Finding relief for pain can often feel like an ongoing pursuit. If your pain is arising from your spine, as it does with ankylosing spondylitis (AS), then seeking long-term ways to reduce pain and maintain mobility is a priority.
In addition to prescription treatments, you may be looking for alternative ways to reduce spine pain and inflammation.
Chiropractic care is a type of complementary therapy. There’s little evidence that it helps with AS symptoms and there are potential risks associated with it. But it may be beneficial as an add-on therapy to your prescribed treatments.
Make sure you talk to your doctor before making an appointment with a chiropractor. Chiropractic care and other types of complementary therapy aren’t meant to replace treatment plans from your doctor.
What is chiropractic care?
Chiropractic care typically involves manual therapy. Manual therapy includes anything from stretching and sustained pressure to spinal manipulation.
Chiropractors are trained to treat a variety of conditions. But their focus is on improving joint motion and function of the musculoskeletal system. They often focus on back pain, neck pain, and pain in your arms or legs.
The manual adjustments that chiropractors are most known for are usually paired with other treatments. This includes soft-tissue therapies, lifestyle recommendations, fitness coaching, and nutritional advice.
The goal of spinal manipulation is to restore joint mobility and reduce inflammation and pain. Chiropractors do this by manually applying a controlled force to joints that don’t move well.
When performed by a trained and licensed chiropractor, spinal manipulation is generally safe. But some people, especially those with AS, should proceed with caution.
Chiropractic care and AS
There’s limited scientific evidence to support the role of chiropractic care in treating AS. Many doctors also have differing opinions on its benefits.
One case series from 2017 measured the impact of chiropractic care among three people with inactive AS. Researchers found that chiropractic care helped reduce symptoms and improve mobility in these people.
“AS is an inflammatory disease, triggered by genetic susceptibility and environmental factors, that is successfully treated with medications to target its inflammatory pathways,” explains Dr. Ronen Marmur, PhD, FACR, a rheumatologist at CareMount Medical. “Relying on a chiropractor for treatment of AS may not be sufficient,” he adds.
The good news is that there are other treatments available for AS, like anti-inflammatory medications and biologics. Dr. Allen Conrad, DC, CSCS, a chiropractor at Montgomery County Chiropractor Center, says simultaneous care plans with a rheumatologist who specializes in AS can be effective for managing pain.
“The combination of low force chiropractic care, ergonomic changes, and concurrent treatment with a rheumatologist is an effective treatment plan for most cases of AS,” says Conrad.
Conrad says ergonomic changes, such as adjusting your chair or desk at work or at home, can improve posture. This may help improve muscle spasms and tension associated with AS.
This brings up a good point: Chiropractors can do a lot more than just spinal manipulation. “If the chiropractor is applying therapy with massage, heat application, or a TENS unit, this could prove to be very beneficial,” explains Dr. Medhat Mikhael, a pain management specialist and medical director at the Spine Health Center at MemorialCare Orange Coast Medical Center.
Risks and drawbacks of chiropractic care
AS often causes fusion of the vertebrae in your spine. Conrad explains that those areas shouldn’t be adjusted, as they’re no longer movable joints. This is due to increased calcium deposits associated with AS.
Conrad also believes that people with advanced stages of AS aren’t candidates for chiropractic adjustments.
Inflammatory back pain, the type associated with AS, requires medical treatment, adds Marmur. That’s why he says physical therapy and stretching play an important role in the treatment of AS. He tells his patients to avoid chiropractic care with adjustments, particularly in advanced cases of AS.
But according to Conrad, chiropractic care can help keep the areas above and below fusions mobile with low force techniques. One example is Activator Methods, a chiropractic technique that puts very little force or rotation into the affected area.
When to seek chiropractic care
The goals of AS treatment are to reduce pain, improve your quality of life, and delay spinal damage.
If you’re interested in how chiropractic care can help you achieve these goals, your first step is to talk with your doctor. Together, you can decide if a complementary treatment is a good option for your AS symptoms. You can also discuss the limitations and risks that may come with chiropractic care.
If you’re given the green light to proceed, Conrad says a chiropractor will do a postural analysis. This determines which type of stretches are appropriate for you. They’ll also review any relevant radiology studies.
Your doctor can refer you to a chiropractor, or you can search through an online database to find someone in your area.
Before seeking chiropractic care as a complementary treatment for AS symptoms, speak with your doctor. Including a chiropractor in these discussions can help you come up with a comprehensive treatment plan.
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