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Massage Therapy For Ankylosing Spondylitis

Overview Of Massage Therapy

Top 3 Exercises for Ankylosing Spondylitis (Physical Therapy DIY)

Massage therapy is a broad term to describe a complementary practice of manipulating the bodys soft tissue to help decrease pain and stiffness.

Although there are several different massage therapies, most Western massage techniques base their routines on a Swedish or classical massage, according to the National Center for Complementary and Integrative Health Trusted Source.

In addition to Swedish massage, there are several other types of massage therapies, including:

  • clinical massage

Massage For Ankylosing Spondylitis

An efficacious non-interventional way of getting rid of pain, stiffness, and decreased mobility is massage therapy. A massage therapists touch is all that an AS patient needs. There are different types of massages that target specific needs of the AS patient.

In a comparison between deep tissue massage and therapeutic massage , it was found that both massages were extremely beneficial for the patients. In this randomized controlled trial, the extent of the disease was measured using the Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index . At the end of the study it was concluded that massage leads to the following changes:

  • Evident reduction in back pain
  • Improvement in range of motion
  • Increased functional capacity
  • A reduction in blood pressure and heart rate

This procedure is as good as other interventions, a study says.

Massage Chair For Ankylosing Spondylitis

With a massage chair, all you have to do is sit back and enjoy!

You really want to flush out pains, stiffness, and fatigue from the body? The undoubtedly easiest way of doing it is visiting a massage therapist. If you cant go due to the COVID-19 induced lockdown or some personal reasons, a massage chair can do the trick for you.

As per a case study, massage therapy or massage chair came out as an effective, safe, and promising treatment in casting out pain, stiffness, and fatigue from an AS patient.

Massage Plus Other Complementary Medicine Treatments

Evidence And Precautions For Massage With Ankylosing Spondylitis

While many people with ankylosing spondylitis and other spinal and inflammatory conditions find massage to be beneficial, there isnt a lot of scientific evidence to support massage as a treatment for AS.

The Spondylitis Association of America states that massage, when done carefully and gently, may provide temporary relief of pain or stiffness and, in some cases, improve flexibility because of increased blood circulation in people with AS.

But its important, the group says, that your massage therapist knows about your condition and any physical limitations you have, and refrains from heavily manipulating any areas where your range of motion may be limited.

Whats more, the SAA says that some people with AS dont tolerate massage well and may experience increased pain after having a massage. While this may not be the most common experience for people with AS, its important to be aware of this risk.

In a research review published in July 2018 in the journal Current Opinion in Rheumatology, the authors concluded that for people with AS, deep tissue massage has been found to be useful for symptom relief in small studies.

But one of the articles authors is skeptical when it comes to making recommendations to his patients.

I dont send any patients to massage, says Atul Deodhar, MD, a professor of medicine and medical director of rheumatology clinics at Oregon Health and Science University in Portland.

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Types Of Massage For Ankylosing Spondylitis Pain Relief

If you decide to try massage therapy for ankylosing spondylitis pain or stiffness, youll find that there are many forms available. Here are a few that you may want to try:

Swedish Massage This is the most popular type of massage, and it can be a good option for people with AS. It uses long strokes, circular movements, and kneading to loosen tight muscles. Pressure can range from very light to deep, depending on the clients preference.

Youre really trying to get blood circulation going in the muscles, says Rachel Simon-Falk, a physical therapist and massage therapist based in Silver Spring, Maryland.

Deep Tissue Massage This form of massage focuses on manipulating both the top layer and deeper layers of muscle and other tissues, and often requires intense pressure. While deep tissue massage is meant to address severe tension and pain, it may cause soreness for a while afterward and may not be appropriate for some people for this reason, according to the Arthritis Foundation.

Shiatsu In this form of massage, the therapist applies pressure to specific spots on the body to promote energy flow and relieve stress. Therapists may also lightly stretch your limbs. Proponents of shiatsu say that it helps balance the flow of qi, the life force present in all living things according to traditional Chinese medicine.

