Best Complementary Treatments for AS Pain
If you’ve been diagnosed with ankylosing spondylitis (AS), a chronic inflammatory form of arthritis, it’s totally normal to head straight for the internet to research ways to manage the condition. Because the more you take control of your treatment plan, the more likely you are to get your symptoms under control. While medications are the most effective AS treatment, you’ll likely hear about other avenues for symptom relief, too: Enter complementary therapies. We spoke to the experts to get the facts about these options and things to keep in mind.
What Are Complementary Therapies?
Complementary therapies are practices used together with conventional medicine, according to the National Institute of Health (NIH). You might also hear the term “alternative” therapy, which means it’s used in place of conventional medicine. So for AS, conventional medicine includes things like nonsteroidal anti-inflammatory drugs (NSAIDs) and biologic medications. These conventional treatments can help slow down the progression of your disease and help you feel better overall, whereas complementary treatments are typically used just for symptom relief, per the Arthritis Foundation.
A Word of Caution
When it comes to complementary therapies, most are still under investigation to determine how well they work and what their role is in treatment, says Terence Starz, M.D., clinical professor of medicine and occupational therapy in the division of rheumatology and clinical immunology at University of Pittsburgh School of Medicine in Pittsburgh, PA. “We have to take a look at the treatment and look at how it affects the disease process—in the case of AS, inflammation,” he explains. “Then we do scientific studies to actually assess efficacy.” That’s why it’s important to talk with your doctor before trying any sort of complementary treatment or product to make sure it’s safe and won’t interfere with your medications.
That said, some things that fall under the umbrella of “complementary” therapies have well-established efficacy. That includes good old-fashioned exercise. “Exercise is extraordinarily important because the inflammation that occurs in AS can really result in loss of motion, and exercise can help with that,” says Dr. Starz. Exercise, especially when started early in your disease course, is crucial and can help you manage pain and stiffness that come with this condition, he says.
Another tried-and-true complementary therapy for AS is physical therapy. “When you look at the treatment recommendations for AS updated a few years ago from the American College of Rheumatology, physical therapy is endorsed as a staple of management,” says Joerg Ermann, M.D., rheumatologist with the Division of Rheumatology, Inflammation and Immunity at Brigham and Women’s Hospital. The goal of physical therapy is to maintain or improve your overall quality of life, which means your comfort, independence, and more, according to the Spondylitis Association of America.
Chiropractic care is another popular complementary therapy, per the NIH, and it involves manual manipulation of the spine. But when considering it for AS—in which the spine is the main areas affected—you have to be cautious, says Dr. Starz. “When there is inflammation present, you have to be very careful because a lot of mechanical stresses can irritate the problem further,” he says. In fact, treatment recommendations for AS strongly recommend against using spinal manipulation for AS patients with advanced disease—for example, if you have spinal fusion or osteoporosis—because it could increase your risk of fractures, says Dr. Ermann.
Acupuncture is a form of Chinese medicine in which a practitioner puts small, thin needs in your skin at certain points on your body, per the Arthritis Foundation. Studies show that it can encourage your body to release “feel-good” hormones called endorphins and help improve function and relieve pain in the short term, according to the SAA. That said, there isn’t much in the way of evidence specifically about its use for AS, so more research is needed, says Dr. Ermann. “Also, acupuncture is typically not covered by insurance and can become quite expensive,” he says.
Natural Health Supplements
Natural health supplements may also be appealing if you’re looking for additional ways to stay healthy when you have AS. “One challenge that comes up with these products is that they are not regulated nearly as directly as are medications overseen by the FDA,” says Dr. Starz. “So you’re not always sure what’s actually in the product.” Again, if you want to try supplements for your AS, talk to your doctor to get the go-ahead first.
Yoga—and other forms of mindfulness, like meditation—is another commonly used complementary therapy that you may be interested in to help manage your AS symptoms. It’s an Indian practice involving meditation, body poses, and deep breathing, per the Arthritis Foundation. And the good news is that studies show yoga can help reduce joint pain and stiffness, among other benefits (hello, mental health boost!). It can be especially helpful for low back pain, the Arthritis Foundation notes.
The Bottom Line on Complementary Therapies for AS
Remember, when it comes to AS, we have the most solid research showing conventional medications like NSAIDs and biologics are beneficial, says Dr. Ermann. “My rec is to rely on these predominantly on these interventions, and I also recommend physical therapy,” he says. “If patients want to do other things, they should know we don’t have a good evidence base that these things work, but it’s certainly something you may try.” Just remember to talk to your doctor before trying anything new to make sure you can do it safely—especially if you have advanced AS with things like spinal fusion, he says.
Natural Pain Relief for Arthritis: The Arthritis Foundation. (2021.) “8 Natural Therapies for Arthritis Pain.” arthritis.org/health-wellness/treatment/complementary-therapies/natural-therapies/8-natural-therapies-for-arthritis-pain
Non-Medicinal Approaches to AS: Spondylitis Association of America. (2021.) “Non-Medicinal Approaches to Treating Spondyloarthritis.” spondylitis.org/spondylitis-plus/non-medicinal-approaches-to-treating-spondyloarthritis/
Exercise for AS: Spondylitis Association of America. (2021.) “Exercise.” spondylitis.org/about-spondylitis/treatment-information/exercise/
AS Treatment Recommendations: American College of Rheumatology. (2019.) “American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network 2015 Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis.” rheumatology.org/Portals/0/Files/Recommendations%20for%20the%20Treatment%20of%20Ankylosing%20Spondylitis.pdf