Ankylosing Spondylitis Symptoms

The mighty Pharaoh Ramses II in Egypt suffered from it just as much as people in Palestine at the time of Jesus – medical historians are certain that ankylosing spondylitis is not a disease of civilization, but was already wreaking havoc 4,000 years ago. And it is probably no coincidence that ancient Egyptian papyrus scrolls called “Ramesseum V” contained not only medical incantations, but also recipes against stiffening and curvature.

Ankylosing spondylitis as a synonym.

The disease named after the Russian neurologist Bekhterev (1857-1927) has many other names. But even under its most common synonym, ankylosing spondylitis (SPA), it is hardly known to the general public; even today, it often takes several years before a diagnosis is made. This is despite the fact that it is just as common as rheumatoid arthritis, known to almost everyone as rheumatism. Like rheumatism, ankylosing spondylitis is a chronic inflammatory disease of the joints, but it mainly affects the spine. It is assumed that hereditary predispositions and environmental influences trigger pathological immune reactions. In 95 percent of those affected, a certain genetic tissue characteristic (HLA-B27) is found that is held responsible for this (but also occurs in healthy people!). The repeated inflammatory processes lead to slowly progressive curvature of the spine and increasing restriction of movement up to stiffening of the joints.

Ankylosing spondylitis: who is affected?

Until a few years ago, it was thought that three to five times as many men as women develop the disease. However, recent studies have shown that the sexes are affected at about the same rate. In the meantime, refined diagnostic methods have made it easier to make early diagnoses. This has shown that there are many more people affected in Germany than previously assumed. It is now assumed that one in 100 people suffers from this disease. It usually begins between the ages of 16 and 45.

Bechterew’s disease: symptoms of the disease

At the beginning, deep-seated low back pain that lasts for months is typical and is worst in the morning and at rest. They radiate to the buttocks and thighs and worsen when coughing or sneezing. Less common is pain in other joints, especially the hip, knee, and shoulder. Nonspecific early signs include fatigue, weight loss, and mood swings. The disease progresses in episodes, sometimes favored by wetness and cold. Over time, the curvature of the spine changes: the lumbar spine becomes flat, and a hump forms in the thoracic spine. Hip and knee joints bend, the neck stretches. This leads to altered posture and reduced mobility. The curvature can become so pronounced that the patient can no longer look straight ahead. The inflammatory episodes can also affect other large joints as well as the iris of the eyes (iritis), the artery (aortitis), or the mucous membranes of the intestinal and urogenital tracts.

Diagnosis of ankylosing spondylitis

In addition to the signs of disease, detection of the HLA-B27 trait in the blood is typical. Radiographic examinations of the spine and pelvis, which show joint changes, are indicative. Other imaging techniques such as magnetic resonance imaging and scintigraphy may be indicated, depending on the patient.

Treating ankylosing spondylitis

There is no cure for the disease. Therefore, pain management and preservation of spinal mobility are the primary goals of treatment. Physiotherapy plays a central role in this process. The exercises taught by the physiotherapist must be performed independently by the affected person on a daily basis. Depending on individual preferences, cold or heat applications also help. Chronic pain can be controlled with painkilling and anti-inflammatory drugs (e.g. ibuprofen, diclofenac). In acute attacks, cortisone may be indicated – either in tablet form or injected by the doctor into the joint space. Medications that influence the immune system (e.g. sulfasalazine, methotrexate) are also successful, but they often have more severe side effects. Since 2003, a newly approved drug (infliximab) has been given as an infusion in certain cases. It blocks a messenger substance that promotes inflammation (tumor necrosis factor). It works very well and is well tolerated by most patients; however, tuberculosis that was experienced in the past can flare up again.However, long-term data are still pending. In cases of severely limited mobility, the patient can sometimes be helped with surgery in which the stiffened joint is replaced with an artificial one. In cases of pronounced curvature, the spine can be surgically straightened and associated visual field limitations improved.

What should the sufferer be aware of?

The active cooperation of the affected person is a mandatory prerequisite for remaining mobile for a particularly long time. The following points should be observed: Exercises must be performed consistently – they should be as much a part of the daily routine as brushing teeth. It is important to pay attention to posture in every situation in life – whether working, sleeping, driving or relaxing. Environmental conditions should be adjusted accordingly (e.g. mattress, seats, clothing, shoes). It is important to take prescribed medications. General health and sensible lifestyle are as important as observing what is good and what is not and learning from it. Encouraging and challenging are important; overdoing it is bad.

4 Popular rehab ideas for ankylosing spondylitis.

  1. Exercises with the pezzi ball
  2. Nordic Walking
  3. Learn diaphragmatic breathing or abdominal breathing
  4. Positioning therapy (initially under supervision)

Bekhterev’s disease: course and prognosis

In a good third of patients, the disease remains limited to the spine. The pronounced form with severe deformation and complete stiffening of the spine occurs only in about 10-20 percent of sufferers – usually the disease comes to a halt before. Most of those affected can continue to work. In addition to the severity and frequency of the relapses, the prognosis also depends on whether and which other joints or organs are affected.