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Body Work

Bodywork is a general term given to those complementary approaches that involve hands-on touching or manipulating of the muscles, joints, or soft tissues of the body. People with ankylosing spondylitis (AS) or other forms of spondyloarthritis may use one or more forms of bodywork as complementary approaches to help manage their symptoms. Complementary approaches are those used alongside or in combination with traditional medicine.

Chiropractic

Chiropractic care is a practice that is focused on the body’s structure and its functioning. Chiropractors perform adjustments aimed to align the spine or other parts of the body to improve function and relieve pain. Most research on chiropractic has focused on people with back pain, and chiropractic seems to provide some benefit for low back pain and neck pain.1 However, few research studies have evaluated the benefit of chiropractic for people with AS.2 Some people with AS may get relief from their symptoms with chiropractic, although chiropractic should be used as a complementary approach in addition to medications.

Because low back pain is commonly the first symptom people with AS may experience, people may see a chiropractor as one of their first healthcare professionals. The Spondylitis Association of America has created educational materials for chiropractors to help them identify and refer possible patients with AS to a rheumatologist for diagnosis. People with advanced cases of AS may have fused joints in their spine, which puts them at a higher risk for spinal fractures, and care must be taken when doing any manipulation.3

Massage

Many people with AS find massage can be beneficial in managing pain and stiffness or promoting relaxation. There are a variety of forms of massage, and they all involve pressing or rubbing to manipulate the muscles, tendons, and ligaments. Two of the most common forms are Swedish massage and deep tissue massage. Massage provides several health benefits, including reducing stress, pain, and muscle tension. In addition to the health benefits, many people find massage produces feelings of caring, comfort, and connection. Massage may be performed by a licensed massage therapist, by a loved one or caregiver, or through self-massage techniques.4,5

Rolfing

Rolfing is a type of bodywork named after its founder, Ida Rolf. Also called structural integration, Rolfing is based on the idea that the body’s structures are connected by seamless networks and working with the connective tissue can help realign and balance the whole body. Rolfing sessions aim to enhance the person’s posture and freedom of movement, potentially releasing tension and relieving pain.6

There have been few research studies that have evaluated Rolfing in people with AS, but Rolfing may help someone with AS manage symptoms such as pain and stiffness.

Talk to your doctor

Many people who use complementary methods like the bodywork approaches described above also use conventional health care. Whatever combination of strategies you choose, it’s important to talk to your doctor about all of them. Your doctor needs to understand all of the therapies or supplemental approaches you’re using to best coordinate your care. In some cases, certain therapies may not be recommended for an individual, and your doctor can help you avoid unnecessary risks.

Written by: Emily Downward | Last reviewed: February 2019
  1. Chiropractic: in depth. National Center for Complementary and Integrative Health. Available at https://nccih.nih.gov/health/chiropractic/introduction.htm. Accessed 2/15/19.
  2. Cornelson SM, Beavers D, Harvey A, Hogarth W, Kettner NW. Chiropractic Care in the Management of Inactive Ankylosing Spondylitis: A Case Series. J Chiropr Med. 2017;16(4):300-307.
  3. Has your patient had inflammatory back pain for 3+ months? Spondylitis Association of America. Available at https://www.spondylitis.org/For-Chiropractors. Accessed 2/15/19.
  4. Complementary therapies. National Ankylosing Spondylitis Society. Available at https://nass.co.uk/managing-my-as/exercise/complementary-therapies/. Accessed 2/15/19.
  5. Benefits of massage. Arthritis Foundation. Available at https://www.arthritis.org/living-with-arthritis/treatments/natural/other-therapies/massage/massage-benefits.php. Accessed 2/14/19.
  6. What is rolfing? Dr. Ida Rolf Institute. Available at https://www.rolf.org/rolfing.php. Accessed 2/18/19.