Managing axial spondyloarthritis (axSpA), an inflammatory form of arthritis that affects the spine and is sometimes also known as ankylosing spondylitis or AS, is always challenging. But the challenge gets a whole lot bigger when you’re flaring.
“If a patient has had trauma, like an injury or a recent infection, it can make them more achy,” says Lawrence Brent, MD, associate director of the Rheumatology Fellowship Program at Temple University Hospital, in Philadelphia. “They may flare up in the upper or lower back, or get flares in the peripheral joints, like the Achilles tendon or the knees.” Emotional stressors like feeling overloaded at work, relationship issues, or navigating a major life change can factor in too.
Events like these can trigger an increase in inflammatory chemicals (even if you’re on medications for your axSpA, such as a biologic), Dr. Brent explains. And the result can be more pain, more stiffness, and more fatigue.
You should always let your doctor know when you’re flaring. But at-home strategies like the ones below can help you cope with—and reduce—your discomfort as well.
Add Some Heat
Prolonged periods of not moving—like first thing in the morning, or after sitting at your desk all day—can lead to serious stiffness in your back or hips. But heat can help. “Getting into a hot shower or bath will make you loosen up a little bit,” says Dr. Brent. Twenty minutes of soaking time should do the trick.
The heat encourages your blood vessels to expand and relax, boosting the flow of blood, oxygen, and nutrients to your achy tissues. And that increased circulation can help loosen up tight joints, according to the Arthritis Foundation.
When a shower or bath isn’t an option, like in the middle of the work day, try an electric heating pad. Just plug the pad in and drape it over any stiff spots for fast relief.
Book A Massage
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Gentle rubdowns are relaxing, and they can also reduce your discomfort. Like heat, massages can direct more blood flow to your tissues to help relieve pain and stiffness. Plus, they can actually boost levels of pain-relieving chemicals in your bloodstream, according to a report in Topics in Pain Management.
Just make sure to get the green light from your doctor first to confirm that massages are a good idea for you; they might have recs for massage therapists who work with axSpA patients, too. You can also find licensed massage therapists in your area via the American Massage Therapy Association’s national database.
Try Turmeric
Here’s one more reason to love that golden milk latte. Turmeric is packed with inflammation-fighting curcumin, which may help improve your symptoms, Dr. Brent says. “It’s not going to be as potent as prescription medications, but it can certainly add to their benefits, and it’s safe.”
In fact, a recent meta-analysis of 29 studies concluded that curcumin is effective at relieving pain in patients with multiple types of arthritis, including axSpA. The analysis looked at doses ranging from 120 to 1,500 milligrams daily, taken for as little time as four weeks or as much as 36. Check with your doctor to decide on the best dosage for you.
Stretch It Out
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You probably already know that regular exercise is a biggie for maintaining your mobility and flexibility and keeping pain in check. But if you don’t have it in you to head out for a walk or take a swim (which makes total sense), you might still be able to stretch.
Gentle stretches are a go-to option for easing pain and stiffness when you don’t have the capacity for more intense movement. While it’s great to stretch your whole body, “you really want to do exercises where you’re stretching your back up more straight, to keep your head and neck moving,” Dr. Brent says. Try bridges, wall sits, or gently tucking your chin to your chest.
Another option: Try a yoga video made with axSpA in mind. Tele-yoga sessions have been shown to improve pain and function and boost mental health in people who have axSpA, found one randomized controlled trial.
Go Big With Breathing
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Inflammation around the joints where your ribs attach to your spine can literally make breathing hurt when your axSpA is acting up. “Deep belly breathing is a way of maintaining the motion of these joints” to help reduce pain and stiffness, Dr. Brent says.
The basic gist is to take slow, deep inhales that fill your belly with air, followed by slow, deep exhales that let the air flow out. But a guided video, like this one from the National Axial Spondyloarthritis Society, can help you really get a feel for the technique. “I’d try to practice deep breathing two to three times a day for a minute each,” recommends Dr. Brent.
Use An Assistive Device
You might have no problem grabbing the cereal box on the high shelf or getting down to tie your shoes on a typical day when your axSpA isn’t acting up. But when you’re flaring, an adaptive device can make it easier to tackle everyday tasks with less pain, Dr. Brent says. And there’s zero shame in that.
“Things like grabbers or sock donners can be helpful for patients with significant spinal disease who have trouble reaching or bending over,” he says. “Slip-on shoes are good too, since you can slide your foot in without having to bend down.”
Meeting with an occupational therapist (OT) or a physical therapist (PT) can help as well, if you’re struggling with a particular task on the reg. In addition to showing you stretching and strengthening exercises that can improve your function and flexibility, they can offer suggestions on specific devices that can help you with whatever everyday hurdles you might be dealing with.
Get Serious About Sleep
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Flare-driven inflammation can eat up your energy, Dr. Brent says. And the emotional stress surrounding your flare can leave you feeling zapped too. All the more reason to double down on your nighttime routine and get to bed early enough to ensure you log seven to eight hours of shut-eye.
Snooze time alone won’t make your flare disappear overnight, of course. But poor sleep is linked to worse disease activity and more pain among axSpA patients, research shows. And getting the rest you need can help turn down the dial on your inflammation while boosting your brain function and your mood. So there’s a good chance some solid sack time will help you feel at least a little bit better.
If pain or stiffness from your flare is making you toss and turn, let your doctor know. Together you can talk about options to help you sleep more comfortably when you’re flaring, such as taking an NSAID pain reliever before bed, Dr. Brent says.
Pace Yourself
It can be tempting to try to get through your daily to-do list even when you’re dealing with a flare. But pushing too hard can leave you feeling worse. So give yourself permission to take it easy for now. “Let your body tell you what you can and cannot do,” Dr. Brent advises. “Conserve your energy by doing the things you have to do, but waiting on the things that are extra until you’re feeling better.”
Marygrace Taylor
Marygrace Taylor is a health and wellness writer for Prevention, Parade, Women’s Health, Redbook, and others. She’s also the co-author of Prevention’s Eat Clean, Stay Lean: The Diet and Prevention’s Mediterranean Kitchen. Visit her at marygracetaylor.com.
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