If you have ankylosing spondylitis, or AS — a type of arthritis that affects the spine — your treatment options may include a class of drugs called biologics. And while biologics can be an effective way to treat AS, staying in good health overall becomes even more important when taking them.
Biologics include medications known as tumor necrosis factor alpha (TNF-alpha) blockers. Chronic inflammation of the spine leads to stiffening of joints and fusion of bone to other bone or parts in the body (ankylosis) — a hallmark of ankylosing spondylitis. TNF-alpha blockers help treat AS by targeting TNF proteins in the body and blocking them from causing the inflammation that can promote ankylosis.
Unfortunately, there’s a downside to using biologics to manage ankylosing spondylitis. These drugs work by manipulating your immune system, and a compromised immune system increases your risk of contracting infections. That's why it’s important to exercise caution and take steps to stay healthy.
There isn’t a magic bullet to ensure good health when taking a biologic drug, says Natalie E. Azar, MD, an assistant clinical professor of medicine and rheumatology at NYU Langone Medical Center in New York City. But in addition to following your ankylosing spondylitis treatment regimen as directed, there are steps you can take to help stay healthy year-round if you take a biologic medication for AS.
Minimize Exposure to Germs
If you know someone is sick, especially with a cold or the flu, keep your distance. This is most important during the winter, but it's a good idea for staying healthy all year. Maintain good hand-washing practices by using soap and water, and lathering all parts of your hands — including the backs, between fingers, and under fingernails. Do this for at least 20 seconds before rinsing your hands.
The Centers for Disease Control and Prevention recommend the following guidelines for when to wash your hands:
- Before, during, and after food preparation
- Before eating
- Before and after taking care of someone who is ill
- Before and after treating a wound
- After going to the bathroom
- After changing a diaper or cleaning someone who has used the toilet
- After coughing, sneezing, or blowing your nose
- After touching animals, animal waste, or pet food
- After touching garbage
Eat a Healthy Diet
People with ankylosing spondylitis don't necessarily need to follow a particular diet, but eating the right amounts of healthy food is good for everyone. Although more research is needed, there is evidence to suggest that people with AS may benefit from eating foods rich in omega-3 fatty acids, such as salmon, albacore tuna, and nuts. According to information published by the National Institute of General Medical Sciences in 2012, omega-3s could help to control inflammation.
Staying active is one of the best things you can do for ankylosing spondylitis, but talk to your doctor before beginning any exercise regimen to prevent the risk of injury. Exercise helps to relieve pain and improve posture and promotes flexibility:
- Abdominal and back exercises can help to reduce back stiffness and encourage good posture. Purposely practicing good posture can help to minimize complications of ankylosing spondylitis.
- Strengthening exercises — with weights or by repetitions of tightening muscles without moving the joints — helps to build muscles around painful joints to encourage better support.
- Range-of-motion exercises help to reduce stiffness, improve movement, and increase flexibility. Ask your doctor about which range-of-motion exercises might be best for you.
- Stretching exercises can be helpful if your spine is painful or inflamed. Stretching and extending the back in careful controlled motions can be beneficial for preventing long-term disability.
In addition, exercising in water can be good for people with AS. Try a water exercise class if you like to socialize while exercising.
Get Your Eyes Checked
Up to 40 percent of people with ankylosing spondylitis will develop inflammation of the eye (uveitis), a complication that can become serious if left untreated. Detected early, uveitis can usually be treated with prescription eye drops. Make an annual appointment during your birth month or near a favorite holiday so you remember to have your eyes checked each year. However, if you experience symptoms of uveitis such as eye pain or redness, blurred vision, or sensitivity to light, see your eye doctor promptly.
See Your Doctor Regularly
Even if your ankylosing spondylitis is well-controlled, it’s still important to see your doctor regularly. “In general, people with ankylosing spondylitis should see their doctor every three months or so,” Dr. Azar says. Schedule these appointments for the start of each new season. If your AS is stable and responding well to treatment, the minimum for visits with your doctor should be twice a year to monitor your condition, she says. You should also see your doctor regularly so he or she can check your overall health on a routine basis.
Your doctor will review your medical history and current state of ankylosing spondylitis in order to determine which vaccinations will be beneficial for you. Typically, an annual influenza vaccine is recommended, as is the shingles vaccination (given one time) and the pneumonia vaccine (administered every five to 10 years), Azar says.
Everyone knows smoking is bad for your health. But people with ankylosing spondylitis can suffer additional consequences of smoking because the disease can affect the mobility of their rib cage. Breathing can be further compromised if the lungs are damaged from smoking. Let your doctor know if you need help to stop smoking.
Taking these steps to stay healthy year-round can help you get the most from your biologic treatment for ankylosing spondylitis and improve your health overall.