Life with ankylosing spondylitis (AS) can be challenging, but the key is finding support. You may be the one with the condition, but that doesn’t necessarily mean you have to go through management and treatment alone.
Here’s who should be on your AS healthcare team, and what you should look for in each specialist.
Rheumatologists have extensive training in the treatment of all types of arthritis. Continuing education keeps them informed of the latest research and advances in treatment.
Your rheumatologist will take the lead in your AS treatment plan. Treatment goals are reducing inflammation, reducing pain, and preventing disability. Your rheumatologist will also refer you to other specialists as needed.
You want a rheumatologist who:
- is experienced in treating AS
- allows time for Q&A and frank discussion
- shares information with the rest of your healthcare team
When seeking a new rheumatologist or any type of medical doctor, here are a few key things to look for:
- has appropriate board certifications
- is accepting new patients
- works with your insurance plan
- has an office location and hours compatible with yours
- answers phone calls or other communications within a reasonable time frame
- has hospital affiliations in your network
Your rheumatologist will spearhead your AS treatment, but you shouldn’t neglect other aspects of your healthcare. That’s where a general practitioner comes in.
You want a general practitioner who:
- is willing to treat you as a whole person
- allows time for questions
- takes AS and AS treatment into account during regular checkups and when treating other conditions
- notifies your rheumatologist of any suspected problems relating to AS
Both your rheumatologist and general practitioner can refer you to other specialists as needed.
Within your doctor’s practice, you might also have occasion to meet with nurses or physician assistants (PAs). PAs practice medicine under direct supervision of a physician.
Physiatrist or physical therapist
Physiatrists and physical therapists help with managing pain, building strength, and increasing flexibility.
A physiatrist is a medical doctor trained in physical medicine and rehabilitation. They help treat pain due to disabling conditions like AS, including injections of joints, osteopathic treatment (which involves manual movement of your muscles), and complementary practices such as acupuncture. They can offer guidance to your physical therapist.
Physical therapists teach you to perform the right exercises correctly. They help you learn how to build your strength, improve flexibility, and monitor your progress.
Look for someone who has experience with AS, other forms of arthritis, or serious back problems.
Dietitian or nutritionist
There’s no special diet for people with AS, and you may never need help in this area. But diet is an important part of your overall health. Also, carrying too much weight can put an added strain on your spine and other joints affected by AS.
If you do need nutritional support, dietitians and nutritionists can get you started in the right direction.
Dietitians and nutritionists aren’t exactly the same. Generally speaking, you should look for a dietitian or nutrition specialist with board certification. Regulations for these professions vary a lot from state to state. Your rheumatologist or general practitioner can refer you to a qualified professional.
Up to 40 percent of people with AS experience inflammation of the eye (iritis or uveitis) at some point. It’s usually a one-time thing, but it’s serious and requires immediate attention from an eye specialist.
An ophthalmologist is a doctor who treats disease of the eye.
Ask your rheumatologist or family doctor for a referral to a board-certified ophthalmologist. Even better if you can find one experienced in treatment eye inflammation due to AS.
Inflammation due to AS can lead to inflammatory bowel disease or colitis.
Gastroenterologists receive extensive training in the treatment of gastrointestinal diseases. Look for board certification and experience dealing with inflammatory bowel disease (Crohn’s disease, ulcerative colitis).
Chances are that you won’t need a neurosurgeon. While surgery can help stabilize and straighten a deformed spine, it’s rarely used to treat AS. It’s considered high risk and usually used only after all other treatments have failed.
Neurosurgeons are trained to treat disorders that affect the central nervous system, which includes the spinal cord. It’s a complex specialty that requires intricate skills.
Your rheumatologist can refer you to a board-certified neurosurgeon who has experience with AS.
Therapist, psychologist, psychiatrist, and support groups
Living with a chronic illness, it’s possible you’ll need some type of support along the way, even if it’s temporary. Of course, there are different levels of support, depending on your needs. Here are some professional distinctions:
- Therapist: Requirements vary. In some states, a therapist may not have any degree requirements. In others, it may require a Master of Psychology. Therapists use a behavioral approach to therapy.
- Licensed professional counselor: Requirements vary from state to state, but most have a master’s degree and clinical experience. They can’t prescribe medication.
- Psychologist: Holds a doctoral degree and is trained in thoughts, emotions, and behaviors.
- Psychiatrist: Holds a Doctor of Medicine or Doctor of Osteopathic Medicine degree specializing in mental health. Can diagnose, treat, and prescribe medication for psychological problems and mental health disorder.
In-person or online support groups can help you deal with issues pertaining to AS or living with chronic illness in general. There’s a lot of variation in support groups. Don’t feel you have to stick with the first one you find. Keep looking until you find one that meets your needs. The Spondylitis Association of America has a list of support groups you can use as a starting point.
Complementary therapy professionals
There are many complementary therapies you can do on your own, such as deep breathing exercises and meditation. For others, such as acupuncture, it’s worth checking credentials.
First, clear it with your rheumatologist. Depending on the level of disease progression and how experienced the practitioner is, some complementary therapies may be more hurtful than helpful.
Ask your doctors for recommendations. Then do some homework on your own. Research credentials and years of experience. Check to see if there have been any complaints against the practitioner.
Some complementary therapies may be covered by your health insurance, so be sure to check that too.Read more in Ankylosing Spondylitis Resources
Distinguishing between dietitian vs nutritionist. (n.d.). Retrieved from http://www.nutritioned.org/dietitian-vs-nutritionist.html
Iritis or anterior uveitis. (n.d.). Retrieved from http://www.spondylitis.org/Possible-Complications/Iritis-Uveitis
Mayo Clinic Staff. (2014, February 18). Mental health providers: Tips on finding one. Retrieved from http://www.mayoclinic.org/diseases-conditions/mental-illness/in-depth/mental-health-providers/art-20045530
Murphy, J. (2015, April). What is a rheumatologist? Retrieved from http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Health-Care-Team/What-is-a-Rheumatologist
Questions and answers about ankylosing spondylitis. (2016, June). Retrieved from https://www.niams.nih.gov/health_info/ankylosing_spondylitis/ What is a physiatrist? (n.d.). Retrieved from http://www.aapmr.org/about-physiatry/about-physical-medicine-rehabilitation/what-is-physiatry