Ankylosing spondylitis: symptoms you should knowA possible cause of chronic back pain is inflammatory rheumatic diseases as in ankylosing spondylitis, formerly also called ankylosing spondylitis. In Germany, there are about 350.000 people are affected by the disease to a greater or lesser extent.
Prof. Dr. med. habil. Eugen Feist
Medical Director of the Helios Fachklinik Vogelsang-Gommern and Head Physician of Rheumatology
Prof. Dr. med. habil. Eugen Feist is medical director of the Helios Fachklinik Vogelsang-Gommern and head physician of the rheumatology department. It classifies which symptoms are indicative of ankylosing spondylitis and how the disease is recognized at an early stage.
What is ankylosing spondylitis??
Bechterew's disease belongs to the group of
Spondyloarthritides. "Ankylosing spondylitis is a chronic inflammatory rheumatic disease that primarily affects the spine and its connections to the pelvis. Inflammation can form there and attack the bone tie as well as the joints", according to Prof. Eugen Feist.
The The disease begins insidiously, so that it is often only recognized after years. In the advanced stage, the inflammations in the axial skeleton can lead to an ossified spinal column, whose individual joints become "so-called" with each otherBamboo spine" are fused.
The exact Cause of the disease is largely unknown. Experts ame a malfunction of the immune system that leads to an excessive inflammatory reaction. A genetic predisposition is present in a large proportion of sufferers. For example, about 90 percent of all sufferers have a special protein called HLA-B27. But also people without this protein are affected.
Where ankylosing spondylitis begins?
A typical feature of the disease is the gradual onset with a nonspecific pain in the pelvis in the region of the sacroiliac joints (sacroiliac joints). Sufferers suffer from chronic pain in the part of the spine affected, which can radiate to the buttocks or thighs – especially if they sit for a long time. The pain usually subsides with movement, but increases again at rest.
Often, these symptoms initially lead to the deceptive suspicion of wear and tear or overuse symptoms, accompanied by an insufficiently effective physiotherapeutic and orthopedic treatment.
The chronic inflammatory rheumatic disease Bekhterev's disease primarily affects the spine and its connections to the pelvis.
What are ankylosing spondylitis symptoms?
"The course of the disease can vary greatly. It often progresses gradually over years and decades, with phases of inflammation alternating with more or less symptom-free periods", so prof. Eugen Feist. "It usually takes several years before a diagnosis is made", says the chief physician. Bekhterev's disease is often initially confused with muscle tension or a herniated disc.
The main symptoms include:
– chronic deep-seated back pain with onset before the age of 45. morning stiffness after getting up for more than 30 minutes – waking up in the 2. night half because of pain – decreasing pain with movement – changing buttock pain
Common accompanying complaints and diseases include:
– non-specific symptoms such as fatigue, fever, weight loss – often asymmetric inflammation in large and small joints – inflammation of the tendon insertions – inflammation of the iris of the eye (uveitis) – increased vertebral fractures due to limited flexibility and reduced bone density – chronic inflammatory bowel diseases (ulcerative colitis and Crohn's disease) – psoriasis
Course of ankylosing spondylitis
Bechterew's disease usually begins between the age of 16. and 40. Year of life. The course of the disease is chronically progressive and occurs in relapses. How frequent and how severe these relapses are varies greatly from individual to individual.
Complaints, such as Pain and stiffness can suddenly become more severe within a few weeks. Subsequently, there is a slight recovery to an almost symptom-free interval.
Although in the foreground Complaints of the spine and joints, nevertheless, other diseases also occur frequently. People with the disease often suffer from Psoriasis (psoriasis) or suffer from Rainbow skin inflammation to suffer from eye.
At Gastrointestinal Tract inflammatory changes of the colon (large intestine) or ileum (scrotum) may occur. Some patients develop a full-blown inflammatory bowel disease, such as Crohn's disease or ulcerative colitis.
Ankylosing spondylitis is Not curable. Therapeutic approaches only slow down the progression of the disease and alleviate symptoms. The life expectancy of patients with the disease. Patients is the same as the population average.
The course of the disease can vary greatly. It often progresses gradually over years and decades, with phases of inflammation alternating with more or less symptom-free periods.
