Understanding Ankylosing Spondylitis: The Impact on Posture

Ankylosing spondylitis is an inflammatory arthritis that causes changes in posture that occur over time. Can exercise and maintaining spinal alignment help improve posture problems?

Ankylosing Spondylitis Posture Improvement

Ankylosing spondylitis/AS is an autoimmune arthritis that primarily affects the spine. It can also spread to other joints of the body and affect the internal organs. Back pain problems are a common side effect of the condition and depending on the severity of damage to the spine, it can have a serious impact on posture.

Affects Posture

The condition usually first affects the sacroiliac joints at the bottom of the spine where they attach to the pelvis. As the condition progresses it works its way to the upper spine. The spine consists of 26 vertebrae/bones stacked on top of each other.

• Ankylosing spondylitis can cause the bones to fuse together. (National Institute of Arthritis and Musculoskeletal and Skin Diseases. 2023)
• The condition causes kyphotic deformity – rounding of the upper back, and the lower back flattening.
• As the disease progresses, the spine becomes immobilized in a stooped-over position and causes significant difficulty with daily tasks.
• A stooped posture can place pressure on the internal organs and lead to breathing difficulties.
• The condition leads to balance problems which increases the risk of falls. (Alessandro Marco De Nunzio, et al., 2015)

Posture Improvement Tips

Standing and Walking

When standing or walking try to remember to:

• Maintain a straight spine.
• Line up the ears, shoulders, hips, knees, and ankles in a straight line.
• Squeeze the shoulder blades together and down toward the back pockets.
• Relax the arms at the sides.
• Look straight ahead.
• Tuck the chin back slightly.

Sitting

The natural curves of the spine need support for proper posture when sitting. Try these tips when at a desk or at a table:

• Position the height of the chair so the hips and knees are bent at 90-degree angles.
• Place the feet flat on the floor or use a footstool based on chair height.
• Place a lumbar support pillow or rolled-up towel behind the lower back.
• Position the screen monitor at eye level to keep the upper back straight.
• Keep the keyboard and mouse close to the body to prevent overreaching which can increase the rounding of the shoulders and upper back.

Lying Down

Ankylosing spondylitis can make lying down uncomfortable. To support the spine while lying down try to:

• Sleep on a semi-firm mattress or type like memory foam to conform to the body.
• Place a pillow between the knees to maintain a straight spine when lying on the side.
• Use a specialized pillow to prevent placing the upper back in a rounded position.

Posture Exercises

For individuals with ankylosing spondylitis stretching and strengthening exercises can help improve body posture. Individuals are recommended to talk to their healthcare provider before beginning an exercise program.

Chin Tucks

• Sit up straight.
• Squeeze the shoulder blades together.
• Rest the arms at your sides.
• Look straight ahead, pull the chin back and in until the stretch is felt along the muscles of the neck.
• Hold for three to five seconds and relax.
• Repeat 10 times.

Corner Stretch

• Stand facing a corner.
• Raise the arms to shoulder height.
• Place one forearm flat against each wall.
• Stagger the feet.
• Slowly shift weight over the front leg and lean in toward the corner.
• Stop once the stretch is felt across the chest.
• Hold for 10 to 20 seconds and relax.
• Repeat three times.

Scapular Squeezes

• Sit up straight with arms resting at the sides.
• Squeeze the shoulder blades together like they are holding an object between them.
• Hold for three seconds and relax.
• Repeat 10 times.

Maintaining spinal alignment will help decrease back pain that occurs with AS.

• Targeted exercises can help stretch tight muscles and strengthen the muscles responsible for maintaining spinal alignment.
• Maintaining healthy posture when sitting, standing, and sleeping can help prevent deformities in the spine.
• Regular physical activity can help combat stiffness and help maintain overall strength.

For an individualized exercise program, see a physical therapist or chiropractor on incorporating posture exercises to help prevent complications from developing.

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Arthritis

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References

National Institute of Arthritis and Musculoskeletal and Skin Diseases. Ankylosing spondylitis.

De Nunzio, A. M., Iervolino, S., Zincarelli, C., Di Gioia, L., Rengo, G., Multari, V., Peluso, R., Di Minno, M. N., & Pappone, N. (2015). Ankylosing spondylitis and posture control: the role of visual input. BioMed research international, 2015, 948674. doi.org/10.1155/2015/948674