If you have Ankylosing Spondylitis, or AS for short, you are probably familiar with back pain and morning stiffness. But did you know that this condition is not always limited to the spine? About a third of AS patients also experience inflammation in other parts of the body. The chest is one of the most commonly affected areas. Do you also feel pain in your chest when you take a deep breath, cough, sneeze, or exercise? Then this article will be very important for you.
How does AS affect your chest?
Simply put, AS is a condition that causes the joints in the body to become swollen, or inflamed. It starts in the joints of the spine, but over time it can spread to other joints in the body. The cartilaginous joints that connect your ribs to the flat bone in the middle of your chest called the sternum can also become inflamed in this way.
When these joints become inflamed, we medically call it costochondritis . This is a very common condition among AS patients. According to surveys, 70% of AS patients experience this chest pain at some point in their lives.
The best part is that costochondritis is not a harmful condition. But it can be painful. Sometimes this pain can last from a few weeks to a few months, or even a year. But it usually gets better on its own.
Chest pain is never something to be taken lightly. It can be caused by costochondritis, or it can be a sign of a more serious condition, like a heart attack. So, if you have any concerns, be sure to see a doctor right away.
What are the symptoms of chest pain?
The main symptoms of costochondritis caused by AS are chest pain, stiffness, and tenderness. This pain can vary from person to person. For some, it may feel like a dull, aching pain, while for others, it may feel like a sharp, stabbing pain.
Let's explain these symptoms in more detail in the table below.
| Feature / Opportunity | Description |
|---|---|
| Actions that increase pain |
|
| Time of day | Some people may feel severe pain and stiffness when they wake up in the morning, but it gradually subsides after about 15-30 minutes. |
| Warning signs that require immediate medical attention! | |
| Emergency situations | If you have one or more of these along with chest pain, go to a hospital's emergency department (ETU) immediately:
|
How to manage chest pain caused by AS?
This chest pain can interfere with your daily activities. Therefore, rather than waiting for it to go away on its own, it is best to see your doctor and get proper treatment. Your doctor may recommend painkillers, exercise, physical therapy, or a combination of all of these. Although these treatments cannot completely cure the disease, they can help you control the pain and provide you with relief.
Medical Treatments
Most importantly, do not use any painkillers without your doctor's advice. Some medications have serious side effects and the risk of addiction.
Your doctor will often first recommend nonsteroidal anti-inflammatory drugs (NSAIDs) , such as ibuprofen and naproxen. These may need to be taken for several weeks or months.
If NSAIDs don't work for you or don't control your pain, your doctor may recommend other medications, such as:
- Analgesics such as acetaminophen.
- Opioids are short-term medications for severe pain.
- Glucocorticoid injections given directly to the painful joint.
- Specific medications that control the underlying inflammation of AS. Examples:
- Anti-TNF drugs: Adalimumab, Golimumab
- Anti-interleukin 17 drugs: Ixekizumab, Secukinumab
- Janus kinase (JAK) inhibitors: Tofacitinib
- Some antidepressants and anti-seizure medications are also used to control nerve pain.
Exercise and Physical Therapy
Exercise is an essential part of AS disease management. Proper exercise can help prevent joint stiffness and damage.
- Light exercise: The doctor recommends a low-impact exercise program, such as walking or swimming, that does not increase pain.
- Mind-body exercises: Exercises like yoga or Tai Chi can reduce stress and provide pain relief.
Your doctor may also refer you to a physiotherapist , who will develop a specific program for you.
- Stretching exercises: These help reduce chest tightness and make breathing easier.
- Nerve stimulation: A special device attempts to stop pain signals from reaching the brain.
- Posture training exercises: Maintaining correct posture can reduce stress on the joints.
Things you can do yourself (Lifestyle Changes)
Along with treatment, small changes in your lifestyle can go a long way in helping you manage this pain.
- Limit things that increase pain: Imagine that lifting something heavy makes you feel worse. Then stop doing that for a while.
- Hot or cold applications: Applying a hot water bottle or ice pack to the painful area can provide temporary relief.
- Rest: If you feel tired, give yourself the necessary rest.
- Mental well-being: Do things that help you relax. Things like meditating or listening to music can help. It is also important to seek counseling to help you manage the stress of living with AS.
Take-Home Message
- People with Ankylosing Spondylitis (AS) may experience chest pain in addition to back pain. The main cause of this is a condition called costochondritis.
- This is usually not a harmful condition, but it can be painful. However, it is essential to seek medical advice to ensure that there are no other serious causes of chest pain.
- Pain that increases with deep breathing, coughing, or sneezing is a common symptom.
- Never take painkillers without medical advice. Always talk to your doctor.
- This pain can be very well managed with proper exercise, physical therapy, and lifestyle changes.
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