“Lifestyle habits are one of the most important factors that can contribute to and modify outcomes in people with inflammatory disorders like ankylosing spondylitis,” says Susan Goodman, MD, an associate professor of medicine at Weill Cornell Medical College and a rheumatologist at the Hospital for Special Surgery in New York City. A lot of what you do — or don’t do — can affect the course of your disease. For instance, these seven lifestyle habits can actually make AS symptoms worse.
1. Lack of Exercise Worsens Stiffness
“A sedentary lifestyle will worsen the stiffness and decreased mobility and flexibility that accompany ankylosing spondylitis,” says Waseem Mir, MD, the founder of New York Integrative Rheumatology and a rheumatologist at Lenox Hill Hospital in New York City. “Regular exercise that incorporates stretching will help reduce these symptoms, and you’ll feel better,” Dr. Mir says. According to evidence published in February 2016 in Seminars in Arthritis and Rheumatism, a balanced exercise plan for AS should include stretching, strengthening, aerobic, and functional exercises, which generally focus on movements that enable you to maintain your balance and perform tasks of daily living with greater ease. The preliminary evidence also suggests that modified Pilates, tai chi, and swimming can be especially beneficial for people with AS.
2. Smoking Cigarettes May Interfere With Treatment
“Smoking is one of the worst things you can do for just about anything, including ankylosing spondylitis,” Dr. Goodman says. “People with a genetic susceptibility to ankylosing spondylitis need an environmental insult to trigger it, and smoking is one of those insults. Smoking also causes a poorer response to medications for ankylosing spondylitis.” What’s more, people who smoke more than 10 cigarettes a day report more pain and disease activity, problems with mobility, and worse overall quality of life, according to a study published in Seminars in Arthritis and Rheumatism in April 2017.
3. Drinking Alcohol Affects Gut Health
“There are a few reasons alcohol is bad for people with ankylosing spondylitis,” Mir says. “For one, it disrupts the ratio of good to bad bacteria in the gut, and a lot of autoimmune diseases tend to be related to gut health.” Second, many alcoholic beverages — including beers, ales, lagers, and malt beverages made from gluten-containing grains — contain gluten, “and many people with ankylosing spondylitis are sensitive to gluten,” he says.
4. Staying Up Too Late Contributes to Lack of Restful Sleep
Ankylosing spondylitis can interfere with sleep in a number of ways, including disturbed sleep because of the pain and depression that often accompany the disease, Goodman says. But it’s vital that you get enough rest. “Sleep has a restoration effect on the body, so people who are sleep-deprived tend to do worse and flare more with ankylosing spondylitis,” Mir says. He recommends getting seven to eight hours of sleep every night. You may be able to sleep more and better if you invest in a mattress and pillow that are comfortable for you and by giving yourself time to relax for an hour before bedtime. If your own efforts to sleep better aren’t helping, speak to your rheumatologist. Pain or other symptoms that keep you awake at night may be an indication that your AS is not as well controlled as it could be.
5. Stressing Out Raises the Likelihood of an AS Flare
“When people with autoimmune diseases such as ankylosing spondylitis are under stress, they’re more likely to suffer a flare,” Mir says. To help keep stress and anxiety at bay, he suggests yoga, tai chi, relaxation breathing, and meditation. “Acupuncture may also help lower stress in people with ankylosing spondylitis,” he says. In a study published in the Chinese Journal of Integrated Traditional and Western Medicine in March 2014, researchers found that people with AS had decreased inflammatory cytokines after treatment with acupuncture.
6. Eating Too Much Sugar May Contribute to Flares
“Sugar disrupts insulin levels, which are connected to the hormone activity that affects flares in people with ankylosing spondylitis,” Mir says. “Processed and canned foods contribute to our overall inflammation levels as well.” Instead, he recommends eating plenty of fresh fruits and vegetables and taking fish oil supplements, all of which have anti-inflammatory effects on the body. “Probiotics help heal the guts of people with ankylosing spondylitis,” he says. You can get probiotics in yogurt and other dairy products, juices, powders, and capsules, according to the American Gastroenterological Association. Talk with your doctor about choosing the right probiotics for you.
7. Not Sticking to Your Treatment Plan Leads to Progression
“Unfortunately, ankylosing spondylitis is a progressive disease, and once damage from the disease has been done, it’s impossible to reverse it,” Mir says. “If you don’t take your medication as directed, your disease will progress faster.” It’s also important to take medications as prescribed to avoid drug resistance, which is much more likely in people who are inconsistent with their treatment regimen, Goodman says. Additional reporting by Susan Jara.
