To stay as healthy as possible with ankylosing spondylitis, certain triggers should be avoided. Learn how to fix lifestyle habits that can make your condition worse.

1. 7 Habits That Can Worsen Ankylosing Spondylitis
By Elizabeth Shimer Bowers Reviewed by Lindsey Marcellin,MD, MPH
To stay as healthy as possible with ankylosing
spondylitis, certain triggers should be avoided.
Learn how to fix lifestyle habits that can make your
condition worse.
Understanding Ankylosing Spondylitis
Physical Therapists on Managing AS
Ankylosing spondylitis, or AS, is a form of arthritis
that causes joint damageprimarily in the spine. AS
can not only lead to severe chronic pain, but also
problems with mobility, according to the
Spondylitis Association of America. But there are
plenty of steps you can take to make your
everyday life more healthy and productive.
“Lifestyle habits are one of the most important
factors that can contribute to and modify outcome
in people with inflammatory disorders like
ankylosing spondylitis,” says Susan Goodman, MD,
an associate professor of medicine at Weill Cornell
Medical College and a rheumatologist at the
Hospital for Special Surgery in New York City. A lot
of what you do — or don’t do — can affect the
course of your disease.

2. In fact, these seven lifestyle habits can actually
make AS worse:
1. Avoiding exercise. “A sedentary lifestyle will
worsen the stiffness and decreased mobility and
flexibility that accompany ankylosing spondylitis,”
says Waseem Mir, MD, founder of New York
Integrative Rheumatology and a rheumatologist at
Lenox Hill Hospital in New York City. “Regular
exercise that incorporates stretching will help
reduce these symptoms, and you’ll feel better.” In
fact, according to a study published in 2014 in the
journal BioMed Research International, people
with AS who practiced an exercise routine that
included strength training, stretching, and
cardiovascular exercises felt better.
2. Lighting up. “Smoking is one of the worst things
you can do for just about anything, including
ankylosing spondylitis,” Dr. Goodman says.
“People with a genetic susceptibility to ankylosing
spondylitis need an environmental insult to trigger
it, and smoking is one of those insults. Smoking
also causes a poorer response to medications for
ankylosing spondylitis." What's more, people with
AS are at increased risk for cardiovascular disease,
and smoking further increases that risk, according

3. to a study published in the journal BMC
Musculoskeletal Disorders in April 2015.
3. Indulging in alcohol. “There are a few reasons
alcohol is bad for people with ankylosing
spondylitis,” Dr. Mir says. “For one, it disrupts the
ratio of good to bad bacteria in the gut, and a lot
of autoimmune diseases tend to be related to gut
health.” Second, many alcoholic beverages contain
gluten, "and many people with ankylosing
spondylitis are sensitive to gluten,” he says. A
good alternative is green tea, which has anti-
inflammatory properties, according to the Arthritis
Foundation.
4. Staying up too late. Ankylosing spondylitis can
interfere with sleep in a number of ways, including
disturbed sleep due to the pain and sometimes
depression that often accompany the disease,
Goodman says. But it's vital that you get enough
rest. “Sleep has a restoration effect on the body,
so people who are sleep-deprived tend to do
worse and flare more with ankylosing spondylitis,”
Mir says. He recommends getting seven to eight
hours of sleep every night.
5. Stressing out. “When people with autoimmune
diseases such as ankylosing spondylitis are under

4. stress, they’re more likely to suffer a flare,” Mir
says. To help keep stress and anxiety at bay, he
suggests yoga, tai chi, relaxation breathing, and
meditation. “Acupuncture may also help lower
stress in people with ankylosing spondylitis,” he
says. In a Chinese study published in 2014,
researchers found that people with AS saw
decreases in inflammatory cytokines after
treatment with acupuncture.
6. Eating too much sugar. “Sugar disrupts insulin
levels, which are connected to the hormone
activity that affects flares in people with
ankylosing spondylitis,” Mir says. “Processed and
canned foods contribute to our overall
inflammation levels as well.” Instead, he
recommends eating plenty of fresh fruits and
vegetables and taking fish oil supplements, all of
which haveanti-inflammatory effects on the body.
“Probiotics to help heal the guts of people with
ankylosing spondylitis,” he says. You can get
probiotics in yogurt and other dairy products,
juices, powders, and capsules, according to the
American Gastroenterological Association. Talk
with your doctor about choosing the right
probiotics for you.

5. 7. Not sticking to your treatment plan.
“Unfortunately, ankylosing spondylitis is a
progressive disease, and once damage from the
disease has been done, it’s impossible to reverse
it,” Mir says. “If you don’t take your medication as
directed, your disease will progress faster.” It’s
also important to take medications as prescribed
to avoid drug resistance, which is much more likely
in people who are inconsistent with their
treatment regimen, Goodman says.
By taking steps to avoid these lifestyle habits, you
can help improve your AS — as well as your
overall health.
Last Updated: 6/8/2015