A diagnosis of ankylosing spondylitis (AS) may leave you feeling overwhelmed and concerned about the future. AS is a chronic, or long-term, form of arthritis that causes inflammation, stiffness, and pain in the joints of your spine.
Your doctor will go over AS treatment options with you. But they may not address everything you need to know to help you manage your condition. Here are eight questions to ask your doctor at your next appointment:
1. What can I do to manage my AS at home?
It’s important to take steps to manage AS to help keep painful flares at bay. You may need to learn different ways to do daily chores. For example:
- Use a robotic vacuum instead of a heavy vacuum cleaner.
- Iron while seated.
- Grocery shop online or enlist the help of grocery store clerks to bag and load groceries.
- Load and empty the dishwasher while seated.
- Use “grab-and-reach” tools to reduce bending.
Practice good posture. Poor posture may cause hunching. Avoid sitting on soft cushions or sleeping in beds that offer little back support. Sit in a high-backed chair with a hard seat.
Ask your doctor to help you identify lifestyle factors that may cause you pain.
2. Should I quit smoking?
If you smoke, you should quit. Research has shown smoking increases inflammation in your body. It also increases your risk of cancer, heart disease, and stroke. It’s more difficult to manage more than one chronic condition at once. Smoking may also make it harder to breathe if you develop AS-related lung problems.
Ask your doctor for information on smoking cessation options and for a referral to a smoking cessation program in your area.
3. Is there an AS diet?
There’s no scientifically proven diet to treat AS. Still, if you eat unhealthy, you may gain weight and put additional stress on your joints. Most doctors recommend eating a healthy diet overall and avoiding foods that cause inflammation and weight gain such as processed foods, foods high in refined sugars, and foods that contain trans fats. A healthy diet includes:
- plenty of produce, especially vegetables high in calcium to help prevent osteoporosis
- high-fiber foods
- lean protein
- salmon and other fatty fish
- whole grains
Dairy falls in the middle of the inflammatory spectrum. Research indicates it may cause inflammation in people allergic to milk. However, it may have anti-inflammatory benefits in people without a milk allergy.
Ask your doctor if dairy is a good choice for you. If you’re overweight, ask your doctor for a referral to a nutritionist to help you come up with healthy eating plan.
4. What are the best exercises for AS?
Regular exercise is critical to managing AS. Being sedentary or resting a lot may cause your joints to stiffen more and increase pain. The type of exercise you do is also important. Avoid high-impact exercises that are hard on your joints such as running and step aerobics. Situps and heavy weightlifting are also tough on your back.
Instead, try to exercise every day, and do low-impact exercises such as:
- gentle walking
- gentle stretching
Ask your doctor to help tailor an exercise program that’s right for you.
5. Where can I get AS support?
Your AS healthcare and support team will likely extend beyond your doctor. It may also include a physical therapist, a nutritionist, and a mental health professional.
Ask your doctor for educational resources, referrals to other AS healthcare professionals, and a referral to a local AS support group.
6. Does AS cause complications?
Inflammation in your spine and other parts of your body may cause:
- eye problems
- difficulty breathing
- heart problems
Not everyone with AS has complications. Ask your doctor about red flag symptoms that may indicate a complication, and which symptoms require urgent care.
7. What research is being done on AS?
Researchers have identified two genes involved in the development of AS, and their search for more is ongoing. Researchers are also seeking to better understand:
- the inflammatory and immune responses of AS
- how environmental factors impact AS
- if new therapies can slow or stop spinal fusion
- if the gut microbiome plays a role in the development or progression of AS
Ask your doctor how you can become involved in AS research, and whether any ongoing clinical trials are happening in your area.
8. What is my outlook?
The outlook is good for many people with AS. The condition can often be managed with lifestyle changes and medications. Eight out of ten people with AS remain independent or minimally disabled in the long term. Undergoing treatment as soon as possible may reduce your risk of developing complications.
You have more control over the progression of the condition than you may think. It’s up to you to communicate regularly with your doctor, follow your entire AS healthcare team’s advice, and practice lifestyle changes to help manage your condition.
Ask your doctor about their experiences with AS patients and what factors might contribute to a positive prognosis.
The bottom line
Fear of the unknown and learning how to manage your symptoms can make an AS diagnosis overwhelming. You’ll likely have many questions. Since it’s easy to forget questions at your appointments, jot them down ahead of time. Bring them and this discussion guide with you to your next appointment. Your doctor is your partner in your AS journey. But they may not anticipate all your questions. It’s important to come to your appointments prepared.