Neck Pain Associated with Ankylosing Spondylitis: Remedies and Suggestions
Ankylosing spondylitis (AS) is a type of arthritis that primarily affects the spine and other parts of the body. A common symptom of AS is neck pain, which can be severe, exhausting, and disabling, affecting activities such as holding the head up, sleeping, walking, and causing tenderness in the head and neck area.
Characteristics of AS-related neck pain
Pain in the neck associated with AS worsens with rest and improves with movement. It is often accompanied by stiffness and limited mobility in the cervical spine. In advanced cases, severe tenderness and sometimes neurological symptoms may occur. The pain is often associated with a spreading sensation from the lower back upwards, and fatigue and systemic constitutional symptoms are common.
Treatment options for neck pain associated with AS
Treatment for neck pain in AS involves a multidisciplinary approach. This includes medications, physical therapy, lifestyle modifications, and occasionally surgery.
Medications
First-line treatment for pain and inflammation is non-steroidal anti-inflammatory drugs (NSAIDs). For more advanced cases, biologic medications may be prescribed to slow the progression of AS. These include TNF blockers, interleukin-17 inhibitors, and Janus kinase inhibitors. Oral corticosteroids and injections may be used for short-term or localized flare-ups. Disease-modifying anti-rheumatic drugs (DMARDs) are mainly used for peripheral joint involvement, but they can also form part of the overall management.
Physical therapy
Physical therapy is core to the management of AS-related neck pain. Exercises that improve flexibility and posture, strengthen muscles supporting the spine, reduce stiffness, and maintain spinal mobility and alignment are emphasized.
Lifestyle modifications
Regular exercise, maintaining good posture, alternating heat and cold therapy for pain relief, and smoking cessation are all important lifestyle modifications for managing AS-related neck pain.
Occupational therapy
Occupational therapy can assist in adapting daily activities to reduce joint strain and maintain independence.
Surgery
Surgery is rarely required but may be an option in severe cases with significant spinal deformity or joint damage, such as hip replacement or corrective spinal surgery.
In summary, neck pain in AS is primarily inflammatory and can be severe and functionally limiting. Treatment involves a multidisciplinary approach combining medications, physical and occupational therapies, lifestyle changes, and occasionally surgery to manage symptoms and preserve quality of life.
The outlook for people with AS-related neck pain depends on how advanced the disease is and the effectiveness of treatments. If neck pain is not an early symptom, it may indicate that the disease has begun to affect more of the spine. In this case, individuals should consult a doctor for a more effective treatment plan.
AS causes the joints and ligaments to become inflamed and stiff. Other symptoms of AS can include pain or stiffness in other parts of the body, vision changes or eye pain, loss of appetite, unintentional weight loss, abdominal pain or diarrhea, fatigue, and symptoms that improve with rest.
Physiotherapy can recommend physical exercises to maintain spine and neck strength and mobility, and advise on safe forms of exercise and appropriate sleep positions. An early diagnosis and treatment can help manage the condition and prevent it from progressing significantly. A deviation from a typical McGregor slope may predict neck pain in AS. Neck pain is a common symptom of AS. An X-ray indicating a large T1 slope is a predictor for neck pain in AS.