Massage Therapy For Ankylosing Spondylitis

Academy Massage Blog: 2016

A relaxing massage for ankylosing spondylitis might be just what the doctor ordered. Learn more about massage for arthritis and get tips for picking a massage therapist.

If you have ankylosing spondylitis, a massage can be much more than a heavenly indulgence. It can soothe the body and help calm the mind in many ways according to Dolly Wallace, a licensed massage therapist who received her board certification through the National Certification Board for Therapeutic Massage and Bodywork . She is also past president of the American Massage Therapy Association.

As is often the case with massage and arthritis, it helps a little more mobility and relief from pain, Wallace says, adding that it can also help with stress, anxiety, and depression. It may also help improve flexibility due to increased blood circulation, according to the Spondylitis Association of America .

Joint stiffness can often cause you to assume uncomfortable postures and positions, which leads to overuse and strain of the muscles, explains Jonathan S. Kirschner, MD, fellowship director of spine and sports medicine and a physiatrist at the Hospital for Special Surgery in New York. Massage can certainly help with muscle pain and stiffness, Dr. Kirschner says, but also notes that it doesnt necessarily help with joint stiffness. For that, he says, physical therapy or doing light exercise is beneficial.

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Massage Chair For Ankylosing Spondylitis

Spinal issues can render you completely inactive and immobile if left untreated. The problem faced by physicians and surgeons is that in most cases there is no definitive cure to the disease. Symptomatic management and minimal correction are the only possibilities.

Ankylosing spondylitis is one such spinal malady that has no known cure. However, you could use a massage chair for ankylosing spondylitis. It relieves the symptoms.

Are There Different Types Of Massage

Massage therapy generally falls into two categories:

  • relaxation typically, this type of massage focuses on stress release and reducing general muscle tension
  • remedial or therapeutic massage this type of massage aims to address injuries and chronic muscular pain, such as that caused by arthritis. Remedial treatments target specific problem areas and are more likely to be beneficial in temporarily relieving the symptoms of arthritis, such as pain.

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Effectiveness Of Soft Tissue Mobilisation As An Adjunct To The Conventional Therapy In Patients With Ankylosing Spondylitis

Patitapaban Mohanty*

Associate Professor , Swami Vivekanand National Institute of Rehabilitation Training and Research, Olatpur, Bairoi, Cuttack, India

*Address for Correspondence: Patitapaban Mohanty, Ph.D, Associate Professor , Swami Vivekanand National Institute of Rehabilitation Training and Research, Olatpur, Bairoi, Cuttack, India, Email:

Dates:Submitted: 20 December 2017 Approved: 03 January 2018 05 January 2018

How to cite this article: Mohanty P. Effectiveness of Soft Tissue Mobilisation as an adjunct to the Conventional Therapy in patients with Ankylosing Spondylitis. J Nov Physiother Rehabil. 2018 2: 001-014. DOI: 10.29328/journal.jnpr.1001016

Copyright License:© 2017 Mohanty P. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Keywords: Chronic low back pain Duration of pain Severity of pain Lung function

Massage For Ankylosing Spondylitis Patients

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Both deep tissue and therapeutic massage improved outcomes among men with ankylosing spondylitis , although deep tissue massage offered more significant benefits in terms of specific symptoms and general lower back pain, according to recent research.

The study, Comparison of deep tissue massage and therapeutic massage for lower back pain, disease activity and functional capacity of ankylosing spondylitis patients: a randomized clinical pilot study, involved 27 men diagnosed with AS.

The researchers describe AS as a chronic, progressive inflammatory rheumatic disease that predominantly affects the sacroiliac joints and spine and state that the main goals of therapy for this condition are to reduce pain, prevent spinal deformation, and improve mobility and overall function.

Subjects in the study were randomly assigned to receive either 10 half-hour sessions of deep tissue massage or 10 half-hour sessions of therapeutic massage within a two-week period.

The deep tissue massage for ankylosing spondylitis consisted of trigger point therapy and oblique pressure for a combination of lengthening strokes, cross-fiber strokes, anchor and stretch, and freeing muscle from entrapment.

