6 Top Ankylosing Spondylitis Self-Care Strategies

Alongside medication and physical therapy for ankylosing spondylitis (AS), self-care plays a key role in managing symptoms and boosting your quality of life. Any activity that helps you feel better and keeps your symptoms at bay counts as self-care.

“Thriving with AS requires a lifestyle shift,” says Catherine Bakewell, MD, a rheumatologist in Salt Lake City and board member for the Association of Women in Rheumatology. “By adopting a lifestyle that supports regular physical activity, good posture, stress management, and plenty of high-quality sleep, you can slow down this disease and have a very good quality of life.”

Here’s how these and other self-care tips can help you get the most out of your treatment and reduce your AS symptoms.

1. Exercise Regularly

Pain and stiffness, two hallmark symptoms of AS, tend to improve with exercise and get worse with rest.

But when your spine feels tight and immobile, exercising may feel like the last thing you want to do, says Jeremy Smith, MD, orthopedic surgeon for Hoag Orthopedic Institute in Orange, California.

“However, encouraging spine flexibility and activating the muscles around the spine can be one of the best things for anyone with AS,” says Dr. Smith.

Stretching and exercise can help reduce pain and inflammation, lessen stiffness and swelling, fight joint fusion, and improve breathing, endurance, posture, and bone density, says Dr. Bakewell. Even just 20 minutes a day is enough to see benefits, she adds.

While no universal guidelines for AS and exercise exist, experts have found that many types of physical activity can reduce symptoms.

Exercises that help extend the back are especially helpful for mobility and pain relief.

Bakewell and Smith recommend low-impact cardiovascular exercise for AS, such as:

When it comes to exercise, it’s vital to listen to your body and develop an exercise plan with your doctor or physical therapist, including the ideal amount of exercise you should get each week. Physical activity that’s too intense could have the opposite effect and spark a symptom flare. “You don’t want to overdo it,” says Aly Cohen, MD, integrative rheumatologist based in Princeton, New Jersey.

2. Eat an Ankylosing Spondylitis–Friendly Diet

Because AS causes an immune response that triggers inflammation in your body, eating a diet rich in anti-inflammatory foods may help lessen AS symptoms.

“I often recommend limiting alcohol intake, saturated fats, and processed starches and focusing on a diet high in fruit and vegetables, whole grains, and lean proteins like fish or chicken,” says Bakewell. However, more research on the role of diet in AS management is still needed, she notes.

It may also be a good idea to limit highly processed foods because they can disrupt your gut microbiome (the ecosystem of natural microbes living in your gut that play a role in your overall health), says Cohen. The reason: When the microbes in your gut are out of balance, your immune system can’t function well, which can disrupt the already compromised immune system in people with AS.

How your body responds to different foods is very individual, so it may take some trial and error to find the best fit for you. Some with AS find gluten-free, Mediterranean, or low-FODMAP diets to be helpful, as well as supplements like omega-3 fatty acids and vitamin D, says Bakewell.

3. Practice Good Posture

Maintaining good posture can lessen pain, make everyday activity more comfortable, and prevent spine stiffening, says Bakewell. “Understanding how to position and support your spine when walking, sitting, and lying down is critical so that bones are properly aligned.”

Some AS-friendly tips to help improve your posture include:

Keep your head over your neck and your shoulders over your pelvis.
Build posture-supporting muscles by standing against a wall with your heels, buttocks, shoulders, and head touching the wall each day.
Choose a supportive chair with a large backrest, adjustable height, lumbar support, and a soft, contoured seat.
Try a sit-stand desk for work.
Sleep on a firm mattress with a thin pillow or no pillow under your head.
Do any posture exercises recommended by your physical therapist.

4. Find Ways to Manage Life’s Stresses

Research shows high levels of stress can worsen AS symptoms. That’s why curbing stress as much as possible is an important part of self-care.

Specifically, it’s a good idea to find effective ways to calm the body’s physical reactions to stress and other difficult emotions, says Cohen. Some techniques that can help include:

“[These activities] help the body shut down stress signals and stop the stress cycle from becoming a chronic problem,” says Bakewell.

5. Get Enough Sleep Each Night

Don’t underestimate the importance of sleep for your overall health. Getting enough sleep each night helps support your immune system, give you more energy, and boost your mental and physical health, says Bakewell.

Research shows many people with AS find it difficult to get the sleep they need due to their condition.

But not getting enough sleep can make certain AS symptoms worse. “When people don’t have enough sleep, they tend to have higher perceptions of pain,” says Cohen. This can become a difficult cycle to break.

Some tips to boost your odds of better sleep each night:

Take your prescribed AS medications as directed.
Avoid caffeine, alcohol, and screens too close to bedtime because they can keep you up at night.
Exercise during the day, but not too close to bedtime, so that your body has time to wind down.
Make sure your mattress and pillows are supportive and comfortable for your spine and joints to help minimize pain.
Keep your bedroom cool, dark, and quiet. A sleep space that’s too warm, noisy, or bright can keep you awake at night.
If these tips don’t work, let your doctor know. They can help you find a solution that works for you.

6. Quit Smoking

Smoking isn’t safe or healthy for anyone, but it can have particularly negative effects if you have AS. People with AS who smoke often report a lower quality of life than those who don’t smoke, research shows.

One reason: Smoking speeds up spinal damage and can amplify other AS symptoms, says Bakewell. The chronic cough that often accompanies long-term smoking can also worsen spinal damage, adds Smith.

That’s one reason it’s so important to quit smoking if you have AS. But as you probably know, quitting smoking can be difficult. If you’re struggling to quit, here are some tips that can help:

Ask your doctor about prescription medications that can help you quit smoking.
Find more constructive ways to manage stress instead of turning to tobacco for relief.
Lean on friends and family members for support and accountability if you need it.

Even starting small by smoking just one less cigarette a day (and gradually building on that progress) can help you in the long run, adds Cohen.

The Takeaway

If you have ankylosing spondylitis, regular self-care can help your medical treatments work better and improve your quality of life. Regular low-impact exercise, a nutritious diet, good posture, stress management, and plenty of quality sleep can all help you reduce your symptoms and live well with AS.