Is Massage Good For Ankylosing Spondylitis

Best Massage For Ankylosing Spondylitis

If youre considering massage therapy to help ease the symptoms of ankylosing spondylitis, first talk to your doctor about whether massage is safe for you and which techniques may work best.

Different people respond to different types of massage , so its important to figure out which type is best for you, Kirschner says. One type involves tapping, and thats usually less effective than some of the deeper, kneading types of massage.

For some, massage can trigger an ankylosing spondylitis flare, according to the SAA. Kirschner says that as long as the therapist is massaging over the muscles and not the joints, it should not cause a problem. If youre having any sort of pain or discomfort, he says, always tell the massage therapist, who will then be able to work around that.

Wallace generally uses soft-tissue massage for ankylosing spondylitis. This includes stretching, some vibration, circle strokes, kneading, long gliding strokes, and mild sacral rocking. Her massage techniques change, however, depending on whether a person is in an ankylosing spondylitis flare or if the disease is under control.

There will be certain times when a person is almost in remission, and you can be a little more aggressive and use more moderate pressure, Wallace says. Then there are times when inflamed, and you need to use a much lighter touch.

Deep-tissue massage should be avoided if a person is in an aankylosing spondylitis flare, Wallace cautions.

Complementary Therapies For Ankylosing Spondylitis

Complementary therapies may also be useful, adds Dr. Chan. These might include acupuncture or gentle massage, although she cautions that supportive evidence is limited. Some therapies such as taking probiotics to reduce inflammation, doing relaxation techniques to ease muscle tension around the thoracic spine, and exploring mindfulness practices that may help with pain relief could be useful as well, she says. Just be sure to discuss these with your doctor before starting any treatment.

Eli Lilly’s Taltz Approved For Ankylosing Spondylitis

In August 2019 the FDA approved Eli Lillys Taltz injection for the treatment of adults with active ankylosing spondylitis .

Like Cosentyx, Taltz is also classified as a humanized interleukin-17A antagonist. Taltz works to lower pain and swelling by inhibiting the release of pro-inflammatory cytokines and chemokines. It’s also approved for the treatment of plaque psoriasis and psoriatic arthritis.

FDA approval was based on Phase 3 studies in 657 adults. At 16 weeks, patients achieved ASAS40 at the following significant response rates:

• COAST-V study : 48% of patients treated with Taltz every 4 weeks versus 18% of patients treated with placebo.
• COAST-W study : 25% of patients treated with Taltz every 4 weeks versus 13% of patients treated with placebo.

The safety profile observed in patients with AS treated with Taltz was consistent with the safety profile in patients with psoriasis. The most common side effects of Taltz include:

• Injection site reactions
• Fungal infections

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Myth Or Fact Tnf Blocker Injections Rarely Cause Skin Reactions

Definitely a myth. In fact, the most common side effect seen with the TNF blockers are injection site reactions on the skin.

• A localized rash, burning, or itching may occur and can last up to one week.
• Roughly 10% to 20% of patients might experience injection site reactions, which are usually described as mild. However, if the reaction still persists after one week, contact your doctor to discuss.

In addition, patients using TNF blockers should consult with their health care provider before receiving any “live” vaccine as TNF blockers may make the vaccine less effective.

Other Possible Causes Of Rib Pain

Although rib pain may be related your ankylosing spondylitis, keep in mind that it could be caused by something else. Dr. Schwab says rib pain is very common among the general population, and he estimates about 80% of people will have pain in the ribcage or thoracic spine at some point in their lives. Some possible reasons may include:

• Bruised, cracked, or fractured rib

• Costochondritis, or inflammation of cartilage near the breastbone

• Osteoporosis, which can leave bones weakened and may affect the thoracic spine

• Pleurisy, a condition involving swelling of the lining of the lungs

• Poor posture or inactivity that can put strain on the thoracic spine

As with other symptoms that may be impacting daily activities and affecting your quality of life, see your healthcare provider if you have persistent pain, so you can catch any issues early and start treatment if needed.

