It is normal to worry about your health and living with axSpA may make you feel more anxious. axSpA is a progressive disease, which means the risk of complications increase the longer you have had it. This can create a fear of disease progression, inability to manage your symptoms and the loss of independence as you become older.
The good news is that research has provided a better understanding of the disease, the involvement of the immune system and the role of genes in axSpA. This has helped to diagnose axSpA earlier and start treatment sooner. Modern medications, like biologic disease-modifying anti-rheumatic drugs (bDMARDS) have greatly improved management of axSpA. Many adults now living with axSpA have better mobility and reduced pain, inflammation, and disease activity (the severity of the condition at a given point in time). However, it is important to remember that people taking biologics should maintain regular physical activity. Exercise adds an additional benefit than biologic therapy alone.
Adults who have well controlled axSpA can usually follow general advice for healthy ageing, along with consultation with their rheumatologist. This includes:
- Being physically active. Being physically active is important to maintain your general health and wellbeing. The Australian Physical Activity Guidelines recommends older people do 30 minutes of medium intensity exercise each day. Activities to improve balance, strength and cardio fitness are particularly important in people with axSpA to help reduce the risk of falls and maintain joint flexibility.
- Eating healthy food. It is important to eat a balanced diet to help maintain a healthy weight, increase energy, and improve general health and wellbeing. The Australian Guide to Healthy Eating illustrates the proportion of the five food groups recommended to eat each day.
- Socialise and stay connected with others. Maintaining social connections is important for everyone. Studies have found that social participation in older age helps to prevent isolation and loneliness, keep us engaged and active and improves quality of life. Getting involved in your community allows you to meet new people while doing something you enjoy.
What if my axSpA is not under control?
If your axSpA has not been treated, is more advanced or you have other complications, you may require more targeted therapy from a range of health professionals to help manage your axSpA. Signs of advanced axSpA may include:
- Fusion of joints in the spine (spinal ankylosis). Overtime inflammation can cause the joints in the spine to fuse together, causing stiffness, pain and decreased mobility.
Source: Tristate Arthritis & Rheumatology
- Joint damage in other areas of the body. axSpA can affect other joints in the body, like the shoulders, elbows, knees and ankles. Joint damage can be caused by inflammation in the joint or inflammation where a ligament or tendon attaches to the bone, called enthesitis.
- Systemic conditions. Inflammation can affect other parts of the body outside of the bone and joints. This might include, uveitis (inflammation of the eye), inflammatory bowel disease, heart disease and osteoporosis.
If you have advanced axSpA, you might find some activities hard to do. Severe spine changes can lead to problems with balance and mobility. In severe cases of axSpA bones may lose density and become brittle, increasing the risk of fractures.
Along with treatment from your rheumatologist and healthcare team it is recommended to see a physiotherapist who can help you to develop an individualised exercise program specific to your condition. Exercises for people with advanced axSpA should emphasis mobility of the spine and peripheral joints, such as your shoulders, hips and knees. Exercises that maintain existing range of motion is also important.
Exercises that are considered not safe for advanced cases of axSpA include:
- High impact exercises, like contact sports.
- Fast movement of exercise with lots of resistance.
- Exercises which require a lot of balance, ability to stay stable or challenge your breathing
- Exercises which require lots of spinal or joint mobility in person with ankylosis (fused bones)
To find exercises suitable for people with advanced axSpA read out resource Exercise and advanced axSpA.
If you are unsure of the severity of your arthritis and its impact on your functional ability, you can take the BASFI survey. The BASFI is a validated questionnaire to measure your level of functional ability. Registered website users can access the survey in the About My Health section under the My Surveys drop-down menu.
Contact your local arthritis office to find out more about appropriate exercise classes for people with axSpA near you or call the Arthritis Infoline on 1800 011 041.