Top Reasons to See Your AS Doctor Now
Skipping treatments or missing checkups for ankylosing spondylitis is not the way to move forward with this challenging condition.
Ankylosing Spondylitis. The disease you can’t pronounce and likely had never heard of—until you or a loved one got diagnosed. It’s relatively rare, but for the 300,000 people in the U.S. (less than one percent of the adult population) who have it, it can be a real pain—literally. The disease, which affects the joints primarily in the lower back, can cause pain, stiffness, and damage, and not because of wear and tear, but thanks to inflammation, says Martin Bergman, M.D., chief of the division of rheumatology at Taylor Hospital in Ridley Park, PA, and clinical professor of medicine at Drexel University College of Medicine. “One of the hallmark symptoms we look for is back pain that’s worse in the morning and gets better throughout the day; another is back pain that awakens you at night.”
The interesting thing about AS, however, is that patients often feel better the more they move. “One of my first patients became a marathon runner because the only time he felt good was when he was running,” Dr. Bergman says. And not only do they feel better, but they do better. In fact, a 2017 study published in Archives of Physical Medicine and Rehabilitation found that people with AS showed improvement in their symptoms and their ability to perform day-to-day tasks when they did more exercise.
Regular care, including medication, physical therapy, exercise, and seeing your doc for regular check-ins is super important when it comes to AS, especially because “this disease wants to fuse the bones and push people forward, so they hunch over,” Dr. Bergman says. Not to mention, regular checkups help your doctor understand your baseline, which is helpful in monitoring disease progression, says Adam Kaplin, M.D., Ph.D., chief scientific officer of MyMD Pharmaceuticals in Baltimore, MD.
If your fear of contracting COVID has you contemplating playing hooky from seeing your doctor (which it shouldn’t, because doctor’s offices are taking every safety precaution under the sun), here’s why you need to get ahold of all the hutzpah you can muster and go.
Delaying Treatment Causes Irreversible Damage
We’re not trying to be alarmist, but the result of untreated ankylosing spondylitis is the fusion of your spine, in such a way that it ultimately becomes inflexible. “Think of AS inflammation as a smoldering coal—it’s slow burning just underneath the surface,” Dr. Bergman says. “You may not feel it, but if you delay treatment, those embers start to burn again, and the more damage is done.” And once a bone is fused, it’s irreversible, Dr. Bergman says: “The bones grow together. So instead of having two bones with a joint in between, it becomes one solid bone.”
Your Doctor Sees What You Don’t
There are things happening that are often so subtle only a doctor would be able to see them, Dr. Bergman says. “You may not necessarily feel some of the little changes like tenderness or joint or tendon swelling, but it doesn’t mean it’s not there,” he says. And depending on the patient, symptoms could progress quickly over weeks to months while others progress slowly over months to years—often without a distinct reason, Dr. Kaplin says.
A Consistent Meds Schedule Is Everything
Medication is an essential and ongoing part of treatment over the course of your lifetime. While meds can’t cure the disease, they can relieve pain and stiffness, so you have a better quality of life and most importantly, you’re able to do all the activities you love doing. “The disease is happening whether you feel it or not, so by not taking your medicine, you’re taking your foot off the breaks of the freight train,” Dr. Bergman says. Not to mention, patients need to be monitored to make sure their meds are working. “I want to know, are you tolerating it? Are you having any side effects? Are you getting rashes? Are you experiencing swelling in other places? I need to know what’s going on, so an in-person evaluation is for both efficacy and safety,” he says.
The other thing about AS meds that’s important to keep in mind is that inflammatory-related conditions involve a consistent course of treatment to maintain a balance and prevent inflammatory triggers. “The reason for consistent anti-inflammatory treatment is that it’s easier to keep the inflammation in remission or at a low level than to try to bring it down when it’s gone out of control,” Dr. Kaplin says.
Physical Therapy Is Key
Physical therapy techniques that include stretching and range of motion exercises help maintain function and prevent that fusion and hunching over. Studies have shown that individual and supervised exercises resulted in more spinal movement overall. “While some physical therapists are giving patients home therapies, or having Zoom sessions, there are deep massage and different kinds of heating techniques, which obviously you can’t do over a phone line,” Dr. Bergman says.
Bottom line? No one wants to get COVID. But you didn’t want to get AS either, and now that you have it, it is 100% in your best interest to keep your scheduled AS treatment appointments or routine check-ins, to be sure you stay one step ahead of this disease.
- Benefits of Movement for AS: Archives of Physical Medicine and Rehabilitation. (2018). “Effectiveness of Exercise Programs in Ankylosing Spondylitis: A Meta-Analysis.” archives-pmr.org/article/S0003-9993(17)31019-5/pdf
- AS & Physical Therapy: Cochrane Database of Systematic Reviews. (2008). “Physiotherapy interventions for ankylosing spondylitis.” cochranelibrary.com/cdsr/doi/10.1002/14651858.CD002822.pub3/full