Common Symptoms: Spondylitis Association of America. Most Common Symptoms.

Thoracic Spine: American Association of Neurological Surgeons. Anatomy of the Spine. and Peripheral Nervous System.

Difficulty With Deep Breaths: National Institutes of Health. Ankylosing Spondylitis.

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Myth Or Fact Ankylosing Spondylitis Leads To Severe Disability

Myth. Not everyone with ankylosing spondylitis has severe disease or physical disability – the disease course is variable and differs greatly among patients.

It is not a life-threatening disease and many people are able to work and function normally throughout their day. In most cases, AS is characterized by painful episodes followed by remissions, a time where the pain subsides.

Studies have shown that patients who have disease onset at an older age may be more prone to severe joint damage. In addition, smokers were more than four times as likely to have severe damage as nonsmokers.

For severe ankylosing spondylitis or other joint problems, surgery or joint replacement may rarely be required.

What Are Complementary Therapies

Complementary therapies are designed to work alongside conventional medicines and treatments rather than to replace them.

Most complementary therapies concentrate on treating the whole person rather than specifically treating the condition itself.

Like conventional medicine, complementary therapies cannot cure axial SpA .

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Finding A Qualified Massage Therapist

If you are looking for a licensed massage therapist, one of the best places to start is the American Massage Therapy Associations website. This site will help you locate qualified healthcare providers in your area. In addition, you can use this tool to look for therapists who are board-certified massage therapists.

These individuals are not only accredited by the state but have also received advanced education and specialized hands-on skills that make them uniquely qualified. Your primary healthcare provider or rheumatologist may also have suggestions for a therapist in your area who is skilled in treating AS.

Myth Or Fact If Nsaids Don’t Work I’m Out Of Options

Definitely not true. The biologics, or tumor necrosis factor -alpha inhibitors , can play a key role in those who do not respond to NSAIDs. TNF blockers can lead to less back pain, stiffness, and inflammation they may also slow progression of AS. TNF blockers may be used in conjunction with NSAIDs for symptom control.

FDA-approved biologics for ankylosing spondylitis include:

• Simponi , Simponi Aria

These agents are administered in the clinic or given by self-injection at home. Some patients with AS may see results as soon as 2 weeks, but for others it may take several months.

In an evidence-based Cochrane Review colleagues concluded that there is moderate to high quality evidence that anti-TNF agents improve clinical symptoms in the treatment of ankylosing spondylitis.

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Exercise And Massage Treatment

Our goals for treatment should be to reduce symptoms, minimize spinal deformity, disability, and in reviewing research there is one topic that continually comes up as a non-pharmaceutical treatment for ASexercise!

There are many similarities between rheumatoid arthritis and AS, but some similarities are still present, so, much of the research revolves around RA instead of AS. It is recommended for people to get 30 minutes of moderate intensity exercise per week 3 days a week, or the equivalent of 90 minutes/week. However, this can include dynamic exercise to improve muscle strength and aerobic endurance.

RCTsshowed how exercise was most effective in physical function and spinal mobility for patients with AS, more specifically supervised exercise was even more effective, and pool exercises were more popular than land based. One study showed that a combination of self and manual mobilization at home helped with chest expansion, posture, and spinal mobility.

So, what does this all mean for us as massage therapists?

What Not To Do When You Have As

Some AS patients find it difficult to handle massages even the lightest touch can be uncomfortable. Others claim that getting a massage makes their AS symptoms worse. Pay close attention to your body and monitor side effects if you attempt massage treatment.

Inappropriate massage techniques may occasionally even cause an AS disease flare-up. You must let your massage therapist know about your illness and let them know if any of their treatments are making it worse.

