Ankylosing spondylitis - living with the pain
If the spine becomes a construction site and movement hurts, although rest does not bring any relief - then ankylosing spondylitis could be the cause. A chronic inflammatory disease that affects the back, but causes far more than just "back pain".
Ankylosing spondylitis - today usually referred to as axial spondyloarthritis - is a disease in which the immune system turns against its own structures. Inflammation occurs where tendons, ligaments and joint capsules radiate into the bone - particularly in the area of the sacroiliac joints and the spine.
What is ankylosing spondylitis - and who is affected?
Ankylosing spondylitis often begins insidiously - usually in young adulthood. Men are more frequently affected than women, with women often showing a milder but more difficult to diagnose form of the disease. The pain is often localized deep in the back, is particularly noticeable in the morning and improves with movement, not at rest.
Typical features:
Pain in the buttocks, lower back or along the spine
Morning stiffness that lasts for more than 30 minutes
Improvement with movement, worsening at rest
Inflammatory processes that are detectable on imaging procedures
Frequent: HLA-B27 positive
Chronic pain in ankylosing spondylitis - a double challenge
Ankylosing spondylitis involves two types of pain:
Inflammatory pain - caused by the autoimmune reaction itself
Chronic pain - due to protective behavior, restricted movement, anxiety and vegetative dysregulation
Many sufferers experience a real battle against their own bodies - between the need to take it easy and the need to keep moving.
Why rest is not the solution - and exercise is therapy
Physiotherapy for ankylosing spondylitis
Movement is not an "add-on", but a central component of therapy. Without targeted movement, there is a risk of increasing stiffness in the spine - with massive effects on posture, breathing, independence and quality of life.
Therapeutic focus:
Mobilization of the spine - regular, gentle, consistent
Posture and breathing training - to prevent kyphosis
Stretching shortened muscle chains, especially the ventral structures
Strengthening the back muscles - for uprightness and stability
Medical yoga & sensomotoric training - for training body awareness and vegetative calming
Goal: Maintain mobility, regulate pain, strengthen body awareness.
Occupational therapy - shaping everyday life despite pain
Ankylosing spondylitis changes your freedom of movement - and therefore also your everyday life. This is exactly where occupational therapy comes in: What do you need to live an independent, active and fulfilling life?
Occupational therapy approaches:
Adaptation of everyday life and workplace, e.g. height-adjustable furniture, break routines
Training functional movement sequences - e.g. standing up, bending down, carrying
Pacing & energy management - to balance activity and regeneration
Goal work and resource-oriented coaching
Creative or body-centered methods for emotional relief
The biopsychosocial understanding - the bridge to holistic therapy
At Hockenholz, we view ankylosing spondylitis not just as an inflammatory disease - but as a complex interplay of:
Immune system & nervous system
Physical movement & inner attitude
Environmental factors & lifestyle
Pain processing & self-perception
We work in an interdisciplinary, resource-oriented manner and always in close coordination with the treating rheumatologistsand general practitioners.
Conclusion: ankylosing spondylitis needs movement, understanding - and good support
Ankylosing spondylitis cannot be cured - but it can be treated well. If you are diagnosed early, keep moving regularly and seek professional support, you can regain a lot of quality of life.
The key is not to withdraw, but to actively engage with your own body. Exercise, education, self-regulation - all of these change the course of the disease.
Are you a therapist and want to learn how to effectively support people with ankylosing spondylitis?
Then find out more about our training courses on chronic pain, movement therapy and psychosomatic support:
👉 www.hockenholz.com/weiterbildungen
Are you affected yourself?
We support you - individually, therapeutically sound and with a human touch. In Berlin or online.