Learning you have a life-changing condition is likely alarming no matter what. But if you have axial spondyloarthritis (axSpA), a chronic form of arthritis that dramatically increases your risk of fracturing your spine, the diagnosis also comes with a second helping of fear.
Here, two rheumatologists lay out steps you can take to protect your back and perhaps tamp down some of your anxiety about getting hurt.
Why axSpA increases the risk of spinal fractures
If you’ve been diagnosed with axial spondyloarthritis, you probably know it causes inflammation, mainly in the spine and the joints connecting the spine and pelvis. This can cause pain and stiffness in the back and neck and make it harder to get around, says Susan M. Goodman, MD, a rheumatologist at New York City’s Hospital for Special Surgery. And although it’s rare, if you have severe axSpA, the bones in your spine can eventually fuse. This causes a permanent loss of motion and increases your risk of fractures. “The fused spine can become very osteoporotic, and because the stiffness makes the bones less resilient, [they’re] at risk for fracture from minor trauma,” she tells SELF.
Now buckle up for some scary but important info: This means even mundane, everyday activities can be dangerous and put you at risk of injury. In fact, spinal fractures are as much as four times more likely for people with axSpA than for people without the disease, and as much as 15% of people with the condition will suffer those injuries. It’s a frightening stat that, unfortunately, makes a lot of sense. If you have a difficult time turning your neck to spot potential dangers, it’s easier to get hurt.
“We need to be able to look all around us at all times to avoid accidents,” says Michael H. Weisman, MD, a Stanford University adjunct clinical professor of medicine and member of the Medical and Scientific Advisory Board at the Spondylitis Association of America. “Think of yourself driving in a car and being unable to move your neck. Or think of [walking]: It’s much easier to fall without getting hurt when you can’t easily see the ground underneath you. You might miss a pothole or a step or a curb.”
All of this can be daunting to hear. But, thankfully, there are ways to protect yourself. Read on for some tips.
Rethink your risk
Part of protecting your spine is recognizing its fragility and realizing you need to be more careful than you used to be.
For instance, everyday activities like walking your dog could result in a fall and, in turn, a fracture. “A sudden lurch from the dog might pull you to the ground,” Dr. Weisman says. Similarly, bathtubs are major sources of slips that can cause spinal fractures for people with axSpA, he says. If you can opt for a walk-in shower instead of a shower-tub combination, you’ll be much safer. Similarly, if you have a dog, you may want to consider getting a walker if your pup needs a lot of exercise.
You’ll most likely need to reevaluate your relationship with more adventurous activities and, in some cases, throw in the towel for good. If you love contact sports like basketball or adventure sports like skiing, Dr. Weisman suggests finding other ways to stay active and have fun that aren’t quite as risky. Things like swimming, Pilates, and yoga are generally considered safe for folks with axSpa and can help keep your spine mobile. A doctor or physical therapist can also help you figure out what cardio and strength training workouts will be safe and enjoyable.
Always be aware of your surroundings
Even lower-risk situations can result in spine fractures, so it’s important to keep your bearings. For example, stay alert about traffic, cyclists, and pedestrians while driving. Keep your hands out of your pockets and move slowly when walking over snow and ice so if you do fall, you land on your hands, not your back. While this may cause a hand or wrist injury, it’s the safer option when you have axSpa. And lastly, make sure health care professionals position you safely on examination tables for checkups and procedures so you don’t fall off and face a potential fracture, Dr. Weisman says.
Take your meds as prescribed
Medications used to treat axSpA can help reduce inflammation. Experts say this may, in turn, help prevent the calcification that leads to spinal fusion. The thinking is, if you can keep the bones from connecting to each other, the spine will be more flexible and less likely to fracture. More research is needed to confirm this hypothesis; however, evidence shows that treatments can increase bone density scores in the spine. “We don’t have the proof yet that it will prevent fractures, although it makes sense that it would,” Dr. Weisman says.
Go to physical therapy
In addition to medication, axSpA treatment typically involves regular physical activity, often under the guidance of a physical therapist.
“Physical therapy can help by increasing mobility and range of motion, strengthening muscles, and preserving balance,” Dr. Goodman says, explaining that this might help you avoid the falls that can end in fractures. “In many situations where the joints are damaged, a physical therapist can help by retraining your muscles to compensate for the loss of function in the joint,” she says.
She adds that Pilates may also be helpful because of its emphasis on strengthening your core, which can improve balance. Ask your PT about making it part of your treatment plan.
Consider an anti-inflammatory diet
There’s currently no research suggesting any specific diet changes help treat or stall the progression of axSpA. But, according to Dr. Goodman, it doesn’t hurt to try eating a Mediterranean-style diet that helps limit inflammation. Focus on eating plenty of fatty fish, fruits, veggies, whole grains, and olive oil, she says.
Related: 7 Simple Ways to Actually Reduce Inflammation in Your Body
Quit smoking
In addition to raising your risk of cancer, heart disease, and lung problems, “smoking is very harmful to the skeleton,” Dr. Goodman says. It is also a risk factor for osteoporosis and slows bone growth and healing, so it can increase your risk for fractures and slow your recovery if you do have an accident.
While chucking your cigarettes won’t directly protect your spine, it’s a good idea to limit the risk factors you can control and quit tobacco if you haven’t already.
If you have axSpA, it’ll likely take a combination of all these tactics—and maybe more—to help you avoid spinal fractures, and even then accidents can still happen. But it’s smart to do whatever’s in your power to keep your back and neck safe for as long as possible.
Get more of SELF’s great service journalism delivered right to your inbox.
Related:
