Ankylosing spondylitis (AS), or Bechterew's disease, is a disease whose symptoms are initially non-specific and therefore its treatment is delayed. This problem affects many patients, as ankylosing arthritis is the second most common inflammatory disease of the joints (after rheumatoid arthritis).

Ankylosing spondylitis (AS) , otherwiseBechterew's disease,is a chronic and progressive inflammatory process that affects the joints ( especially the sacroiliac joints), intervertebral discs and ligaments of the spine. In these places, calcium s alts quickly accumulate, then ossification and, consequently, gradual stiffening.

Ankylosing arthritis is the second most common inflammatory disease of the joints (after rheumatoid arthritis).

The disease affects men more than women and usually occurs between the ages of 16 and 30, although it can also affect children and the elderly.

Ankylosing spondylitis (AS) - causes

The etiology of this chronic rheumatic disease is not fully known. The genetic factor is believed to play a key role. In 90-95 percent patients have the presence of the HLA-B27 antigen.

However, because the HLA-B27 antigen has nearly 7 percent of the population, and only about 1% of the population is ill, researchers also indicate other possible causes of AS: immunological (disorders of the immune system) and environmental (bacterial infections - especially of the gastrointestinal tract and genitourinary tract).

The cause of inflammation may also be microtrauma.

Ankylosing spondylitis (AS) - symptoms

The initial symptoms of the disease are not uncharacteristic - the patient complains of progressive weakness and malaise. Only later does a dull pain in the spine appear, which:

  • is located in the sacroiliac region
  • radiates to the buttocks, back of the thighs and knees
  • usually occurs at night, in the morning
  • yields not with rest, but with exercise, e.g. gymnastics, etc.

In the next stages of development, the disease occursossification of the spine in the lumbar, thoracic and / or cervical spine. His bracing starts in the morning and disappears after exercise.

As the disease develops, the inflammation spreads to higher and higher parts of the spine, intervertebral joints and rib-vertebral joints, leading to their degeneration. Then the patient is constantly hunched (hyperphosis of the thoracic section), his neck protrudes forward (cervical hyperlordosis), and he himself feels pain and limitation when moving his head.

Then there is a progressive limitation of lower limb movements, as well as stiffening and restriction of chest movements. As a result of inflammation of the cervical spine, the spine and respiratory center may even be damaged.

The disease also develops other ailments: uveitis, proteinuria, aortic valve insufficiency, ascending aortitis, and other neurological symptoms related to the respiratory or digestive systems.

10 million Poles suffer from ZZSK, RST and other rheumatic diseases. This is not only a problem for elderly people.

First signals of ZZSK

They may appear many years before the onset of symptoms typical of AS. The first is recurrent iritis, which occurs in 20% of patients. sick. Of course, they need to be treated by an ophthalmologist, because it can lead to blindness, but you should also consult a rheumatologist.

The second sign is recurrent swelling and pain in the peripheral joints (most often the knees). They should persuade the patient to seek help not from an orthopedist, but from a rheumatologist.

Ankylosing spondylitis (AS) - diagnosis

In order to diagnose AS, imaging tests are performed, incl. X-ray of the spine. In addition, the doctor orders laboratory tests: determination of the HLA B27 antigen (a genetic marker of this disease), inflammatory markers (ESR, CRP) and blood counts.

The most important thing for the diagnosis of the disease, however, are the clinical symptoms - inflammatory pain in the spine and sacroiliac joints, and limited mobility of the spine.

To confirm the disease, if there are no changes in radiological examinations, an MRI is performed. This method of imaging allows you to capture changes that are not visible on X-rays, which enables early diagnosis of the disease.

Ankylosing spondylitis (AS) - treatment

The goal of AS treatment is to reduce the negative consequences for the patient, i.e. to reduce the severity of symptoms and the impact of the disease on the quality of life, and to slow down its course.

The basispharmacological treatment consists of non-steroidal anti-inflammatory drugs. They relieve pain, morning spine stiffness, and inhibit inflammation.

In order to avoid side effects, preparations that protect the stomach and intestines are included. Additionally, medications are used to eliminate muscle tension.

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If therapy with anti-inflammatory drugs is ineffective, the patient may apply for treatment with biological drugs. They quickly improve well-being, and in combination with exercise, they increase the mobility of the spine in all its sections. But they are expensive (the cost of a monthly treatment is 4-5 thousand PLN), therefore the National He alth Fund refunds them only to those patients who are not helped by classic therapy. They are used during periods of exacerbation of the disease.

Rehabilitation, and above all kinesiotherapy, that is treatment with movement, also plays a huge role. Breathing exercises, strengthening exercises and muscle stretching exercises selected by the physiotherapist slow ossification and reduce inflammation. They should be performed daily for at least 30 minutes.

Where to go for help

Association of ZZSK Patients and Their Supporters

It was established in Wrocław on the initiative of people struggling with this disease. We are a non-profit organization and we base our activity on the work of volunteers and cooperation with other associations and organizations working for the benefit of sick people. More information: www.zzsk.org.pl

ASSOCIATION OF YOUNG PEOPLE WITH INFLAMMATORY CONNECTIVE TISSUE DISEASES "LET'S GET TOGETHER"

The "3majmy się się" association was founded in 2008 by people who fell ill in childhood or adolescence, and now, as adults, want to actively support rheumatic patients: children, adolescents, young adults and their families. Find out more at: www.3majmysierazem.pl

Category:

Spine, bones, joints