part of a patient going to physiotherapy is learning and understanding how they will apply the exercises in the comfort of their home.

A physiotherapist will work with you directly to develop exercises and routines to enhance your strength and mobility. They will show you how you will incorporate these routines and exercises into your daily life.

Per recommendations, possible benefits of routine exercise for individuals with AS include:

  • Enhanced posture and mobility
  • Less stiffness and pain
  • Enhanced physical function
  • Increased strength

At a physiotherapy session, you will often do different exercises that will assist in relieving your AS symptoms. The physiotherapist will further teach you how to exercise to address affected areas and do the exercises in the comfort of your home.

Every situation differs, and physiotherapists tailor their programs to specific patients’ needs. However, some prevalent exercises a physiotherapist might recommend include the following:

  • Strengthening exercises
  • Stretching routines
  • Cardiovascular exercises for alleviating symptoms and improve general health
  • Exercises to help the spinal cord.
  • Functional training to assist you in continuing and increasing daily activities

Techniques to Manage Pain

Research notes that patients who exercised registered a 21 percent pain reduction compared to the ones who never exercised. Exercise can indeed benefit many individuals with AS. However, not all exercises work for everybody. Some people require low-impact and gentle exercises or those focusing on reducing pain or stress. These include activities like deep breathing, yoga, and other low-impact exercises that benefit the patient without hurting the body.

Deep Breathing Exercises

Having AS can cause difficulty taking a deep breath and breathing generally. A physiotherapist can work with you on doing deep breathing exercises. These will help increase your lung capacity and expand your chest. Belly breathing, or diaphragmatic breathing, is a deep breathing exercise that assists in increasing lung efficiency and strengthening the diaphragm. This is how you do diaphragmatic breathing:

  • Lie or sit in a position you find comfortable
  • Place one hand on your stomach and the other on your chest
  • Inhale via your nose so that your stomach is raised and pushed against your hand while keeping your chest still
  • Exhale via pursed lips while your stomach drops

Stretching or Flexibility Exercises

Flexibility exercises like stretching can assist individuals with AS in maintaining mobility and lowering the possibility of the joints fusing. The areas that need stretching include the thighs, hips, chest, and back. Your physiotherapist can suggest stretching exercises that are particular to your situation. You could also do yoga to assist you in staying mobile and reducing back pain.

Strengthening Exercises

The Spondylitis Association of America provides that core muscle strengthening can assist patients with AS in reducing pressure on the spinal cord and minimizing back pains. Core muscles refer to abdominal ones and those supporting the spinal cord.

One of the exercises that can assist in strengthening muscles is the plank. This exercise entails assuming the top of a pushup position and staying that way. As a start, your physiotherapist may show you how to do a standing plank against the wall. As you build strength, you can do the plank on your knees and move to perform a complete plank. You could balance on your forearms rather than your hands to relieve pressure on your hands.

Posture Training

If you have AS, you may change your posture to compensate for the pain associated with the condition. With time, insufficient posture can result in increased stiffness and back pain. It could also put increased pressure on the spinal cord.

A physiotherapist might recommend different posture training exercises in this case. These might include prone standing and lying with your back against a wall. The exercises strengthen the extensor muscles in the hips, upper back, and lower back to improve spinal cord extension. This is how you do prone lying exercises:

  • Lie on your stomach flat on a hard surface
  • Put a towel or pillow under the forehead or abdomen for comfort
  • Strengthen your arms by the sides
  • While focusing directly on the ground, lift your chest and head some inches off the ground while gently squeezing the shoulder blades together.
  • Maintain this posture for the longest time possible without losing the proper position
  • Repeat thrice

To do back-against-the-wall exercises for posture, follow these steps:

  • Stand against the wall so your shoulders, butt, and heels are touching the wall
  • Bring your head back to the wall
  • Maintain this position for about twenty-thirty seconds, then relax and repeat
  • Repeat ten times

Movement Retraining Exercises

Your physiotherapist will teach you how you can efficiently move while preserving energy. AS patients experience inflammation, decreased flexibility, significant loss of joint mobility, and related pain. Thus, your physiotherapist can teach you how to pace yourself to do functional activities.

Individual Activities

Personal activities entail various types of exercises that usually center on low-impact aerobics. The activities can assist in improving your general mental and cardiovascular health. They also help decrease disease activity and pain. Individual activities may include any low-impact exercise, such as:

  • Doing tai chi
  • Cycling
  • Swimming
  • Walking
  • Practicing yoga
  • Using an elliptical machine

You can speak with your physiotherapist about exercises you would like to attempt. You could further work with a physiotherapist to establish the ideal exercise for your needs.

Physiotherapy After Surgery

Undergoing a surgical procedure is not the first treatment recommended for AS. Put otherwise, doctors will likely recommend surgery only if patients’ daily lives have been severely impacted and other treatment options have not been successful.

Your physician will likely suggest physiotherapy after surgery. A physiotherapist will work closely with you, much like before surgery. They will teach and guide you through flexibility, strength, and other forms of exercise. The primary difference here is that the objectives of physiotherapy after surgery will center on assisting you in safely and fully recovering.

The Duration of Physiotherapy for Effective Outcome

The number of physiotherapy sessions AS patients need varies depending on doctor recommendations and the patient’s needs. Based on the specialist, sessions are often between thirty minutes and one hour. How frequently you attend physiotherapy each week is contingent significantly on your needs.

Check with your insurer to establish what expenses are linked to physiotherapy. Insurance might only pay for a given number of sessions annually or monthly.

Movements You Should Avoid

Most exercises are secure for individuals with AS. However, you may have to refrain from high-impact ones like martial arts and contact sports. Your physiotherapist can give you more details on what movements and exercises to avoid.

Preventing Ankylosing Spondylitis

The precise cause of AS remains unknown. However, research notes that environmental and genetic factors may contribute to its development. Consequently, it is impossible to prevent AS from happening.

So, treatment options help prevent the worsening of the condition. The objective of almost every treatment is to stop or slow the progression of the disease, alleviate symptoms, and improve quality of life.

Find a Professional Physical Therapist Specializing in Ankylosing Spondylitis Treatment Near Me

Do not wait to start physiotherapy if you have AS. If you are searching for the best AS physiotherapy in Las Vegas, we welcome you to visit Suarez Physical Therapy. Here, our qualified physiotherapists provide personalized treatment and compassionate care to assist patients in overcoming AS. Our goals are to support and rehabilitate patients at every step of their journey. Set an appointment with us now by calling 702-368-6778 and take the initial step toward recovery and relief.