Range of Motion Improvement in Ankylosing Spondylitis Patient with Persian Traditional Medicine; Case Report

BACKGROUND Ankylosing spondylitis (AS) is a chronic inflammatory disease of the skeletal system without definitive treatment. Nowadays, the aim of therapeutic interventions is preventing disease progression, but eventually many patients have different degrees of decreased range of motion, especially in the spine accompanied by pain and fatigue. METHODS A 44-year-old man with AS from 22 years ago was treated with NSAIDs and sulfasalazine. He visited for developed pain and stiffness in spine from 7 years ago. He did not confer with the rheumatologist from 2012 due to the lack of treatment satisfaction and maintained his treatment with 75 mg indomethacin daily. The patient was assessed in the Iranian traditional medicine clinic and other problems were chronic fatigue, interrupted sleep, and extreme dry skin. Diagnosis was general dryness and treatment started with oral and tropical moisture and nutritional advice. RESULTS In the third month of treatment, joint pain, morning stiffness and sleep disturbance improved. After 8 months, in addition to complete improvement of skin dryness, sleep disturbance and joint pain, range of motion in cervical and lumbar spine were increased. In cervical rotation, distance from the chin to acromion decreased from 24 to 15 cm in right rotation and 20 to 13 cm in left rotation. Additionally, in cervical flexion distance from the chin to sternal notch decreased from 16 to 8 cm after treatment. In the lumbar spine, an increased Schober's index was seen. CONCLUSION The use of Persian traditional medicine's viewpoints and treatment strategies can be effective in improving Ankylosing spondylitis prognosis and proposed for future clinical research.