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BASDAI [Bath Ankylosing Spondylitis Disease Activity Index]
Total score 4 or greater -suboptimal control of disease
BASFI [Bath Ankylosing Spondylitis functional Index]
No cutting point, higher the score, higher functional impaired
Doesn't improve with your developed strategies after 7 days
When symptom is more intense or different than normal. (For example, it causes particularly strong back pain.)
If you have Fever with chills, sweats, or weight loss:
Could be a signal an underlying infection, patients taking biologics are at increased risk of infection and should seek medical attention immediately
A flare can be defined as the acute worsening of symptoms.
Axial inflammation in Spondyloarthritis
Chronic lower back, pelvic, and hip pain that comes and goes Stiffness
Flare: feel significantly more intense and debilitating may be like stabbing in nature or feel like muscle cramps
Symptoms affect one primary area, causing pain, immobility, and fatigue.
Gentle exercise, stress management, listening to your body and the right medication treatment plan, you can get through these periods of flare-up.
Symptoms are more severe and may affect multiple parts of the body.
In addition, may have flu-like illness (fever, sweating); hot, burning joints; muscle spasms; and more sensitivity.
Episodes may last from a few days to a few weeks
Some flares are due to treatment interruption or discontinuation
Delaying doses or extending the time between doses, or
Loss of efficacy of the drug
Result of “random” fluctuations in disease activity
Patients linked flares to situations of increased emotional stress or an episode of “overdoing it.”
Infections are another potential trigger.
Inability to follow established exercise routines during the COVID-19 pandemic has been a recent problem
Use objective ways to assess disease activity and functional ability BASDAI [Bath Ankylosing Spondylitis Disease Activity Index]
Flares might be lasting from days to weeks
Many patients may have found their own ways of dealing with the situation
Coping strategies such as:
Changes in the exercise routine -> gentle exercise e,g Tai-Chi, deep breathing exercises
Long hot baths or showers and other nonpharmacological interventions
Walking, range-of -motion exercises, even just stretching or deep breathing. swimming and hydrotherapy are also well-tolerated
Find a balance between rest and gentle exercise to keep your joints moving
Heat or cold therapy
Try employing mind/body techniques such as meditation
You might feel completely wiped out. “With the fatigue it brings about, take nap a couple of times a day
In Ankylosing spondylitis, fatigue from inflammation, can feel like you have the flu, body ache all over
(uncontrolled systemic inflammation is the factor that predicts fatigue in AS)1
Apply many fatigue - fighting measures are under your control, such as :
Regular exercise helps reduce pain and inflammation –sleep better helps ease fatigue
Try the exercise/ physiotherapy recommendation
Fight fatigue, feed your body a healthy diet of lean proteins, healthy fats, fruit, vegetables and whole grains
Don’t skip meals, start every day with a good breakfast.
Set the right mood for sleep, try stick to a sleep schedule and soothing bedtime routine. Try warm bath, some gentle stretching
Ask for help! If fatigue, poor sleep, or depression are taking a toll. Suggest you may need referral for managing stress and mental health
What is a Flare? [Online] at: https://spondylitis.org/spondylitis-plus/examining-flares-in-spondyloarthritis/ Accessed on 18th Oct 2021
Ankylosing Spondylitis Flares [Online] at: https://creakyjoints.org/about-arthritis/axial-spondyloarthritis/axspa-symptoms/ankylosing-spondylitis-flare-ups/ Accessed on 18th Oct 2021
Try Do-It- Yourself first(DIY) in AS flare [Online] at: https://www.everydayhealth.com/hs/psoriatic-arthritis-managment-treatment/tough-day-tips-pictures/ Accessed on 18th Oct 2021
Disclaimer: This material is not meant to replace professional advice from HCPs. Please consult your doctors/physiotherapist if you have any questions or before undertaking any physical activities.