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Alternative Treatments for Spondylitis

Medically reviewed by Ariel D. Teitel, M.D., M.B.A.
Written by Liz Aguiniga, Ph.D.
Updated on October 12, 2021

There are multiple treatment options for those with spondylitis that have been approved by the U.S. Food and Drug Administration (FDA). However, some people look to complementary and alternative medicine (CAM) to help manage their symptoms. Complementary and alternative medicine refers to medical practices or products that are not a part of standard medical care. CAM does not slow down the progression of spondylitis, but it might help relieve spondylitis symptoms.

Spondylitis is the name for a family of rheumatic (autoimmune and inflammatory) diseases that cause arthritis involving the spine. Spondylitis, sometimes called spondyloarthritis, consists of six subtypes:

  • Ankylosing spondylitis (AS), also known as radiographic axial spondyloarthritis
  • Enteropathic arthritis, or arthritis associated with inflammatory bowel disease
  • Psoriatic arthritis
  • Reactive arthritis
  • Undifferentiated spondyloarthritis
  • Juvenile spondyloarthritis

The symptoms for each subtype of spondylitis vary, but most people suffer from chronic pain, including lower back pain and joint pain.

Standard treatments for spondylitis include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce the inflammation and pain
  • Biologic disease-modifying antirheumatic drugs (DMARDs) to suppress a specific aspect of the immune system
  • Traditional DMARDs to reduce inflammation

Some doctors may also prescribe opioids to help reduce the pain and corticosteroids to help reduce inflammation. Antidepressants may be prescribed to address some of the mental health issues associated with having a chronic condition. Most medications can cause side effects, which is one of the reasons people may look to CAM to help ease pain or improve their overall health.

Talk to a health care professional before trying any of the therapies listed below as they may interact with medications or current therapies.

Acupuncture

Acupuncture is one of the most popular traditional Chinese medicine techniques and is commonly used to alleviate pain. The treatment involves inserting very thin needles into specific parts of the body. The insertion of the needles into the skin is supposed to strategically shift the energy from one part of the body to another thus helping to re-balance the body.

A study of 60 patients with cervical spondylitis showed that using seven acupoint-penetrating needles combined with traction reduced neck pain and improved the quality of sleep. Although this study shows promising results for using acupuncture to reduce pain for patients with cervical spondylitis, note that this is a very small study.

A systematic review of more than 70 clinical trials that tested the efficacy of acupuncture for treating patients with rheumatic diseases showed that acupuncture was effective for reducing lower back pain for some rheumatic diseases. However, the results were inconclusive for treating AS.

The National Center for Complementary and Integrative Health states that acupuncture is generally a safe technique when performed by an experienced well-trained individual who uses sterile needles. However, when done improperly, acupuncture can cause serious damage including collapsed lungs, punctured organs, injury to the central nervous system, and infections.

Avoid Seeing a Chiropractor

Chiropractic adjustments, or spinal manipulations, are done by using the hands or small instruments to apply a sudden force to the joint and should only be done by a trained chiropractor. The sudden force pushes the joint beyond the normal range of motion and is often followed by a popping or cracking sound.

Serious complications can arise after a chiropractic adjustment. Some of the risks include compression of the nerves in the lower spinal column, induction of a certain type of stroke, or disk herniation.

The Spondylitis Association of America warns against using chiropractic treatments for people with AS or individuals with fusion (extra bone growth) due to spondylitis.

One MySpondylitisTeam member reported a negative experience: “Chiropractic procedures made me worse.”

Exercise

Exercise is important for overall health. Although it may be more difficult to do regular exercise when living with spondylitis, movement typically helps improve joint stiffness and reduce pain.

Learn more about guided stretching and exercises for joint pain.

Physical Therapy

A physical therapist can help with physical rehabilitation through patient education. Physical therapy can improve range of motion and promote good posture. Studies have shown proper exercise programs can increase the quality of life for patients who have AS by improving mobility and body function.

Specifically, the study found that a combination of exercises can reduce symptoms of AS:

  • Stretching exercises can increase range of motion
  • Strength training can increase muscle strength
  • Spinal mobility exercises can improve posture
  • Cardiovascular exercise can help with breathing function
  • Functional training can improve physical coordination

Tai Chi

Another popular traditional Chinese medicine technique is tai chi. Tai chi is a type of low-impact exercise that involves a series of movements performed slowly and (hopefully) gracefully. Tai chi is considered a meditative movement because it requires the person to perform a series of focused postures while focusing on breathing deeply.

