Treating Axial Spondyloarthritis: Exercise & Physical Therapy

Conditions on the AxSpA spectrum are not curable, but they can be treated. They are chronic, progressive conditions, but treatment can help alleviate symptoms, improve quality of life, and increase mobility. Exercise and/or physical therapy is an important part of treatment for people living with AxSpA spectrum conditions and complements other types of therapies in your treatment plan. Exercise is a first-line treatment and is typically one of the first things suggested to people living with AxSpA.

It is suggested that as soon as you can (check with your doctor), to start exercising when you get your AxSpA spectrum diagnosis, and continue regular exercise.1 Exercise and physical therapy have been found to be more effective when done as a supervised outpatient group, but exercise and physical therapy are helpful no matter what.2

Benefits of exercise for AxSpA

Posture improvement

One of the things that exercise and physical therapy can help with is posture control. Exercise can help improve posture.3 Posture training can be part of physical therapy, as well. In AxSpA spectrum conditions, disease progression can lead to the spine becoming immobile in a fixed position.1 Posture training and exercise can help prevent this. In everyday life, especially if you are sedentary, sitting at a computer or desk all day can involve a slumped posture. This causes shortening of muscles in the back of the thighs, tilting of hips, and the head and neck tilted forward.1 In posture training, these behaviors are all addressed, helping you maintain good posture.

Joint mobility

Exercise and physical therapy help increase and maintain flexibility, increase range of movement, and can help reduce stiffness and pain.3 The inflammation in AxSpA spectrum conditions can lead to joint and spine stiffness, which makes it hard to do everyday things and causes reduction in mobility. Staying active can help reduce the stiffness and increase joint mobility, which in turn also increases quality of life and physical functioning.2

Increased mobility also has been found to reduce feelings of depression.2 This finding cannot be underestimated, as depression can have a significant impact on one’s life, emotionally, socially, and physically.

Chest expansion

As AxSpA spectrum conditions progress, there may be less mobility with the spine or it may start to fuse into a fixed position that impacts breathing or the chest. As joints become stiff, this includes the joints where the ribs connect to the vertebral column. When these become stiff, this can cause reduced chest expansion.4 Exercise can help reduce the stiffness and improve mobility so that the chest is able to expand more without being harsh to the spine.5 An exercise like swimming, especially breaststroke, helps to expand the chest and encourage mobility of the joints.5

Chest expansion is also related to posture training, since good posture can help prevent excess or abnormal curving of the spine.5 This curving can further narrow the chest and prevent expansion.

Before starting an exercise routine on your own, talk with your doctor and make sure it’s safe to do so. Getting a professional physical therapist is a good idea, since they can show you the correct way to do exercises and provide guidance to ensure proper form, reduce the risk of injury, and maximize the benefits of physical activity. Especially combined with other forms of treatment, physical activity is a cornerstone of AxSpA spectrum treatment plans.

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Written by: Jaime Rochelle Herndon | Last reviewed: November 2020