Improving mobility in ankylosing spondylitis patients
Most patients who are given the diagnosis of ankylosing spondylitis have no idea what the disease is all about. Essentially, ankylosing spondylitis is a form of inflammatory arthritis that localizes in the spine. Because it is an auto-immune disease, the body attacks the facet joints between the vertebra, resulting in fusion and the hallmark forward stooping posture. It is difficult to diagnose and patients can live with it for years undetected. Arthritis is generally thought to be an old person’s disease, however, ankylosing spondylitis is most commonly seen in individuals between 17 and 35 years of age.
A new class of drugs called biologics have revolutionized the treatment of auto-immune diseases and many patients are able to improve their quality of life as a result. Dr. Carlo Ammendolia at the University of Toronto says that the use of these drugs actually control the inflammatory process and are life changing for those struggling with the pain ankylosing spondylitis, however, they do not address the fusion of the joints that can impair mobility. Since most people are young when they receive their diagnosis, the thought of not being able to enjoy all of life’s activities because of spinal fusion can be devastating. Through his research, Dr. Ammendolia is working with patients to develop management approaches to help minimize or slow the fusion process.
Dr. Ammendolia has identified several tailored exercises that when combined with the drugs can help improve or slow the fusion process. “The exercise program is really geared towards lifestyle and self management where patients are doing things sitting, standing, walking and sleeping in a posture that mitigates that risk to fuse in that posture.” The goal is to improve the muscles around the joints so that optimal posture is maintained. Chiropractic care also plays a role, with carefully considered adjustments adding to the overall treatment plan. Push/relax techniques are used to help regain neck flexibility. In cases where joints are already fused together, manual adjustments are not performed.
As much as we hate to admit it, most health care, especially disease management, requires commitment from the patient to improve or maintain their wellness. That is of course what Empowered Health is all about, right? With these protocols, Dr. Ammendolia hopes that individuals suffering from ankylosing spondylitis will be “kick started” into self-management of the condition. Next steps include developing tools and resources that will help patients track and monitor their progress.