A meta-analysis of seven controlled clinical trials found that patients with osteoarthritis who practice tai chi for at least 12 weeks have significant improvement of their arthritis symptoms and physical function. The authors suggested that tai chi should be incorporated as part of the rehabilitation program.

There is currently only one clinical trial that focuses on using tai chi to ease the symptoms of spondylitis. Researchers found that practicing 60 minutes of tai chi twice a week for eight weeks significantly improved disease activity and flexibility in a controlled clinical trial of 40 patients with AS.

Some MySpondylitisTeam members have also tried tai chi to help with their symptoms. One wrote, “I have found tai chi helpful for me. Yoga as well, but the tai chi positions are easier for me to get into.”

According to the National Center for Complementary and Integrative Health, tai chi may help reduce pain for people with knee osteoarthritis and help people cope with fibromyalgia and back pain. The National Institutes of Health has funded studies to review whether tai chi can help reduce anxiety or offer other psychological benefits. The results of those studies have been inconclusive.

Yoga

Similar to tai chi, yoga is also considered a meditative exercise. Yoga is a combination of physical postures, breathing techniques, and meditation. There are several types of yoga that range from slow and gentle movements to more physically demanding movements. Many studies suggest yoga can provide overall well-being. However, most of those studies include only small sample sizes.

One study found that yoga is effective at decreasing pain while improving the quality of life for people with rheumatoid arthritis. Unfortunately, there are no studies on the impact of yoga on spondylitis.

Pilates

Pilates is a low-impact exercise that focuses on increasing flexibility, muscle balance, and core strength. Pilates emphasizes proper postural alignment, which is important for people with spondylitis. People with AS who did Pilates three times a week for 12 weeks showed significant improvement in their physical capacity. A systematic literature review of 23 studies found that Pilates was an effective treatment for reducing pain and improving disability levels for patients with AS.

Although these studies may have a small number of participants, the results suggest that Pilates may help people manage symptoms of spondylitis.

One team member asked if exercise helps with symptoms, and another member responded, “Agree with the stretching exercises. Helps me. Any exercise I can do always improves my pain and stiffness.”

The Arthritis Foundation has an exercise program that is offered at many YMCAs and other community organizations. The program focuses on low-impact activities that help with balance, coordination, stretching, and cardiovascular endurance. Exercise is essential for good health, but make sure to speak with a medical professional before beginning any exercise program.

Dietary and Herbal Supplements for Spondylitis

Dietary supplements include tablets, capsules, liquids, and powders that are swallowed and are intended to supplement the diet. Dietary supplements are evaluated by the FDA as food and not as a medication, which means they are not tested for efficacy or validated as a treatment option for specific diseases.

Some herbal products such as vitamins and supplements have been studied as potential therapies to help ease spondylitis symptoms. Some of the supplements that may help with symptoms of spondylitis include:

  • Vitamin D — Vitamin D has anti-inflammatory and antioxidant properties; it also helps the body absorb calcium, which contributes to good bone health and reduces the incidence of osteoporosis. Studies have found vitamin D may reduce disease progression in patients with AS.
  • Omega-3 fatty acids — Omega-3 fatty acids are anti-inflammatory and help reduce arthritic pain.
  • Turmeric — Curcumin is the biological component in turmeric that gives the spice its anti-inflammatory and antioxidant properties. Curcumin has been shown to have a positive effect and provide pain relief on multiple inflammatory diseases including rheumatoid arthritis.
  • Ginger — Ginger has anti-inflammatory properties and has been shown to decrease disease activity in patients with rheumatoid arthritis.

Some team members have found that taking dietary supplements helps reduce their spondylitis symptoms. One member wrote, “Good day today … yippee! Started taking turmeric curcumin, and it has helped with the stiffness and pain. So grateful.”

Another member responded, “I started a new regimen of acupuncture, CBD, and turmeric/curcumin that has kept me from starting Humira and no NSAIDs for five weeks. Hope it’s a long-term regimen.”

