But if you have a condition like ankylosing spondylitis, inflammation can increase symptoms of pain, stiffness, and swelling. “Any time you have an autoimmune condition, when there’s inflammation in the body, you’re more susceptible to flares,” says Gerardo Miranda-Comas, MD, a rehabilitation and physical medicine specialist at Mount Sinai Medical Center in New York City. Inflammation can also cause more lasting damage. “In diseases like ankylosing spondylitis, inflammation can lead to bony damage and fusion of joints,” says Kevin Deane, MD, a rheumatologist at University of Colorado Hospital in Aurora. “And that can lead to significant disability down the road.”
1. Take your medications as directed.
Drugs used to treat ankylosing spondylitis — whether they’re over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen, or prescription therapies like TNF inhibitors — all have the effect of reducing chronic inflammation in the body. Talk to your doctor before starting any medications to reduce inflammation. People with ankylosing spondylitis should consider “following what their healthcare providers and rheumatologists recommend” in terms of drug therapies to be a key step in reducing inflammation, says Dr. Deane.
2. If you smoke tobacco, quit.
According to Deane, not smoking is probably the single most important lifestyle factor to reduce inflammation in ankylosing spondylitis. If you smoke, he says, quitting is “critically important.” “We know that smoking drives the immune system, revs it up, and makes inflammation worse,” he says. There’s a large body of evidence that links smoking to increased inflammation in the body. One recent example, published in March 2017 in the journal BMC Complementary and Alternative Medicine, showed that smokers had higher levels of high sensitive C-reactive protein — a marker of inflammation — than nonsmokers.
3. Include good fats in your diet.
While there isn’t any perfect, proven diet for ankylosing spondylitis, Deane says that following a Mediterranean-type diet — rich in fruits and vegetables, whole grains, olive oil, nuts and seeds, and fish — may help to reduce inflammation in the body. Omega-3 fatty acids, in particular — found in certain fatty fish, nuts, and seeds — may help counter inflammation. In a study published in March 2017 in the Scandinavian Journal of Rheumatology, researchers found that people with psoriatic arthritis — an inflammatory type of arthritis closely related to ankylosing spondylitis — who took omega-3 supplements experienced less disease activity, showed lower markers of inflammation, and required lower doses of medications to control their condition. On the other hand, Dr. Miranda-Comas notes, saturated fats like those found in red meat and full-fat dairy have been linked to pro-inflammatory processes in the body and should be avoided as much as possible.
4. Avoid high-heat cooking.
According to the Arthritis Foundation, cooking food at high temperatures can lead to the formation of chemicals called advanced glycation end products (AGEs), which can trigger your body’s inflammatory response and have been linked to a number of different health conditions. To reduce AGEs in your diet, it’s especially important not to use high heat to grill, sear, or fry beef, pork, chicken, and fish.
5. Try using anti-inflammatory spices.
Incorporating spices like garlic, turmeric, ginger, cinnamon, and cayenne pepper into your diet may help reduce inflammation, according to the Arthritis Foundation. Deane notes that when people make efforts to include these spices in their diet, “they often change their cooking habits to incorporate these potentially helpful items” — increasing their intake of vegetables and reducing fried foods in the process, which may help in other important aspects of health including weight loss and maintenance of a healthy weight. This may also help limit inflammation, he adds.
6. Do low-impact extension exercises.
For people who have ankylosing spondylitis, exercise programs guided by rheumatologists, physical therapists and other health professionals can improve function and reduce disability, Deane notes. “We particularly like extension exercises — things like swimming, where the back is arched backwards, putting it into a very healthy shape,” he says. These low-impact exercises can help strengthen muscles in your back without causing strain or injury. Building your core through strength-training exercises can also help support your spine, says Miranda-Comas. “In general, if a patient has good back flexibility, they should be able to do any kind of back exercise,” he says — but be aware of any limitations you may face due to restricted mobility, and don’t force any activity that doesn’t feel right.
7. Use heat or cold therapy.
While applying cold is recommended for most injuries, “When someone has a chronic condition that isn’t an acute injury, they can use either cold or heat,” says Miranda-Comas. In general, he recommends using heat to treat stiffness from inactivity and cold to treat soreness from activity, but you can experiment and do whatever feels right for you, he says. Whether you’re using cold or heat, Miranda-Comas says, you can apply it multiple times each day for 20-minute intervals to get the maximum benefit. This time limit is usually recommended, he says, because cold packs lose their effect, and heat may potentially cause burning if applied for a longer period of time.
8. Get a good night’s sleep.
Getting enough sleep is critical for people with ankylosing spondylitis, says Miranda-Comas. “Poor sleeping habits can lead to a pro-inflammatory state,” he says. In addition to its direct effect on inflammation, poor sleep can worsen your mood and sap your motivation to exercise and eat a healthful diet, says Miranda-Comas — potentially further increasing inflammation in your body.
9. Practice relaxation techniques.
While there isn’t a great deal of evidence to support a direct effect on inflammation, “Mindfulness, I think, improves people’s overall function and outlook,” and can help with pain control, says Deane. Practices that may help you relax and increase mindfulness include meditation, deep breathing, guided imagery, and gentle exercises like yoga or qigong. Additional reporting by Brian Dunleavy
