Ankylosing spondylitis is a chronic inflammatory rheumatic disease that can cause persistent pain, stiffness, and progressive limitation of spinal mobility. Managing symptoms often requires a combination of pharmacologic therapy, regular physical activity, and long-term lifestyle adjustments.

Vincent Marique, 50, has lived with ankylosing spondylitis for 30 years. The disease was not outwardly visible, and he managed it through regular exercise and a modified diet.

A bodybuilder and a three-time Belgian champion in several categories, Marique first noticed tendon and joint pain, which he initially attributed to weight training.

Speaking with MediQuality, part of the Medscape Professional Network, Marique said, “These were actually the first symptoms of ankylosing spondylitis. Based on medical explanations establishing the likely cause and effect relationship, it appears that I have been living with the disease for nearly 30 years, with the first tendon and joint symptoms appearing after 4-5 years of weight training, around 1995, when I was 20.”

The diagnosis was confirmed only in 2013 after the second back surgery. “Since then, I have been fully aware of the condition and have received regular rheumatologic follow-up since 2014. My rheumatologist encouraged me to remain physically active. I was prescribed the anti-tumor necrosis factor agent adalimumab, which slows the degenerative process but also weakens the immune system. Even a simple toothache can be a serious problem. I also take meloxicam every day.”

During spinal surgery, which involved L4-L5-S1 spinal fusion, Marique underwent a bone graft to replace severely damaged intervertebral discs. These lesions result from significant anterolisthesis of the spine, causing marked instability at that level.

“I was suffering from multiple inflammatory episodes and even walking became difficult. These problems lasted for 4 years”, he said. The experience took a psychological toll. Marique developed depression but recovered without medication. “Although I felt deeply frustrated the disease had wiped out 15 years of effort and exposed me to the risk for paraplegia, I never believed it would defeat me. If you give in to frustration, you will lose. Everything begins in the mind.”

Another challenge following surgery was that prolonged immobilization led to weight gain, and he later lost approximately 30 kg. Marique attributed his recovery to lifestyle changes. “What saves me is my lifestyle is. It also slows the progression of the disease, although I still have flareups. When this happens, I push through it. I follow a healthy diet, add anti-inflammatory spices such as turmeric and cinnamon, drink plenty of water, and exercise,” he said.

Marique now manages the disease while continuing the life he loves. He developed his own training approach that combined bodybuilding with a focus on well-being. Each morning, he performs approximately 45 min of mobility and stretching exercises to preserve tendon and muscle flexibility, which is essential in ankylosing spondylitis. He also trains 3-4 times/wk, adjusting the intensity according to how his body feels. As he marks his 50th birthday this year, he hopes to take on a final challenge by competing in a bodybuilding contest this summer.

Beyond this individual experience, research has also examined the role of physiotherapy and structured exercise in managing ankylosing spondylitis.

A study conducted by Maria A. T. van Wissen, from the Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, Netherlands, was published in Rheumatology.

The findings show that a supervised, personalized exercise program maintained for 1 year can significantly improve functional capacity and quality of life in adults with axial spondyloarthritis and severe functional limitations.

In the study of 214 participants, patients were randomly assigned to either the personalized exercise program or usual care. The program included supervised sessions, patient education, and goal setting.

At 52 weeks, patient-specific complaint scores improved more in the exercise group than in those in the usual care group. Exercise therapy also reduced functional disability without causing serious adverse events, supporting its safety and clinical benefits in this population.

This story was translated from MediQuality, part of the Medscape Professional Network.