Ankylosing Spondylitis? TCM can help!

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What is ankylosing spondylitis?

          Ankylosing Spondylitis, also known as AS, is a chronic systemic inflammatory disease that primarily attacks the axial skeleton and adjacent structures (Weisman, 2011). Common symptoms are chronic pain and discomfort in the back or joints, such as hips, shoulders, knees, or feet. It is most common for AS to develop in adult males between the ages of 15 and 25, although it may begin at a younger age and in females as well. When left untreated, the inflammation of the spinal joints will gradually destroy the cartilage and fibrous tissue of the surrounding structures and the ligaments and replace them with bone (Weisman, 2011). 

What ARE THE SYMPTOMS OF ANKYLOSING SPONDYLITIS?

 

          Patients may experience fatigue, anorexia, and general physical discomfort (Weisman, 2011). However, due to the common symptoms of AS, they usually go undiagnosed as they may be mistaken for countless other health issues. For example, it is common for patients with AS to complain about chronic back pain and state that the pain feels worse when they are inactive, such as at bedtime or after sitting for a long time; the pain usually improves after physical activity. Other symptoms include enthesitis - pain, stiffness, and limited range of motion in the spine; arthritis of the hips and shoulders; and osteoporosis which is loss of bone density (Weisman, 2011).

WHAT ARE THE CAUSES OF ANKYLOSING SPONDYLITIS? 

 

          Ankylosing spondylitis can be caused due to genetic factors, infection, endocrinological factors, or immunological factors (Cheng, Y., et. al., 2021). The specific cause of AS is uncertain. However, medical researchers found that AS may develop due to a person’s genetics, such as those with the HLA-B27 gene (Weisman, 2011). The researchers also show that environmental factors play a significant role in the development, as well as bacterial or viral infections, which may trigger the deterioration of AS in predisposed individuals (Weisman, 2011). 

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What are the causes of ankylosing spondylitis in Oriental Medicine?

          Oriental medicine believes that health stems from the balance of Qi - vital energy, and symptoms arise due to a blockage; therefore, balancing the Qi will restore wellness (Hal et al., 2021). Oriental medicine sees the syndrome of AS as a deficiency in origin and excess in superficiality. It is due to insufficiency of the Kidney, weakness of Governor Vessel (GV), and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of Qi and blood and malnutrition of the bones, muscles, and joints (Liu, 2008). 

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What can Oriental medicine do to treat ankylosing spondylitis?

         

          Oriental Medicine has a variety of noninvasive modalities to treat AS: acupuncture, ear acupuncture/ear acupressure, traditional Chinese herbs, moxibustion/moxa, cupping, and dieting. These modalities help improve the quality of life of AS patients as they help relieve the pain and send signals for the body to return to its balance.

ACUPUNCTURE

          Acupuncture is a traditional Chinese medicine modality that involves inserting thin needles into specific areas of the skin to activate the body’s pain-relieving chemicals that stimulate healing (Hal et al., 2021). It has proven to be effective in improving symptoms of AS by regulating the immune imbalance and inflammatory reaction to reduce joint pain and systematic symptoms (Chen et al., 2020).

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EAR ACUPUNCTURE/ EAR ACUPRESSURE

          Acupressure is a form of acupuncture in which specific ear points are stimulated without a needle (Lin et al., 2015). The ear has been discovered to correspond to various human body areas. For example, the higher points control the hip, knee, or heel, and the lower points control head and neck area (Angel Y., 2021). Symptoms of AS can be relieved by stimulating ear points corresponding to the spine. 

TRADITIONAL CHINESE HERBS 

          Chinese herbal medicine is a comparable and alternative therapy widely used worldwide. It is confirmed to have better effects in treating AS and alleviating side effects of western medicine (Liu, M., Deng, X.-L., & Yu, J., 2021). The herbs are usually consumed in the form of tea, although they may also be found as capsules, liquid extract, or powder.

MOXIBUSTION

          Moxibustion is a characteristic therapy that applies heat to to-be-stimulated acupoints by burning moxa or herbal material. The heat would be transferred to the skin and recognized by the thermal sensory receptors as invasive stimulation (Chen et al., 2020). It also avoids the side effects of oral drugs and reduces the patients' physical burden by enhancing their physical function (Wang et al., 2021).

CUPPING

          Cupping has been around for thousands of years (Chirali, 2014). It is a safe, therapeutic, and effective treatment for patients seeking alternate remedies. Typically, the cupping method uses glass or plastic cups on the patients’ skin to create localized pressure, allowing blood to flow (Ma et al., 2018). Cupping therapy is widely used to ease the symptoms of AS and to provide patients with relief to their aches and pains by reducing stiffness and improving physical functions (Ma et al., 2018).

