I now manage my autoimmune disease entirely through diet and lifestyle.
However, I do still get the occasional ankylosing spondylitis flare from time to time.
These are rare (at the time of writing I’d been 72 days without flare) but they do still happen.
Typically they are triggered by stress, illness or a food or medication my body has reacted to. You can read more about what can trigger what I call ‘mystery flares’, here.
In this article, I want to run through my personal flare-busting strategy with you.
“Typically this protocol helps me go from a full-blown flare to flare free and feeling normal, in 4 days or less.”
As ever, the usual caveats apply. This is what currently works best for me based on my tests and trials. It may work great for you right away, or it might need tweaking to suit your biology. We are all a little different. I’m just sharing this to give you an idea of some things you can look into and try.
As ever, I’m always learning and will pivot, amend and let you know if I discover new, better or complementary techniques!
Ok, let’s get to it. I’ve split this up into 2 phases.
✔️ Phase I: The Fast
The aim in this phase is to a) Help ‘starve out’ certain bacteria that the immune system may be reacting to. b) Give your gut lining a chance to recover. c) Avoid additional potentially inflammatory stimuli. c) Use safe, inflammation-reducing techniques (such as cold exposure) to keep you moving and to aid sleep.
✅ Up to 72 Hour Food Fast
Up to 72 hours (water, pure bone broth, black coffee only)
If you can get pain-free in less time, great!
✅ Pause Supplements
Obviously only do this if it is safe to do so. Please continue to take any essential medication. The general idea is that we don’t want to take anything that could potentially cause your body to overreact while in this heightened state of immune response
✅ Stress Check
Important: Is there a potential stress trigger at play? e.g. work, personal, finance etc. Be really honest with yourself. If so, address it. Stress can trump any wellness protocol and prolong flares further. It’s always best to tackle this head-on
✅ Daily Hot and Cold Exposure
Morning: Take a hot shower followed immediately by a 2-minute ice-cold shower. If you are new to cold exposure start slow and build your way up. Try 15 seconds at first and extend the time gradually.
Afternoon: Soak in a hot bath (optional: add Epsom salts for a magnesium boost)
✅ Biofreeze (or preferred topical pain relief)
The idea here is to help you get on with normal, day-to-day things. This is the only form of pain relief I take. I don’t take any NSAIDs unless there is no other choice.
Apply the gel to the affected area as and when needed up to 4 times a day.
Always apply one application just before bed to help aid sleep
✅ 2 x Walks Daily
Take an extended walk in the morning
Take a short walk in the evening
Try to hit at least 15k steps.
✅ Nightly Bed of Nails
This is optional but I’ve found it extremely helpful. Bed of Nails is made by several different companies and is essentially a foam pad covered in white plastic nails that you lie on. It’s inexpensive and easy to find online.
Use for 30 minutes (just before bed)
This acts a little like a deep-tissue massage
Before attempting a food fast please ensure that it is safe for you to do so. For example: if you have low blood sugar, or any other underlying health problem, just check in with your doctor first. Also if you struggle with, or have struggled with, an eating disorder then please don’t attempt this part of the protocol.
✔️ Phase II: Recovery
The aim in this phase is to keep up the good work, stay strong and keep the inflammation down (and movement up!) using safe protocols. The key difference is that we are now reintroducing food.
Important: This part is ongoing until flare-free
🚫 No breakfast (intermittent fasting)
✅ Lunch = Salmon and avocado
✅ Dinner = Beef mince and avocado
(Avoid old/browning avocado as this is high in histamine)
✅ Drinks = Water, black coffee, pure bone broth
✅ Yoga or Stretching
Listen to your body and do this as needed. This may not be possible at first or may require shorter, modified routines. For example, I’ve sometimes found I can’t do anything on day 1 or day 2 but after that am able to do a couple of short, 90 second stretches
Remember, I’ve listed what works for me. Your ‘safe foods’ list may look different to mine. Some people don’t do well on avocados… some have a fish allergy… some don’t react well to beef. Feel free to tweak as needed. If you haven’t done so already I recommend doing an elimination diet and creating your personalised Wellness Plan. You can see my guide here.
💡 Optional Extras
Here are a few other things you can try (provided it is safe for you to do so).
✔️ Extended sauna and cold exposure
✔️ Massage and/or acupuncture
Obviously make sure you have a good practitioner
✔️ Plug-in electric heat pad
Position the heat pad on the bed to cover base of your spine, as and when needed. Depending on where you live, this may be difficult in Summer when it’s hot but can be really helpful in autumn, winter or spring.
✔️ What to Expect
This isn’t meant to sound glib, but always expect the unexpected.
In my experience, no journey out of a flare is exactly the same.
There have been times when a simple 24-hour fast has completely batted away my flare and I’ve not had to do anything else.
Other times it has taken 40 – 60 hours of fasting to see any kind of effect and then a few more days of ‘safe eating’, exercise and stretching to make real progress.
On one occasion (and this has only happened once for me) the fasting didn’t have any effect. I believe, in retrospect, I was fighting off a bug that was otherwise asymptotic. I’d spent time with friends who had the flu a week prior.
If you are unwell (for example if you are fighting a virus) it may not fully clear up until you’ve addressed that.
Likewise with stress. If there’s a major stress event causing you to flare you have to address the root cause first.
Just remember this:
It will pass. It always does.
I really hope you found this useful. I will update this page if I make any further discoveries. I would also love to hear what you do to get out of flare.
Please leave a comment below.