In addition, vigorous massage or manipulation of the back or neck should be avoided in people with reduced spinal mobility due to AS. The side effects of these therapies, such as increasing weakening or sensory abnormalities, might result in spinal fractures and unexpected neurological problems.

Avoid deep tissue massage if possible, especially if your symptoms worsen. For some with AS, this more vigorous style of massage can be quite uncomfortable.

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Identifying Rib Pain From Ankylosing Spondylitis

Differentiating between ankylosing spondylitis-related rib pain and other pain problems comes down to few key factors. If youre experiencing stiffness and reduced mobility first thing in the morning and it improves quite a bit after some activity, thats highly suggestive of AS, says Dr. Chan. She adds that other include:

• Burning or ache in your ribs, especially if you havent moved in a few hours

• Difficulty twisting your torso, such as turning around to look behind you

• Fatigue or trouble maintaining energy throughout the day

• Pain in the middle of your back

• Shortness of breath

• Tightness in the center of your chest that feels close to the skin

• due to rib pain discomfort

Breath issues, in particular, can accompany AS-related rib issues. For example, you may have trouble taking deep breaths, as if your lungs arent able to expand fully. Or, you may be able to take those breaths, but you feel sharp pain while inhaling. That can be due in part to inflammation limiting the space in your ribcage, says Dr. Schwab. It may also be from tightness in the chest that causes the shoulders to round forwardthe combination of and inflammation can create a hunch that also restricts your space to breathe.

Symptoms Of Ankylosing Spondylitis

The disease is more common in women than men. The disease progression is inevitable in most cases and the symptoms worsen over time.

Like auto-immune disorders, patients suffering from ankylosing spondylitis experience periods of exacerbated symptoms i.e. flare ups followed by reminiscence.

This debilitating disease manifests itself in the following ways:

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Myth Or Fact Ankylosing Spondylitis Is Easily Curable

This is a myth, too. There is not a cure for Ankylosing Spondylitis however, there are FDA-approved medications that can reduce AS symptoms and help to manage the pain.

• AS is characterized by acute, painful relapses of back pain followed by periods of remission where symptoms subside.
• In some patients, pain may occur elsewhere – for example in the shoulders, hips, ribs, and small joints of the hands and feet.
• Pain may be worse in the morning and decrease during the day and with exercise.

AS is an autoimmune disorder, which is an illness that occurs when the immune system wrongly attacks tissues in the body. NSAIDs are helpful for pain and studies show TNF blockers can slow or halt AS disease progression.

Secukinumab , the first in a new class of medicines called interleukin-17A inhibitors was FDA approved in 2016 to treat AS. Consentyx significantly reduces signs and symptoms of AS and increases overall mobility.

Biofeedback And Splint Therapy

Some people experience severe jaw pain that prevents them from opening their mouths completely. Biofeedback therapy a non-drug treatment involving electical sensors can help: Through the therapy, people learn to control muscle tension.

Some people also find relief through splint therapy, which involves wearing a mouth guard custom-made by a dentist.

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Easing As Symptoms At Home

Home treatments for ankylosing spondylitis can help manage your symptoms and put you back in the drivers seat of your health.

Dont underestimate how poor sleep or excess stress can affect your overall health. Its important to have a regular sleep cycle and get enough hours of sleep per night.

Its also vital to have a healthy way to reduce stress in your life. This can be as simple can making time to talk to a confidant, taking a walk outdoors or seeing a therapist if the stress is interfering with your daily activities. Talk to your healthcare provider about your plan and keep on top of your medical treatment, too.

Myth Or Fact Tnf Blocker Side Effects Are Very Dangerous

Not always. But you should educate yourself.

As with most medicines, TNF blockers have some serious side effects. However, most of the very serious side effects are also very rare. An increased frequency of infections, including tuberculosis or fungal infections, may occur. Prior to beginning treatment with TNF blockers, a TB test is given to rule out an active infection.

Also, a very rare side effect is the increased frequency of certain cancers, for example:

• non-melanoma skin cancers .