DIET

          A proper diet plays a significant role in maintaining good health overall. For AS patients, it is crucial to pay attention to what they eat, as some foods may assist in strengthening their bones and reducing inflammation. It is recommended to eat foods rich in calcium and high in Vitamin-D to help keep bones strong and support muscles (Lee, K., n.d.). Mayo Clinic recommended avoiding salt, sugar, caffeine, and alcohol as those foods inhibit calcium from being absorbed adequately or create calcium loss (2019). 

References

Angel, Steve (2021). Acupressure and the ear: A healing path. Johns Hopkins Nursing Magazine. https://magazine.nursing.jhu.edu/2020/04/healing-path/

Chen, J., Lu, L.-B., Tang, G.-H., & Xiong, J. (2020). The efficacy of moxibustion and acupuncture therapy for ankylosing spondylitis: A Protocol for an overview of systematic reviews and meta-analysis. Medicine, 100(15). https://doi.org/10.37766/inplasy2020.8.0035

Cheng, Y., Yin, J., Hu, X., Xu, P., Liu, Y., & Lei, C. (2021). Assessment of ankylosing spondylitis based on the theory of Yin and Yang in traditional Chinese medicine. Journal of Clinical and Nursing Research, 5(5), 33–36. https://doi.org/10.26689/jcnr.v5i5.2468

Chirali, I. Z. (2014). History of cupping therapy. Traditional Chinese Medicine Cupping Therapy, 1–16. https://doi.org/10.1016/b978-0-7020-4352-9.00001-1

Gajendran, D. (2021). 6 effective acupuncture points for treating ankylosing spondylitis. Modern Reflexology. https://www.modernreflexology.com/acupuncture-points-ankylosing-spondylitis/

Hal, M. V., Dydyk, A. M., & Green, M. S. (2021). Acupuncture. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK532287/

Lee, K. (n.d.). Ankylosing spondylitis: What to eat for bone health. EverydayHealth.com. Retrieved September 23, 2022, from https://www.everydayhealth.com/ankylosing-spondylitis/what-to-eat-and-avoid-for-strong-bones/?utm_source=google_search&utm_medium=cpc&utm_campaign=eh_cs_ag_140254491994&utm_content=eh_cs_cid_601153318300&gclid=Cj0KCQjwsrWZBhC4ARIsAGGUJurqwinwySgT5bFyw6CDJ9wkthqOyx-wXOwKGDwj1yWnUGDVPNGt_MAaAhrmEALw_wcB

Lin, W.-C., Yeh, C. H., Chien, L.-C., Morone, N. E., Glick, R. M., & Albers, K. M. (2015). The anti-inflammatory actions of Auricular Point Acupressure for chronic low back pain. Evidence-based complementary and alternative medicine: eCAM. Retrieved September 23, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4480805/

Liu, M., Deng, X.-L., & Yu, J. (2021). Effectiveness and safety of Chinese herbal formula combined with western medicine for ankylosing spondylitis. Medicine, 100(25). https://doi.org/10.1097/md.0000000000026374

Liu, P. (2008). TCM treatment of ankylosing spondylitis by tonifying the kidney and strengthening the governor vessel. Journal of Traditional Chinese Medicine, 28(1), 44-45

Ma, S.-yu, Wang, Y., Xu, J.-qi, & Zheng, L. (2018). Cupping therapy for treating ankylosing spondylitis: The evidence from systematic review and meta-analysis. Complementary Therapies in Clinical Practice, 32, 187–194. https://doi.org/10.1016/j.ctcp.2018.07.001

Mayo Foundation for Medical Education and Research. (2019). Ankylosing spondylitis: Eat Well for bone health. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/ankylosing-spondylitis/in-depth/ankylosing-spondylitis-and-diet/art-20460747?utm_source=google_search&utm_medium=cpc&utm_campaign=mc_cs_ag_80532438231&utm_content=mc_cs_cid_380781070961&gclid=EAIaIQobChMIq8mIxbWq-gIV1smUCR2MWQmaEAAYASAAEgJmUfD_BwE

Wang, J., Jiang, Q., & Zhu, Y.-wei. (2012). Clinical observation on long snake moxibustion for ankylosing spondylitis. Journal of Acupuncture and Tuina Science, 10(4), 213–217. https://doi.org/10.1007/s11726-012-0606-9

Weisman, M.H. (2011). Ankylosing spondylitis. Oxford University Press.