Nonpharmacologic management of axial spondyloarthritis

Successful management of ankylosing spondylitis requires a comprehensive approach that includes nonpharmacologic management strategies comprising physiotherapy and exercise, as well as self-management and patient education. Accumulated data on nonpharmacologic approaches in patients with AS could be extrapolated for patients with axial spondyloarthritis including nonradiographic axSpA. Conventional exercise protocols along with self-management and patient education have been shown to be beneficial. Cardiovascular fitness exercises together with spinal flexibility exercises increase physical fitness and reduce peripheral pain. Combination of TNF? blockers with a rehabilitation program has synergistic effects. Data on complementary and alternative medicine approaches for the management of AS are scanty; however, one can extrapolate from the literature pertaining to forms of rheumatic disorders. Rehabilitation strategies should be patient-centered and individualized according to the needs and expectations of the patient. © 2019 Elsevier Inc. All rights reserved.