Exercise and Axial SpA: How to Stay Active Without Aggravating Your Symptoms

Disclaimer: You should always consult your healthcare professional before making any changes to your exercise regime, diet or healthcare.

For people with axial spondyloarthritis (axial SpA), staying active is crucial to managing symptoms and maintaining mobility. However, the inflammation and stiffness caused by axial SpA can make it difficult to exercise without aggravating these symptoms. The key lies in selecting the right types of exercise and adjusting routines to fit your individual needs.

In this article, we’ll explore the importance of exercise for axial SpA, provide evidence-based recommendations for the types of exercise that are safe and beneficial, and offer tips for preventing symptom flare-ups while remaining active.

1. Why Exercise is Important for Axial SpA Patients

   Axial SpA primarily affects the spine and sacroiliac joints, causing pain, stiffness, and reduced mobility. If left unmanaged, it can lead to permanent spinal damage and reduced quality of life. According to theNHS, exercise is an essential part of managing axial SpA because it can help relieve pain, improve mobility, and maintain joint function.
   TheNational Institute for Health and Care Excellence (NICE)recommends exercise as a core non-pharmacological intervention for managing spondyloarthritis, emphasizing that it helps reduce stiffness and pain, improves flexibility, and prevents progression to ankylosis (fusion of the spine) (Reference 1).
   

   Key Benefits of Exercise for Axial SpA

   • Pain Management: Exercise helps improve blood circulation and releases endorphins, both of which can reduce chronic pain associated with axial SpA (Reference 2).
   • Enhanced Spinal Mobility: Regular physical activity prevents stiffening of the spine and helps maintain proper posture.
   • Mental Health Benefits: Living with a chronic condition can lead to anxiety and depression. Exercise can help alleviate these symptoms by boosting mood and reducing stress levels.

2. Best Types of Exercise for Axial SpA

   Selecting the right kind of exercise is essential to avoid aggravating axial SpA symptoms. The focus should be onlow-impact, joint-friendly exercisesthat promote flexibility, strength, and cardiovascular health.

   Stretching and Flexibility:

   Flexibility exercises are crucial for maintaining joint mobility and preventing stiffness, which is a hallmark symptom of axial SpA.

   • Yoga: Yoga focuses on gentle stretching and can be particularly beneficial for improving spinal mobility. Research has shown that yoga can help reduce disease activity and improve physical function in people with axial SpA (Reference 3).
   • Tai Chi: Tai Chi’s slow, flowing movements improve balance, flexibility, and muscle strength. Studies have found that Tai Chi can help reduce pain and stiffness in people with arthritis, making it a good option for axial SpA patients (Reference 4).

   Strength Training:

   Building muscle strength is important for supporting joints and improving posture, which can prevent worsening of spinal deformities like kyphosis.

   • Resistance Exercises: Resistance training, including light weightlifting or resistance band exercises, helps build strength without placing too much strain on inflamed joints. Studies suggest that resistance training, when performed correctly, can improve overall function in people with axial SpA (Rererence 5).
   • Pilates: Pilates focuses on core strength, flexibility, and posture, which can help stabilize the spine and alleviate axial SpA symptoms. Research has supported Pilates as a safe and effective option for improving physical function in patients with spondyloarthritis (Reference 6).

   Cardiovascular Exercise:

   Low-impact cardiovascular exercises are ideal for maintaining heart health and improving endurance without exacerbating symptoms.

   • Swimming: The buoyancy of water helps reduce the impact on joints, making swimming an excellent exercise for axial SpA. The NHS notes that swimming improves flexibility and strengthens muscles while relieving stress on the spine (Reference 7).
   • Cycling: Stationary cycling is another good option for improving cardiovascular health. Adjusting the bike for proper posture can reduce the risk of strain on the spine .

3. How to Stay Active Without Aggravating Your Symptoms

   While regular exercise is essential for managing axial SpA, it’s important to adapt your activities to avoid exacerbating symptoms. Here are some strategies based on clinical guidelines and expert recommendations:

   • Listen to Your Body: Pacing is key. Exercise should be challenging but not painful. According to NASS, axial SpA patients should avoid pushing through pain, which could trigger a flare-up. If you experience sharp pain or increased inflammation after exercising, scale back or modify your routine (Reference 3).
   • Warm Up and Cool Down: Warming up before exercise is critical for preventing injury. Spend at least 5–10 minutes warming up with gentle stretches or walking. After exercising, cool down with stretches to prevent post-exercise stiffness (Reference 7).
   • Incorporate Rest Days: Rest days give your body time to recover. On these days, you can engage in low-intensity activities like walking or stretching to keep your joints mobile without overloading them .
   • Work with a Physical Therapist: A physical therapist with experience in treating axial SpA can create a customized exercise plan that targets your needs without causing harm. According to NICE, physiotherapy is an important part of axial SpA management, and working with a specialist can help ensure you're exercising safely (Reference 1).

4. Preventing Flare-Ups During Exercise

   Exercise has numerous benefits for managing axial SpA, but if not done correctly, it can trigger flare-ups. The following strategies can help prevent exacerbating your symptoms during exercise:

   • Stay Hydrated: Hydration is critical for joint health, as dehydration can contribute to joint stiffness. Make sure to drink plenty of water before, during, and after exercise (Reference 2).
   • Focus on Posture: Proper posture during exercise is essential to prevent spinal strain. A physical therapist can guide you through exercises with correct form to avoid exacerbating axial SpA symptoms (Reference 3).
   • Manage Stress: Stress is a common trigger for flare-ups in axial SpA. Exercise that incorporates relaxation techniques, such as yoga or mindfulness-based practices, can help manage both physical symptoms and emotional stress (Reference 5).

Conclusion

Exercise plays a crucial role in managing axial spondyloarthritis, helping to reduce pain, improve mobility, and enhance overall well-being. By focusing on low-impact activities like swimming, yoga, and Pilates, axial SpA patients can stay active without worsening symptoms. Always remember to listen to your body, pace yourself, and seek guidance from healthcare professionals when developing an exercise routine. With a tailored and consistent exercise plan, it’s possible to stay active while managing axial SpA effectively.

References:

1. NICE Guidelines - Spondyloarthritis
2. NHS - Axial SpA Treatment
3. NASS - Exercise for AS
4. Journal of Rheumatology - Yoga and Arthritis
5. Tai Chi and Arthritis
6. Resistance Training for Axial SpA
7. Pilates for AS
8. NHS - Swimming Benefits