Ankylosing Spondylitis: 6 Tips to Maintain Good Posture From Morning to Night

Good posture can help anyone avoid back pain and discomfort, but for people with ankylosing spondylitis, it can help sidestep a vicious cycle of pain and aggravated symptoms.

Ankylosing spondylitis is a type of arthritis that causes inflammation of the vertebrae, which can lead to severe chronic pain. As the condition progresses, long-term inflammation can create new pieces of bone to form on the spine, which can cause the vertebrae to fuse together, leading to kyphosis, a type of spinal curvature that results in a forward-hunching posture.

According to the Spondylitis Association of America (SAA), the hallmark symptom of ankylosing spondylitis is pain in the sacroiliac joints, located at the base of the spine where it joins with the pelvis.

When people experience back pain, they often change their posture to ease the pain, notes the SAA. Over time, postural changes can cause stiffness and weakness in muscles and joints and lead to more pain.

Trying to maintain the best possible posture throughout the day can help reduce the severity of symptoms and prevent the spine from fusing in a non-upright position, according to UK-based Versus Arthritis. This is because good posture helps keep bones and joints in correct alignment so that muscles can function properly and not get strained from misuse.

Maintaining good posture also decreases stress on ligaments and prevents muscle and joint fatigue. Bad posture, on the other hand, can cause back pain for anyone, notes the University of Washington Department of Orthopedics and Sports Medicine. Correcting it can help prevent future arthritis-related pain.

“It’s essential to maintain good posture and flexibility early in ankylosing spondylitis,” says Rachel Motschiedler, an occupational therapist at the University of Utah Hospital in Salt Lake City. And so is staying active, even if you have an advanced case of the condition, as inactivity can contribute to worsening of symptoms and decreased quality of life, she adds.

Posture Tips for People With Ankylosing Spondylitis

Here, Motschiedler and Lisa Baird, a physical therapist at the University of Utah Hospital, offer ways to maintain good posture and avoid discomfort and pain in everyday activities.

Morning routine: When you have ankylosing spondylitis, you’ll likely be stiff first thing in the morning. Even getting out of bed can be difficult and painful. Baird recommends the log roll technique for getting out of bed.

“While laying on your back, bend your knees up. Then roll on your side toward the edge of the bed,” Baird says. “Lower your legs to the ground while pushing up with your arms from the bed while lying on your side until you’re in a seated position.”

Other simple stretches can loosen up your joints. While still lying in bed, raise your arms over your head and clasp your hands together. Once you’re seated, you can reach one arm across your body and slowly rotate at the waist as far as you can without moving your hips. Repeat on the other side.

Driving: When you’re driving in the car, you have the added support of a rigid, upright seat that almost forces you to sit up straight. Pulling up the seat closer to the pedals can ensure that you’re resting your back against the seat and won’t have the impulse to slouch or hunch over.

Sitting at a desk: Many people with ankylosing spondylitis likely have jobs where they’re seated most of the day. Though you may not think about it, there is a way to sit properly and maintain good posture.

The Mayo Clinic advises against crossing your legs — this encourages you to slump or hunch over. Your knees should be level with your hips, and your chair should be giving you support in the lower and mid-back areas. Keeping your shoulders relaxed and pulled back will prevent tension from forming there. If you work at a computer, make sure it is placed directly in front of you so you’re not twisting or bending your back to type.

“Because sitting places more pressure on your spine than any other position, it’s important to change positions frequently,” Motschiedler says. “If possible, get up from your desk to walk for a few minutes at least every hour.” Consider performing some work tasks while standing if you can, she adds.

Walking and standing: Just as sitting too long can be detrimental, so can standing for too long. “Staying mobile is important,” Baird says. “[Arthritis] has an inflammatory component, and overdoing things can do permanent damage.”

As far as everyday posture while walking or standing, the Cleveland Clinic recommends keeping your weight on the balls of your feet while keeping your knees a little bent. Keep your back as straight as you can without discomfort, with your shoulders pulled back and stomach tucked in. Your head should be level and your earlobes should be in line with your shoulders.

Lifting or bending over: If you’re able to bend over or lift objects, kneel down on one knee with the other foot flat on the floor. Get close to the object you’re lifting and lift with your legs, not your back, recommends the North American Spine Society. Keep the object as close to your body as you can while carrying it around.

Sleeping: While you’re not consciously thinking about your posture while sleeping, what you sleep on and what position you fall asleep in can help curb unnecessary pain and discomfort.

Shop around for a mattress that meets your specific needs, the National Sleep Foundation recommends. This may mean a firm or soft mattress. Ask your healthcare provider what type of mattress is best for you, or consult the staff at the mattress store to find out which ones are typically recommended for people with arthritis or chronic back pain problems.

You may also consider purchasing a special pillow designed to help you maintain good posture while you sleep — it may be one you put between your legs to keep your spine aligned or one that supports your neck all night.

The Sleep Foundation recommends that you avoid sleeping on your stomach. It can strain your neck and flatten the natural curve of your spine. If you’re able to sleep on your back, keep a pillow underneath your knees. If it’s more comfortable to sleep on your side, Motschiedler says, put a pillow between your legs.