Ankylosing Spondylitis and Massage Therapy
Ankylosing Spondylitis (AS) is a chronic and often progressive condition that primarily involves pain and inflammation of the joints of the spine. When used with massage therapy a greater quality of life can be achieved allowing the patient a more prolonged life span with full mobility of joints. AS affects the joints between the vertebrae and the sacroiliac joints (the area where your spine meets your pelvis). AS has a wide range of symptoms which range from lower back pain and stiffness that is worse when mobility is lessened and improves as the patient is active and mobile. AS is associated with Rheumatoid Arthritis and only a qualified physician can determine whether or not you have AS. Although your general practitioner or primary doctor can also determine whether or not you have AS, it’s a good idea to see a rheumatologist if you suspect you have AS or any other type of arthritis.AS symptoms as discussed before is chronic lower back pain, pain and stiffness in the hips, pain and stiffness in shoulders, restricted expansion of the chest, stiffness in the neck, tiredness, inflammation of the eyes, and finally inflammation of other body parts. The stiffness in the hip will also decrease the range of motion in the ball and socket joint of the hip. Despite the lack of active range of motion the patient should be re-educated to stretch and force to the soft end feel point to introduce more mobility in the joint. Massage therapy is great when used in conjunction with conventional treatments for inflammation.
AS gets worse overtime as the ability to function gets progressively limited over time massage therapy can fight back to maintain mobility through passive stretching and massaging the muscles associated with the hip and axial skeleton movement. During the first ten years of the pathology the patient will lose most of his or her mobility. Massage can when done during the first ten years avert the loss of this range of motion in the patient. Putting the symptoms in remission and restoring the patient’s range of motion. There are many different techniques that can be used by the massage therapist to aid the patient with their symptoms.
Massage therapist can pull from their library of massage techniques the use of passive stretching techniques along with proprioceptive neuromuscular facilitation (PNF) (Adler, 2007). Using the contraction and relaxation of the muscle groups around the hip and trunk of the axial skeleton put the symptoms of AS in full remission. The longer that the patient takes to seek out treatment the more therapy will be needed to return the patients range of motion to what the average person deems normal for functional motion.
The treatment of AS is defined by William C Shiel, Jr. MD, FACP, FACR in an article for medicinenet.com in 2008, states, “The treatment of ankylosing spondylitis involves the use of medications to reduce inflammation and/or suppress immunity to stop progression of the disease, physical therapy, and exercise. Medications decrease inflammation in the spine and other joints and organs. “ (William C. Shiel Jr., 2008) After reading further in the article many of the tips and techniques that he suggest doing are within the scope of practice for Licensed Massage Therapists in the state of Florida. Passive and active stretching along with massage to assist the muscles, tendons and ligaments to relax and contract is exactly what is described in treatment to relieve the symptoms of AS.
Patients who have chronic, severe inflammation of the spine can develop a complete bony fusion of the spine (ankylosis). Once fused, the pain in the spine disappears, but the patient has a complete loss of spine mobility. These fused spines are particularly brittle and vulnerable to breakage which is where massage therapy along with passive and active stretching come into play. It is vital that the patient fight to maintain the patient’s mobility in the spine for as long as possible. Since there is no complete cure to the genetic disorder this becomes a life long struggle. The patient may even need to seek long term disability to be able to afford the necessary treatment that will be needed thought the patient’s life time to remain mobile in extreme cases.
On a much more positive note, if the disorder is caught in the early stages massage therapy along with exercise and proper inflammatory medication should allow the patient to stay off the symptoms of the genetic disorder. Patients with ankylosing spondylitis can also have arthritis in joints other than the spine. All of these joints can have range of motion testing for assessment done to ensure that the symptoms are not progressing throughout the body. It is more common for the symptoms to occur more commonly in women. Patients may notice pain, stiffness, heat, swelling, warmth, and/or redness in joints such as the hips, knees, and ankles.
In conclusion, massage therapy along with communication with the patients physician as to the course of treatment can significantly affect the symptoms of AS. So much so, the symptoms can be stopped and put into remission for the patient that the therapist is treating once a diagnosis has been established by the primary care physician or a rheumatoidologist and treatment has begun. Nevertheless, you will ultimately have a patient that will be forever thankful in helping them to remain mobile and have the ability to function normally. These genetic disorders symptoms are very easy to overcome with simple research into PNF stretching and range of motion testing during treatment.
Adler, S. S. (2007). PNF in Practice. In S. S. Adler, PNF in Practice (p. 302). Springer Medizin Verlag Heidelberg.
William C. Shiel Jr., M. F. (2008). Ankylosing Spondylitis Causes, Diagnosis, Information, Symptoms and Treatment on . Retrieved 03 19, 2009, from http://www.medicinenet.com: http://www.medicinenet.com/script/main/art.asp?articlekey=274&pf=3&page=1
May 12th, 2010 at 4:24 pm
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