AS loves exercise
Several trials have shown regular flexibility exercise is very beneficial for both pain and physical function.1 Make time to regularly do good-flexibility exercise; in my clinic, those that do report less pain and reduced use of medications.
AS hates smoking
Not only is smoking not good for heart health, it’s also specifically not good for AS. Smoking is associated with a range of worse outcomes in AS, including earlier disease onset,2 higher disease activity3 and a greatly increased risk of bony bridging in the spine (ankylosis).4
Take your non-steroidal anti-inflammatory drugs (NSAIDs)
In the clinic, often patients say that they don’t want to use anti-inflammatories (like ibuprofen) unless they “really need them” because they’re worried they won’t work when the pain is more severe. There’s no evidence to suggest that NSAIDs stop working if you take them all the time – in fact, long-term use may help slow disease progression.5 If you need to take NSAIDs, then take them – at the dose and frequency prescribed.
Be aware of anterior uveitis (or iritis)
Anterior uveitis (also known as iritis) is inflammation of the colored part of the eye. It’s common in patients with AS, up to 40–60% of whom will get it at some time.6,7 It’s important that if you develop a red, sore eye that is sensitive to light you need to see your doctor (or visit the hospital) and tell them you’re worried it might be uveitis.
Be aware of psoriasis too
Skin psoriasis is a condition that occurs quite commonly in the general population,8 but it is even more common in patients with AS.7 Often, psoriasis is a silvery skin rash on the knees or elbows but it can also occur on the scalp (where it may cause dandruff).8 There are many effective treatments for psoriasis, so if this is a problem you need to see your doctor.
Getting pregnant with AS
Although everyone is different (with different sets of problems), in general there is no reason why patients with AS can’t have children. Often treatments need to be changed when trying to get pregnant and during pregnancy. Don’t be afraid to talk to your doctor or rheumatologist about your plans for pregnancy and a family.
Inflammatory bowel disease can be part of life with AS
Around 1 in 8 patients with AS patients develop inflammatory bowel disease.7,9 This is a problem where the wall of the bowel gets inflamed. It’s important you talk to your doctor or rheumatologist if you are having problems with abdominal bloating or pain or if you have diarrhoea, blood or mucus in your bowel motions.
Early treatment is better treatment
There are a number of studies demonstrating that the earlier you treat your AS, the better it is for the condition.6 This means lower levels of disease activity and reduced complications like uveitis. Don’t be shy about getting treatment; also, help family and those around you by encouraging them to see a doctor if they have persistent back pain for three months or more.
Ask your doctor about current and new treatments
No matter what you have heard or read on the internet, the person with the best knowledge of the treatment options available – and what is right for you – is your rheumatologist. Often patients think that they have tried all the treatments (or run out of options) so miss appointments with their rheumatologist.
Things change rapidly, with new treatments coming along often. If you think you are not getting the most out of your current treatment, make time to speak to your rheumatologist about it.
Weigh up the benefits and potential side effects of treatment
Often patients are really worried when they read about potential side effects of treatments. But it’s important to remember that treatment with medications is always a balance between the expected benefits and potential risks or side effects. The balance people choose will often be different for different people.
The most important thing to remember, for this point and all the other is this: ask questions if you’re unsure. Remember, it’s not the doctor with AS or taking treatments – it’s you. You need to be happy with the information you’re getting or the medicines you’re taking. Don’t be shy – speak up!
This article was written by Dr Philip Robinson, with help from the resident experts at ThisASLife.com. A social site, helping the whole AS community to: Learn. Share. Inspire. Discuss.
1. Lim HJ et al. Rheumatol Int 2005; 25:225–229.
2. Videm V et al. J Rheumatol 2014; 41:2041–2048.
3. Wendling D, Prati C. Expert Rev Clin Immunol 2013; 9:511–516.
4. Poddubnyy D et al. Ann Rheum Dis 2013; 72:1430–1432.
5. Haroon N et al. Ann Rheum Dis 2012; 71:1593–1595.
6. Robinson PC et al. Arthritis Rheumatol 2015; 67:140–151..
7. Stolwijk C et al. Ann Rheum Dis 2015; 74:65–73.
8. Langley RG et al. Ann Rheum Dis 2005; 64(suppl2):ii18–23.
9. Smale S et al. Arthritis Rheum 2001; 44:2728–2736.