Living Well


When one lives with a condition like axial spondyloarthritis (AxSpA),it is important to adopt healthier eating habits.

Maintaining a healthy weight

It is essential to maintain optimal weight. Weight gain may put a burden on knee and foot joints, and increase pain. While walking, the hips, knees and ankles carry three to five times the total body weight. This means that for every pound of body weight, 3 to 5 pounds (approximately 1.5-2.5 kgs) of extra weight is further added to each knee while walking. Losing 10 pounds (approximately 4.5 kg) can decrease additional stress on joints.

Healthy balanced diet

For a healthy balanced diet, consider eating:

At least 4 portions of vegetables (including at least 1 leafy green vegetable) every day

2 portions of fruit

Protein in the form of fish, beans, pulses, nuts, eggs and meat (in limited amounts)

Around 700mg of calcium a day, which can be gained from 200ml of semi-skimmed milk or 150g of low-fat yoghurt

While choosing carbohydrates, choose healthy high-fiber foods and whole grain varieties, like brown rice, brown wholemeal bread

Omega-3 fatty acids found in oily fishes and nuts like walnuts


Although making lifestyle changes might not be the first thing someone with AxSpA thinks about, they can be beneficial in managing symptoms, promoting well-being and improving quality of life. Some of these lifestyle changes include:

Sleeping well

Giving up smoking

Exercising regularly

Ergonomic posture while sitting and sleeping

Adapting a proper working style

Sleeping well while having axial spondyloarthritis

Almost half of the people with AxSpA have moderate to severe insomnia; meaning, they cannot sleep well due to pain or stiffness. The lack of sleep leads to fatigue the subsequent day, worsened by constant pain or stiffness. Some tips that may help promote better sleep are:

Using a firm, flat mattress to have good sleeping posture

Sleeping on the back to avoid bending the spine and hip joints

Avoiding big pillows that lift the shoulders and bend the spine

Not putting a pillow under knees while sleeping

Giving up smoking

For people with AxSpA, cigarette smoking has been known to cause higher disease activity, more structural damage on radiographic tests, greater inflammation, decreased functional ability and poor quality of life. Smoking cessation is advisable to prevent accelerated disease progression.

Here are some ways that can help quit smoking:


When having an urge to smoke, find a distraction, such as talking to friends

Commit to quit. Stick to the resolution of giving up smoking

Try chewing nicotine gums when there is an urge to smoke

Engage in other hobbies

Seek medical support, if needed.


Regular exercise

AxSpA may affect a patient in different ways at different times. Exercising can improve health and flexibility, thereby offering relief from the symptoms. To help manage AxSpA, both medications and exercise are important.
Exercise helps in the following ways:

Improves flexibility

Increases movement

Improves posture

Improves sleep

Reduces stiffness and pain

Some exercises which might be helpful include:

Knee rolls

Pelvic tilts

Rotation using hand to knee

Knee hugs

Lumbar extension

Arm opening

Remember, exercises are beneficial when they are done regularly and over a long period of time. So, make it a habit to exercise regularly.

Work and axial spondyloarthritis

It can be hard to keep active with a hectic work schedule. Here are some tips that can help:


Impaired mobility and chronic pain can make travelling seem difficult. Try these tips to make travelling as painless as possible:

Use the calendar tool on the phone to set medication reminders

Align travel plans with the medication schedule

Travel during off-peak season and when places are less crowded

Find time to exercise during the trip

Ask for a hard mattress and thin pillow at the hotel

Go for a swim

Enjoy travelling, sightseeing, taking pictures and making memories with proper planning ahead of time.


AxSpA does not have a negative impact on pregnancy or on the baby's health. The rate of miscarriage, stillbirth and preterm birth among women with AxSpA is similar to any healthy women6. Women having AxSpA generally have healthy babies, and they carry them full term. They are unlikely to be at a higher risk of any pregnancy-related complications.

Symptoms during pregnancy
There is no fixed pattern of symptoms during the pregnancy. However, some women find that their symptoms improve or stay more or less the same.

Exercising during pregnancy
It is important to keep exercising as far as possible during pregnancy. This will help with AxSpA symptoms and promote overall health. Weight gain is detrimental for AxSpA, hence it is essential to optimize the weight gain during pregnancy.

Medications and pregnancy
Some women wish that they remain medication-free during pregnancy and breastfeeding, to avoid possible toxicity to the baby. Women with AxSpA often need to continue their medication. A doctor can give appropriate advice on medications after weighing the possible risks and benefits.


  • Most women with AxSpA have normal labour. It is recommend that those with AxSpA consult their gynaecologist in advance about pain relief during labour
  • Previous surgeries do not necessarily hamper a woman’s chance of having a normal delivery
  • It has been observed that caesareans tend to be carried out more often among AxSpA patients

Having AxSpA will not directly affect a woman’s ability to conceive. However, some medications need to be taken with care or be replaced when one is trying to conceive, during pregnancy and even after childbirth and during breastfeeding.