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Daily exercise gives relief to a type of arthritis

SINGAPORE — Regular exercise is known to be a good lifestyle habit for everyone. For people suffering from a type of arthritis called Ankylosing Spondylitis (AS), however, daily exercise is more than a lifestyle choice. It is a key part of managing symptoms such as chronic pain and stiffness in the lower back and hips.

Recommended exercises for patients with AS include flexibility and strength training, as well as swimming. Today file photo

Recommended exercises for patients with AS include flexibility and strength training, as well as swimming. Today file photo

SINGAPORE — Regular exercise is known to be a good lifestyle habit for everyone. For people suffering from a type of arthritis called Ankylosing Spondylitis (AS), however, daily exercise is more than a lifestyle choice. It is a key part of managing symptoms such as chronic pain and stiffness in the lower back and hips.

AS, which commonly occurs in younger individuals aged 15 to 35, is a form of inflammatory arthritis that affects the joints in the spine.

Its early signs include pain and stiffness in the lower back and hips, especially in the morning and after periods of inactivity, said Dr Kevin Lee, senior consultant and orthopaedic surgeon, and medical director of Pinnacle Orthopaedic Group and Pinnacle Joint and Sports Centre.

In more severe cases, the inflammation can cause the spine to fuse together in a fixed, immobile position and the person might develop a hunched, forward-stooped posture, said Dr Lee.

PHYSIO OVER MEDS

A 28-year-old who was recently diagnosed with AS, after suffering from a persistent backache for four years, takes anti-inflammatory medication to lessen the pain. However, what really helped improve the stiffness in his lower back are daily workouts.

The patient was referred to a physiotherapist who taught him stretching, breathing and back-strengthening exercises, which he does every morning and sometimes in the office.

For AS patients like him, physiotherapy is one of the most important treatments, said Dr Amelia Santosa from the Division of Rheumatology at National University Hospital (NUH).

“As with any medication, there are side effects. Physiotherapy has been shown to improve pain, stiffness, mobility and physical function. It has also been shown to slow the natural progression of the disease.

“Patients complain that the stiffness and pain return when they do not do their exercises regularly,” said Dr Santosa.

Even so, an in-hospital survey conducted by NUH found that 55 per cent of patients diagnosed with AS skipped their first physiotherapy session in 2012.

NUH sees about 70 patients with the condition every year.

Dr Santosa shared that most patients miss their physiotherapy appointment as they do not want to miss work and return on a different day for their session. There was also a lack of awareness of their condition.

Recommended exercises for AS patients include flexibility and strength training, posture re-education, as well as swimming.

To encourage patients to attend their physiotherapy sessions, the hospital last year started a one-stop arthritis clinic, which is run by a physiotherapist and rheumatologist. Patients now see their doctors and attend their physiotherapy session on the same day.

The take-up rate for the combined clinic was 100 per cent in the first quarter this year.

“The exercises are generally simple enough to be done at home or at work, without the need for special equipment. The aim is to maintain the patient’s quality of life, functionality and posture,” said Dr Santosa.

There is currently no cure for AS. Besides regular exercise, medication including non-steriodal anti-inflammatory drugs (NSAIDS) can help patients manage pain. Other types of medication like biologics might be able to slow or stop the disease from progressing in some individuals, added Dr Lee.

Dr Lee said a common treatment regimen for AS typically involves a combination of medication, physiotherapy, exercise and good posture practice. Surgery might be required in cases of severe joint damage.

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