For the therapeutic massage sessions, the following five techniques were employed: effleurage, petrissage, friction, holding and vibration.

Evidence-Based Complementary and Alternative Medicine.

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What You Need To Tell Your Massage Therapist Prior To Your Treatment:

It is important that your massage therapist is aware of your diagnosed condition, as there are many forms of arthritis, each with their own treatment needs and precautions. You should advise them of your medical treatments and other medical conditions.

In follow-up consultations, be sure to update your therapist about the effects of the previous treatment and of any changes to your condition.

How Ankylosing Spondylitis Causes Jaw Pain

The places where joints, ligaments, and tendons attach to the bone are called the entheses. Inflammation of the entheses is a hallmark symptom of AS and may occur in multiple parts of the body. These places are called hot spots. When the jaw joint becomes inflamed, it becomes swollen and tender.

Research shows that the inflamed tissues in the entheses may swell enough to put pressure on the nerves in the area, causing pain.

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Biofeedback And Splint Therapy

Some people experience severe jaw pain that prevents them from opening their mouths completely. Biofeedback therapy a non-drug treatment involving electical sensors can help: Through the therapy, people learn to control muscle tension.

Some people also find relief through splint therapy, which involves wearing a mouth guard custom-made by a dentist.

What Are Complementary Therapies

Massage for Ankylosing Spondylitis (AS)

Complementary therapies are designed to work alongside conventional medicines and treatments rather than to replace them.

Most complementary therapies concentrate on treating the whole person rather than specifically treating the condition itself.

Like conventional medicine, complementary therapies cannot cure axial SpA .

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What Causes Jaw Pain In Ankylosing Spondylitis

According to one study, females diagnosed with AS who grind their teeth may be more likely to develop jaw pain due to TMD. The study also found that men with the following factors are at higher risk of developing TMD in ankylosing spondylitis:

  • Having measurably severe symptoms
  • Having a neck disability

Disease Measurement In Medical Practice

There are 4 main measures of AS disease activity, collectively known as the Bath indices, which were developed by a team of rheumatologists, physical therapists, and research specialists. These indices are

  • the Bath AS Metrology Index, which measures movement in the cervical, dorsal, and lumbar spine the hips and the pelvic tissues.

  • the Bath AS Functional Index, which uses 10 questions about coping with daily living to measure functional aspects of life. Most responses are recorded using a visual analogue scale .

  • the Bath AS Disease Activity Index, which measures disease activity in relation to levels of fatigue, pain, morning stiffness, joint pain, and swelling, and localized tenderness.

  • the Bath AS Patient Global Score, which is used in conjunction with other Bath indices as an evaluation of well-being in general.

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Reconnecting To The Body

Other symptoms can affect the overall body, as well. For instance, Gardiner points out, gastrointestinal symptoms like cramping can lead to postural misalignment, while the fluctuating hormone levels of autoimmune thyroid diseases can cause energy and weight issues. She has noticed that fascia may be particularly rigid in clients with thyroid issues, so she finds myofascial release particularly helpful.

Chronic diseases also bring emotional issues. More visible autoimmune diseases such as psoriasis can cause people to feel embarrassed. And even just the nature of an autoimmune disease can make people feel disconnected from their own bodies. It can be as simple as the stress of knowing that your body is attacking itself, says Gardiner.

The often-difficult process of diagnosis can add to that stress. According to an AARDA study, it took an average of 4.6 years for people with a serious autoimmune disease to get a diagnosisand 46 percent had been told they were chronic complainers or too concerned with their health.8

For people with autoimmune diseases, Dr. Blazek-ONeill says the most common outcomes of massage therapy is decreased stress, improved sleep and decreased pain symptoms. I think people with autoimmune diseases feel like their body has betrayed them in some way, she says. Their body is doing something it is not supposed to do and it alienates them from their body. Massage therapy can help them get in touch with their body in a positive way.

