In this blog I share five things you can do to manage morning stiffness caused by Ankylosing Spondylitis.
This also applies to Axial Spondyloarthritis (axSpA), Spondylitis, and any other form of Spondyloarthritis.
Once you have gotten out of bed, read this blog by Jamie which includes two short routines for morning stiffness.
- Recognize morning stiffness as a common symptom of AS.
- Measure the impact and duration of morning stiffness using the BASDAI assessment.
- Acknowledge the emotional toll of morning stiffness and seek diagnosis and treatment.
- Try modified yoga exercises tailored to axSpA/AS.
- Take action by consulting a Rheumatologist for assessment and treatment options.
Recognize morning stiffness as a common symptom of AS/axSpA/ SpA
I woke up and couldn't move, for up to 2 hours.
For me, it was a weird incomprehensible thing every morning, especially because I was undiagnosed at the time. Mine started in 2008, lasted about a year and it was really depressing. I would go to bed knowing that when I woke up , I was not going to be able to move your body for a long time. For me, sometimes it was over an hour. The only good thing about it was that it led directly to me getting diagnosed with Ankylosing Spondylitis. At last, I knew what this thing was.
Measure the impact and duration of morning stiffness using the BASDAI assessment.
The Bath Indices are a globally used, evidence based set of assessments and measurements of your AS/axspa.
One of them is called the BASDAI and two of the questions are:
“How would you describe the overall level of morning stiffness you have had from the time you wake up?”. Answers on a scale from 0 = none, to 10 = very severe.
“How long does your morning stiffness last from the time you wake up?”. Answers from 0= none, to 10 = 2 or more hours.
You can download the Bath Indices from the website of the National Axial Spondyloarthritis Society, NASS. Click here to download
Go to the BASDAI assessment and complete it for yourself. You can then take the results to your Rheumatologist to discuss.
Acknowledge the emotional toll of morning stiffness and seek diagnosis and treatment
Going to bed at night knowing that when I woke up I would not be able to move, that is the most depressing AS symptom I’ve ever had. I was still undiagnosed after over 35 years of symptoms. It was just weird. And it went on for months. Every morning it was taking over 30 minutes to get out of bed, sometimes 2 hours.
In a way it helped because my GP recognised how bad things had got, started to ask about Ankylosing Spondylitis and soon I did get diagnosed. I was elated. Imagine that, being elated when I’ve just been diagnosed with AS. But it is true. After 36 years of symptoms, I finally got an answer. And then the anti-inflammatory medications put a stop to the morning stiffness, my depression lifted and I could get out of bed!
Try modified yoga exercises tailored to axSpA/AS
Start with stretching toes and fingers. For me I could move them first. If it takes you longer than 5-10 minutes to get moving and get up out of bed, focus on the things that move first. I could move my fingers and toes, then my neck, so try some slow and careful turning of your neck from side to side.
Then some windscreen wipers with knees raised and together, soles of feet on the bed mattress.
See these demonstrated in this video
Learn some Yoga for AS modifications from our Website, Virtual Library and the Live Classes, that you can apply when you wake up.
How to get out of bed is rather like coming out of a yoga pose. Roll on to your side, place palms of both hands on the bed and push up from the side to sitting on the edge of your bed, without twisting the spine.
You get the benefits, relief from stiffness being one of the main ones, from regular, safe practice of yoga modified for AS.
The mental toll of morning stiffness is high. Yoga for AS is safe, has benefits and you can enjoy it.
People stick to what they enjoy, in the company of others in the same boat.
Take action by consulting a Rheumatologist for assessment and treatment options
- Low back pain that started before the age of 35 years
- Waking during the second half of the night because of symptoms
- Buttock pain
- Improvement with movement
- Improvement within 48 hours of taking non-steroidal anti-inflammatory drugs (NSAIDs)
- A first-degree relative with spondyloarthritis
- Current or past arthritis
- Current or past enthesitis
- Current or past psoriasis
This guidance is drawn from the NICE guidelines
Enjoy the video provided below, which discusses several of the topics addressed in this blog:
Spondyloarthritis in over 16s: diagnosis and management, https://www.nice.org.uk/guidance/ng65, 28 February 2017
Bath Indices, https://nass.co.uk/homepage/health-professionals/resources-for-health-professionals/bath-indices, Feb 2016