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When is Rest Best?

People with ankylosing spondylitis commonly experience pain, stiffness, and tenderness in their back and hip joints. These symptoms, along with the progression of AS, can reduce the body’s ability to move.

Why exercise when you have AS?

Exercise and physical therapy are important ways to keep your body as healthy and flexible as possible when you have AS or other types of arthritis. In fact, exercise is so important that experts recommend spending at least five to 10 minutes every day.

On days when you are feeling more pain, before giving up on exercise altogether, try low-impact techniques like restorative yoga, tai chi, or gentle exercises balancing on a fitness ball.2

The benefits of exercise include1:

  • Improving posture
  • Increasing mobility
  • Limiting swelling
  • Reducing pain
  • Improving mood and sleep
  • Reducing depression and anxiety
  • Helping slow joint deterioration

When should you rest?

Despite the benefits, sometimes exercise can be too much. It’s important to know when to limit your movement and just let your body rest. In fact, research shows that getting enough rest is important for managing pain, just like getting exercise.

When you feel ‘bad’ pain

If exercise is causing you pain or you are feeling ‘bad’ injury pain rather than ‘good’ working muscles pain, sometimes it’s best to take a break. This kind of pain can be a sign that you are working your muscles too hard or are experiencing an injury. If the pain keeps up, consult with your healthcare team to determine the cause.2

During a flare-up

If you are experiencing a flare-up, sometimes concentrating on reducing pain and swelling is the best strategy for a couple of days. Remember, before you stop altogether, consider modifying your routine to avoid putting stress or pressure on a particularly painful joint. For example, try swimming rather than walking if your hip hurts.2

When you feel extreme fatigue

Fatigue can accompany symptoms of AS, especially when you have a bad flare-up. Fatigue can be a sign that your body simply needs rest to restore injured tissues and reduce inflammation. However, tiredness and low motivation can also result from depression and anxiety. So consider staying active when you can, knowing that exercise can lift your mood when you are feeling low.

Links between sleep and pain

It is important to listen to your body’s signals when you feel tired or fatigued. As important as exercise is for staying healthy and reducing pain and inflammation, getting enough sleep is equally critical.3

The links between getting enough sleep and coping with pain are actually very complex. We know that pain can disrupt sleep. People with chronic pain sometimes have trouble falling asleep, staying asleep, or they wake up too early. According to studies, as many as 80% of people with arthritis have trouble sleeping.3

But the reverse is true, as well. Research shows that not sleeping well at night can make your pain worse the next day. And over time, continued sleep problems can lead to increased depression and disability among people with arthritis. It’s not clear exactly why. Some researchers think that lack of sleep can make people more sensitive to pain. But it also may be true that inadequate sleep leads to increased inflammation and tissue damage.3

Whatever the reason, it is clear that getting enough sleep is an important part of managing the pain and discomfort of AS as well as other types of inflammatory arthritis or chronic pain.

    Treatment of Ankylosing Spondylitis and Related Diseases. Spondylitis Association of America. Available at: https://www.spondylitis.org/Treatment-Information Accessed April 19, 2019.
  1. Carrie DeVries. When I’m in Pain, Should I Exercise or Rest? Arthitis-health. February 24, 2016. Available at: https://www.arthritis-health.com/blog/when-im-pain-should-i-exercise-or-rest Accessed April 19, 2019.
  2. Sleep and Pain. Arthritis Foundation. Available at: https://www.arthritis.org/living-with-arthritis/pain-management/chronic-pain/sleep-factors.php Accessed April 19, 2019.

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