We’re not just pulling your leg

Tell us about physiotherapy, for people not familiar with what you do

To put it very simply, physiotherapists are specialists in human movement, exercise and physical activity. Physiotherapy – or physical therapy as it is known in some regions, such as North America – is the science of getting back movement and function in the bodies of people in whom it’s been taken away.1

Sometimes physiotherapy helps get back the use of an arm or leg following an injury – maybe an ankle sprain from playing sport or a fracture following an accident. Other times, physiotherapy helps with the treatment of longer-term conditions like multiple sclerosis, osteoporosis, rheumatoid arthritis and, of course, AS.

So physiotherapy can be helpful for people with AS?

Absolutely, yes. In fact, there is agreement among international experts that physiotherapy is a cornerstone of AS management.2 For some, physiotherapy helps decrease pain and increase mobility in the lower back and spine. Although physiotherapy alone doesn’t stop AS from progressing, it can work alongside other types of medical treatments – like drugs, for example – to help treat the symptoms of the condition and maximise function. Combining exercise and drug treatments may produce better outcomes than just exercising or taking medication.3

At the initial consultation, a physiotherapist will carry out a thorough assessment – this allows treatments to be tailored for the individual. An AS physiotherapy programme might include a range of therapeutic exercises – for example, range-of-motion and stretching exercises targeting movement around the spine and neck. A balanced programme could also include muscle strengthening exercises, postural re-training, and aerobic exercise like swimming or cycling. Practical advice and education are also important components of the physiotherapy service.


"Physiotherapy is a cornerstone of AS management."

Is there a lot of research out there to support it?

We see lots of people with AS in our clinic, who are very positive about their experiences. And there’s an evolving body of research out there too.4,5 Importantly, no harmful effects of physiotherapy have been reported – rather a range of potential benefits. These include reduced pain and stiffness, improved movement of the back and neck and lower reported disease activity.4

The potential benefits of physiotherapy extend beyond physical improvements.4 People with AS often tell us that, with regular exercise, their mental health improves, they sleep better and they experience less fatigue during the day. They get a ‘feel good factor’ from exercise, and this carries over into other aspects of their lives – like work or family time.

Exercising under the supervision of a physiotherapist, or as part of a physiotherapy-led exercise group, can lead to better results compared with exercising alone.4,5

Why isn't physiotherapy used more often?

The role physiotherapy plays in your treatment depends on the healthcare system where you live and the advice your doctor gives you. Both European and North American organisations have published international guidelines that, as part of a series of recommendations, strongly support the use of supervised physiotherapy for people with active AS.2,6

What if I want physiotherapy?

Physiotherapy can really help manage AS. However, a good deal of personal commitment and time – and sometimes money – are needed. Talk to your doctor about how appropriate and available physiotherapy is for you in your part of the world.

This article was written by Tom O’Dwyer and Dr Fiona Wilson, with help from the resident experts at ThisASLife.com – a social site, helping the whole AS community to Learn. Share. Inspire. Discuss.

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1. World Confederation for Physical Therapy, 2011. “Policy Statement: Description of physical therapy”. Available at http://www.wcpt.org/policy/ps-descriptionPT
2. Braun J et al. Ann Rheum Dis 2011; 70:896-904.
3. Lubrano E et al. Semin Arthritis Rheum 2015; 44:542-50.
4. O’Dwyer T el al. Rheumatol Int 2014;34:887-902.
5. Dagfinrud H et al. Cochrane Database of Syst Rev 2008; CD002822.
6. Ward MM et al. Arthritis Rheumatol 2015 Sep 24: doi 10.1002/art.39298. [Epub ahead of print].


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Meet Fiona & Tom


Dr Fiona Wilson



Tom O'Dwyer


Dr Fiona Wilson is an Assistant Professor at Trinity College Dublin and a qualified physiotherapist; with over 25 years of clinical and research experience. She works with Tom O’Dwyer, a practising physiotherapist with international experience working in a major teaching hospital in Dublin. He recently completed his PhD in Physiotherapy with his thesis "Physical Activity and Physical Fitness in Adults with Ankylosing Spondylitis".

Among a range of shared research interests, together they’re investigating the positive effects of physiotherapy for people with AS.

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