How Is Ankylosing Spondylitis Treated

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The major aims of management include pharmacological relief of pain and stiffness. These are achieved through physical therapy and lifestyle modification programs aimed at preserving spinal mobility or at least preventing spinal deformity and disability. During these treatment processes, prompt recognition and management of articular and extra articular is essential.

Formal instruction in proper posture and exercises emphasizing spinal mobility and strengthening of muscles is important. A range of motion exercises for the neck, shoulders, and hips as well as deep- breathing exercises to maintain chest expansion should be performed by the patient daily. Of all therapeutic modalities, only regular exercise has been shown to curtail the progression of spinal stiffness and restriction.

Treatments with non-steroidal anti-inflammatory medicines may reduce spinal stiffness. For extreme cases, stronger therapies can be instituted.

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Jaw Pain With Ankylosing Spondylitis: Causes And Management

The pain thats a hallmark of ankylosing spondylitis typically affects the back and neck. However, it can also impact other parts of the body, including the jaw. Experiencing jaw pain can impact a persons quality of life, making it difficult for them to swallow, eat, and open their mouth.

Jaw pain is a common complication for people with ankylosing spondylitis and other types of arthritis. Some researchers estimate that about 15 percent of people diagnosed with AS experience inflammation and pain in the jaw. Others report that as many as 35 percent of people with the condition experience jaw pain.

Many members of MySpondylitisTeam report jaw pain. Some members report that their AS jaw pain developed into temporomandibular disorder sometimes referred to as temporomandibular joint syndrome. The temporomandibular joints are located on either side of your face, directly in front of your ears. They connect your lower jawbone to your skulls and help with eating and talking.

OMG! The jaw pain! Does anyone else have it? one member wrote. It goes from side to side, and just won’t quit! I have spent a fortune with the orthodontist getting mouth pieces I wear day and night. They help, but it still hurts!

Recognizing jaw pain in ankylosing spondylitis and understanding what causes it can help you find better ways to manage it.

Best Massage For Ankylosing Spondylitis

If youre considering massage therapy to help ease the symptoms of ankylosing spondylitis, first talk to your doctor about whether massage is safe for you and which techniques may work best.

Different people respond to different types of massage , so its important to figure out which type is best for you, Kirschner says. One type involves tapping, and thats usually less effective than some of the deeper, kneading types of massage.

For some, massage can trigger an ankylosing spondylitis flare, according to the SAA. Kirschner says that as long as the therapist is massaging over the muscles and not the joints, it should not cause a problem. If youre having any sort of pain or discomfort, he says, always tell the massage therapist, who will then be able to work around that.

Wallace generally uses soft-tissue massage for ankylosing spondylitis. This includes stretching, some vibration, circle strokes, kneading, long gliding strokes, and mild sacral rocking. Her massage techniques change, however, depending on whether a person is in an ankylosing spondylitis flare or if the disease is under control.

There will be certain times when a person is almost in remission, and you can be a little more aggressive and use more moderate pressure, Wallace says. Then there are times when inflamed, and you need to use a much lighter touch.

Deep-tissue massage should be avoided if a person is in an ankylosing spondylitis flare, Wallace cautions.

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Are Massage Chairs Safe And Beneficial

A massage chair may alleviate pain and other symptoms of AS. However, these devices may not work well for everyone.

There is limited to no data on massage chairs specifically for AS symptoms. However, anecdotal evidence suggests that massage chairs have drawbacks, including not working well, making buzzing noises, and taking up lots of space.

A person interested in a massage chair should consider trying a few chairs out, if possible, before committing to a purchase.

45 states and the District of Columbia, therapists must get specialized training and certificates to perform massages.

When selecting a massage provider, a person should consider asking their doctor for recommendations. They may know therapists that specialize in working with people with conditions such as AS.

A person should avoid massage therapists without a license and be wary of those with no experience treating people with AS.

Some nonmedicinal treatment options that a person can try, either at home or at a local practice, include:

  • regular exercise that incorporates strength training, stretching, and cardiovascular activity
  • physical therapy to help regain or maintain function

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