Taking a natural supplement may not seem like a problem, but many supplements can interact with several medications or create other medical issues. It is essential to seek medical advice from your rheumatologist before beginning any supplement regimen.

Diet

Similar to exercise, having a healthy diet is important for overall health. For people who suffer from chronic inflammatory conditions like spondylitis, certain foods can trigger the onset of symptoms. Some people find that eating an anti-inflammatory diet like the Mediterranean diet, or a high-fiber diet can help reduce symptoms.

One team member wrote, “The objective to treating AS for me is eliminating foods that cause inflammation and increasing foods that battle inflammation and calm it.”

Complementary and alternative medicines may help ease some of the symptoms of spondylitis. However, it is essential to consult a rheumatologist before trying any CAM to check whether they can be used along with your current treatment plan.

Talk With People Who Understand

MySpondylitisTeam is the social network for people with spondylitis. On MySpondylitisTeam, more than 71,000 members come together to ask questions, give advice, and share their stories with others who understand life with spondylitis.

Are you or someone you care for using natural remedies or alternative treatments to manage the symptoms of spondylitis? Share your experience in the comments below, or start a conversation by posting on your Activities page.

References
  1. Complementary and Alternative Medicine — National Cancer Institute
  2. Chronic Illness and Mental Health: Recognizing and Treating Depression — National Institute of Mental Health
  3. Acupuncture — Mayo Clinic
  4. An Evaluation of the Effectiveness of Acupuncture With Seven Acupoint-Penetrating Needles on Cervical Spondylosis — Journal of Pain Research
  5. Efficacy of Acupuncture in Rheumatic Diseases With Spine Involvement: Systematic Review — Medicina Clinica
  6. Acupuncture: In Depth — National Center for Complementary and Integrative Health
  7. Chiropractic Adjustment — Mayo Clinic
  8. Herniated Disk — Mayo Clinic
  9. Complementary Treatments — Spondylitis Association of America
  10. Exercise and Ankylosing Spondylitis With New York Modified Criteria: A Systematic Review of Controlled Trials With Meta-Analysis — Acta Reumatologica Portuguesa
  11. Exercise for Ankylosing Spondylitis: An Evidence-Based Consensus Statement — Seminars in Arthritis and Rheumatism
  12. Tai Chi and Qi Gong: In Depth — National Center for Complementary and Integrative Health
  13. Efficacy of Tai Chi on Pain, Stiffness and Function in Patients with Osteoarthritis: A Meta-Analysis — PLoS One
  14. Tai Chi for Disease Activity and Flexibility in Patients With Ankylosing Spondylitis — A Controlled Clinical Trial — Evidence-Based Complementary and Alternative Medicine
  15. Yoga: What You Need To Know — National Center for Complementary and Integrative Health
  16. The Efficacy of Tai Chi and Yoga in Rheumatoid Arthritis and Spondyloarthropathies: A Narrative Biomedical Review — Rheumatology International
  17. Pilates for Beginners: Explore the Core — Mayo Clinic
  18. Effect of Pilates Training on People With Ankylosing Spondylitis — Rheumatology International
  19. Is Pilates an Effective Rehabilitation Tool? A Systematic Review — Journal of Bodywork and Movement Therapies
  20. Arthritis Foundation Exercise Program (AFEP) — Centers for Disease Control and Prevention
  21. Dietary and Herbal Supplements — National Center for Complementary and Integrative Health
  22. FDA 101: Dietary Supplements — U.S. Food and Drug Administration
  23. Vitamin D in Ankylosing Spondylitis: Review and Meta-Analysis — International Journal of Clinical Chemistry
  24. Omega-3 Fatty Acids (Fish Oil) as an Anti-Inflammatory: An Alternative to Nonsteroidal Anti-Inflammatory Drugs for Discogenic Pain — Surgical Neurology
  25. Curcumin and Autoimmune Disease — Advances in Experimental Medicine and Biology
  26. Efficacy of Spice Supplementation in Rheumatoid Arthritis: A Systematic Literature Review — Nutrients
Updated on October 12, 2021
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Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Liz Aguiniga, Ph.D. is a freelance medical writer with a doctorate in life sciences from Northwestern University. Learn more about her here.

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