Some agents have also been linked with a severe allergic reactions .

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What To Watch Out For

Some people with AS dont tolerate massages well even the lightest touch can be painful for them. Others report that massages cause their AS symptoms to worsen. If you decide to try massage therapy, pay close attention to your body and watch for any negative effects.

The bones in your spine shouldnt be manipulated during massage therapy. This can lead to serious injury. Try to avoid deep tissue massage, especially if your symptoms are flaring. This more aggressive type of massage can be quite painful for those with AS.

You should keep in mind a number of things when looking for a massage therapist:

• Will your insurance cover massage therapy? If so, does this therapist take your insurance?
• What fees are involved, and do they differ according to type of massage? Are package rates available?
• Does the therapist have experience with AS or other types of arthritis?
• What types of massage are offered?
• Is the therapist board certified? Do they belong to any professional organizations?

Jaw Pain With Ankylosing Spondylitis: Causes And Management

The pain thats a hallmark of ankylosing spondylitis typically affects the back and neck. However, it can also impact other parts of the body, including the jaw. Experiencing jaw pain can impact a persons quality of life, making it difficult for them to swallow, eat, and open their mouth.

Jaw pain is a common complication for people with ankylosing spondylitis and other types of arthritis. Some researchers estimate that about 15 percent of people diagnosed with AS experience inflammation and pain in the jaw. Others report that as many as 35 percent of people with the condition experience jaw pain.

Many members of MySpondylitisTeam report jaw pain. Some members report that their AS jaw pain developed into temporomandibular disorder sometimes referred to as temporomandibular joint syndrome. The temporomandibular joints are located on either side of your face, directly in front of your ears. They connect your lower jawbone to your skulls and help with eating and talking.

OMG! The jaw pain! Does anyone else have it? one member wrote. It goes from side to side, and just wonât quit! I have spent a fortune with the orthodontist getting mouth pieces I wear day and night. They help, but it still hurts!

Recognizing jaw pain in ankylosing spondylitis and understanding what causes it can help you find better ways to manage it.

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How Ankylosing Spondylitis May Cause Rib Pain

According to the American Association of Neurological Surgeons, the spines thoracic vertebrae are located in the upper back and connect to your ribcage. As in the other parts of the spine, each vertebra is separated by discs for support and cushioning.

Inflammation in these discs can impact the whole ribcage, says Frank Schwab, M.D., chair of orthopedic surgery at Lenox Hill Hospital in New York City. Because AS is an inflammatory condition, it tends to stiffen muscles, ligaments, and tendons, so you may feel aching around the ribs as well as inside them, and limitations on your movement.

This can happen in front by the sternum, lower down near the bottom of your ribs, or in back where the ribs attach to the spine. The inflammation associated with AS flares can also make your whole torso feel stiff, adds Dr. Schwab, especially in the morning.

Cosentyx: Expanding Treatment Options For Ankylosing Spondylitis

Cosentyx is the brand name for the drug secukinumab and is administered by subcutaneous injection, usually every four weeks.

Secukinumab inhibits interleukin-17A , effectively blocking the release of chemicals by the immune system responsible for inflammation.

Fever, headache, muscle aches, sore throat, fatigue and a stuffy or runny nose are common side effects. Cosentyx also increases your risk of infection and patients treated with Cosentyx should not receive live vaccines.

Studies have shown that 61% of patients had an improvement of at least 20% in their ankylosing spondylitis symptoms after 16 weeks of Cosentyx treatment, with 36% experiencing over 40% improvement. Many of these patients had failed to respond to, or were intolerant of, biologics.

In June 2020, the FDA also approved Cosentyx to treat active non-radiographic axial spondyloarthritis . nr-axSpA is part of the axSpA spectrum, which is characterized by inflammatory arthritis of the spine associated with chronic inflammatory back pain, but may not show on X-ray studies.

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