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Pain Management & Triggers for Ankylosing Spondylitis

pain management for ankylosing spondylitis symptoms
Pain management for ankylosing spondylitis requires identifying the triggers that aggravate your symptoms. Here are those possible causes of AS.

Ankylosing spondylitis (AS) occurs when the body’s immune system attacks its own joints for reasons that are not yet well understood. Joints between the bones in the spine and/or between the spine and pelvis are usually the first targets of this immune attack.

The actual causes and triggers of AS are still unknown. However, research has shown that patients who inherit the HLA-B27 gene are more prone to the condition. Recently, new genes (IL23R, ERAP1 and ARTS1) have also been linked with AS.

Below are the potential common triggers and causes of ankylosing spondylitis.

Causes that may aggravate AS:

  • Sedentary lifestyle
  • Improper sitting posture
  • Stress and a highly demanding work life
  • Certain bacterial infections may play a role in aggravating AS. The most likely culprit is an intestinal or a long-standing urinary pathogen (bacterium). Additionally, salmonella, yersinia and campylobacter infections have been implicated in some studies.
  • Certain sexually transmitted infections, such as Chlamydia trachomatis and Neisseria gonorrhoeae (common organisms responsible for reactive arthritis), are related to AS.
  • Apart from the above, excessive alcohol consumption, cigarette smoking and foods with high fat and sodium may also aggravate the signs and symptoms of AS.

Other possible causes of AS:

  • AS tends to start in the teens and 20s, striking men two to three times more often than women.
  • Family members of patients with AS are at a higher risk, depending partly on whether they have inherited the HLA-B27 gene.
  • Many patients with AS either have another family member with the condition or have another family member that has some type of rheumatologic or autoimmune condition. The risk of AS increases if patients have family members who have this condition even if they don’t have the HLA-B27 gene.
  • An uneven ethnic distribution of AS exists with the highest frequency appearing in the far north, in cultures such as Alaskan and Siberian Eskimos and Scandinavian Lapps (also called Samis), who have a higher frequency of the HLA-B27 gene. Moreover, the condition occurs more often in certain Native American tribes in the western United States and Canada.

Which diet is suggested for patients with ankylosing spondylitis?

No particular foods have been found to make ankylosing spondylitis (AS) either better or worse. However, it’s sensible to eat a well-balanced diet and keep a healthy weight. Being overweight will increase strain on your back and other joints, which could further aggravate your AS pain.

Patients with ankylosing spondylitis should make sure they get enough calcium and vitamin D, which are important for bone health, because they have an increased risk of osteoporosis. However, few studies have reported that an anti-inflammatory diet and a low to no starch–glutensugar diet are useful for AS patients (less inflammation and less pain).

That said, ankylosing spondylitis patients should increase the following:

  • Eat plenty of proteins, vegetables and fruits.
  • Include any type of unprocessed meat at least once in the diet (fish, poultry, pork and lean cuts of beef or lamb).
  • Increase intake of all green vegetables (cabbage, cauliflowers, sprouts, courgettes, peppers, mushrooms, spinach, broccoli or carrots).
  • Include more available fruits in your diet.
  • There are no restrictions on spices (pepper, salt or herbs).
  • Blanched almonds, pine nuts and sesame seeds can be included in your daily diet.
  • Increase intake of foods rich in omega-3 and vitamin D, such as fatty fish and mushrooms.
  • Dietary supplements might help patients get the extra nutrients they are missing.

Foods that may need to be regulated:

  • Start by eliminating all dairy products for two months.
  • If that doesn’t help, experiment with the elimination of wheat, corn, soy, sugar and citrus fruits one at a time.

Many diets have been recommended to patients with AS, including avoiding certain food types. There’s no convincing evidence that these work, and there’s a chance that they may make a patient’s health worse by missing out on essential nutrients. If you are keen on trying any of these diets, it would be a good idea to discuss it with a dietitian or doctor first.

What are the treatment options for patients with ankylosing spondylitis?

Depending on a patient’s signs and symptoms and medical condition, ankylosing spondylitis (AS) may be managed conservatively or surgically, through the following ways:

  • Recent research and studies have shown that nonsteroidal anti-inflammatory drugs (NSAIDs) and tumor necrosis factor-alpha (TNF-α) blockers have positive effects on patients with AS. Patients with AS who are treated with these drugs found improvement in their pain, physical function and morning stiffness.
  • Surgery is usually not required in most patients with AS; however, doctors might suggest this option when patients are in a progressive stage where pain is severe. They may perform repair or replacement of the damaged joints (hip/knee) and tendons.
  • Physical therapy has proven to be the most effective in patients with AS. Exercises are designed to improve flexibility and range of motion. Doctors recommend stretching exercises and strength-building exercises for improving posture and strength.
  • Doctors design proper sleep and walking positions along with abdominal and back-strengthening exercises to improve or avoid the hunched-forward posture, as well as maintain an upright position. They also recommend deep breathing exercises too.
  • Doctors recommend swimming as a choice of exercise because it shows good results in patients with AS. Swimming helps reduce pain and improve posture and breathing.

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