Ankylosing spondylitis (AS) is a lifelong condition that may require a combination of medication, exercise, and other therapies. You likely will meet several different types of doctors and medical specialists who will care for you.
Members of your health care team may include:
Primary care doctor
This may be the first person you see about your AS. Your primary care physician may be a family doctor, an internist, or even a nurse practitioner. They may diagnose your AS and offer treatment. Or, they may refer you to a specialist who is more familiar with AS.
This doctor specializes in diseases of the joints, muscles, and bones. Your rheumatologist may be your main AS doctor. AS is a type of rheumatic disease. They can treat your pain, swelling, and stiffness in your spine and elsewhere. At first, you may need to see your rheumatologist every 2-4 weeks to check how well you respond to medications and therapies. After that, your appointments may be every month or every several months.
Exercise and physical rehabilitation can be an important part of managing your AS. A physical therapist is a health care specialist who works people with movement problems. They can teach and help you do exercise and stretches to loosen your joints, relieve pain, improve your posture, and get your body to move more easily. Your physical therapist may create a program for you that includes deep breathing exercises, swimming, and water activities to help expand your chest and to keep your spine in motion. They may also use other methods such as manual therapy.
They don’t work with people just in the workplace. Occupational therapists evaluate you, your home, and your daily activities so you learn better and easier ways to handle tasks. They might suggest aids such as a bench in the shower, a grabber to reach objects, or a car ladder to minimize your pain and discomfort. Once you have a plan in place, you won’t need regular occupational therapy visits.
Some people with AS also have an eye disease called iritis, or inflammation in the colored part of your eyes. In fact, it’s not uncommon for your ophthalmologist to be the first doctor to detect your AS. They use a special microscope to tell the difference between iritis and other conditions. It can be simple to treat if caught in time.
They’re experts on problems with your digestive system. Research suggests that inflammation in your gut may play a role in joint damage where your spine and pelvis meet. A small number of people with AS also have an inflammatory bowel disease such as Crohn’s disease or ulcerative colitis.
AS sometimes may cause gastrointestinal symptoms. You may find that certain foods seem to help or make your symptoms worse. A nutritionist can advise you on which foods may be best for you. They also can help you keep a healthy weight to ease the stress on your joints.
Medications for AS include over-the-counter and prescription anti-inflammatory drugs as well as biologics that require injections. Your pharmacist can answer questions, show you how to use auto-injectors, and advise on how to prevent or ease side effects. They also can call your doctor to make sure that your medication therapy stays on track.
Mental health therapist
It’s always good to talk to someone about how you are doing. Life can be challenging but it can get better. A therapist can help if you feel depressed, nervous, or even alone. There are also many support groups and arthritis self-help programs.
If your AS gets severe, you may need surgery. But this is rare. An orthopedic surgeon can do hip replacement and even operate on your spine. A neurosurgeon specializes in repairing damaged spine and nerves.