Can Islamic prayers benefit spondyloarthritides? Case report of a patient with ankylosing spondylitis and increased spinal mobility after an intensive regimen of Islamic prayer.

A 35-year-old Arab male had severe Ankylosing Spondylitis for 10 years with syndesmophyte formation in the lumbar spine, decreased spinal mobility (modified Schoeber's test of 0.5 cm), BASDAI of 4, and BASFI score of 6. He was initially started on non- steroidal anti-inflammatory medications (NSAID) and a regular swimming program as well as physiotherapy. Due to lack of response he was started on Etanercept monotherapy. After 1 month his modified Schober's had improved to 1 cm, BASDAI to 2, and BASFI to 1. At 5 months after starting treatment, there was no further improvement. Patient embarked on an intensive regimen of Islamic prayers during the month of Ramadan, lasting approximately 2 h daily, for 1 month. At the end of 1 month he had improved spinal mobility with a modified schober's test of 2.5 cm and stable BASFI scores. Islamic prayers consist of several postures, including stretching, bending and kneeling. Further study is needed, but Muslim patients can be easily motivated to perform long hours of Islamic prayers, and this can offer benefits, when used in conjunction with conventional treatments, for spondyloarthritis.