Stages of Bekhterev's disease
To give a rough idea, ankylosing spondylitis can be divided into three stages, which can differ in the type and severity of symptoms:
– Duration: 6 weeks to 3 months – low back and buttock pain, especially in the morning and when lying down for a long time – back stiffness when standing up – pain decreases with movement – prere sensitivity at collarbone, ribs, vertebrae, iliac crests, ischium, hips, heels
– Duration: 10 to 20 years – changes in the sacroiliac joints visible on X-ray – movement often only possible with pain – relapsing worsening of the disease – increasing stiffening and deformation of the spine
– after about 20 years – inflammatory processes and ossification come to a halt – spine resembles bamboo pole – a hump forms in the thoracic spine – cervical spine is tilted forward – due to a bent-over posture, those affected look toward the ground most of the time, the abdomen is bulging and breathing is more difficult
Ankylosing spondylitis symptoms in women
Ankylosing spondylitis has long been considered a man's disease. Nevertheless Women about equally often affected. "Symptoms do not differ significantly in women. However, mild to moderate courses are somewhat more frequent than in men", according to the head physician.
The typical stiffening of the spine usually progresses more slowly in women. Women should therefore have a thorough examination if they are experiencing discomfort.
In women, the first symptoms are more frequent in the joints outside the body axis. At the beginning, the cervical vertebrae are affected rather than the lower back. Inflammation of tendon insertions and bursae also occur in areas of the body that are not typical for Bekhterev's disease. Stiffened tie or ossifications are characteristic of later stages. Nevertheless, the pain burden is by no means lower in women.
Symptoms do not differ significantly in women. However, mild to moderate courses are somewhat more common than in men.
What are the symptoms of an ankylosing spondylitis flare-up??
A relapse in ankylosing spondylitis is characterized by Deep-seated, dull back pain, especially in the gluteal region as well as the spine without radiation into the lower extremities characterized. As a rule each relapse leads to gradual deterioration of the disease.
"Symptoms can last for several weeks and limit quality of life and performance at work and at home. In addition, the mood often deteriorates," according to Prof. Feist. From the sixth week, doctors speak of a chronic clinical picture.
Is it perhaps ankylosing spondylitis??
If you notice typical symptoms of ankylosing spondylitis, you should see a doctor. To clarify a possible disease, the doctor takes the patient's medical history. In particular, the symptoms that occur play an important role in this discussion.
Possible questions to help clarify the diagnosis include:
– If the low back pain has already lasted longer (more than three months)? – If the symptoms occur before the age of 45. The first symptoms appear at the age of 50? – If morning stiffness lasts longer than 30 minutes? – Low back pain improves with exercise, but not with rest? – Does low back pain interfere with sleeping through the night? – If the symptoms have a gradual onset? – Is there a reciprocal buttock pain? – If there are visual disturbances, heart and/or kidney problems?
Based on the answers, further tests and diagnostic procedures can be performed to determine whether the spinal disease is present. These are among others Blood tests and various imaging techniques, such as X-rays and magnetic resonance imaging (MRT). An early diagnosis is possible by means of MRI, since inflammatory changes in the sacroiliac joints can already be detected in the early stages of the disease. X-rays may show structural changes in the spine or sacroiliac joint.
What ankylosing spondylitis therapy looks like?
The therapy should Relieve symptoms and slow the progression of the disease. There is no cure yet. Treatment options can be combined as part of therapy. Are always individualized to the needs of the patient.
Treatment options include:
– drug therapy – surgical therapy – healthy lifestyle – other therapeutic measures, such as physiotherapy, physiotherapy
Prof. Dr. Feist says: "Initially, symptom-oriented therapy with the use of non-steroidal anti-inflammatory drugs (NSAIDs) as well as continuous and regular physical therapy play an important role."
In cases that do not respond to therapy, biologics are often used with very good success. In affected patients, a significant improvement of the disease activity up to remission can regularly be achieved in this way.
Initially, symptom-oriented therapy with the use of non-steroidal anti-inflammatory drugs (NSAIDs) as well as continuous and regular physical therapy play an important role.
Recognize symptoms correctly at an early stage
The disease is insidious, its symptoms become noticeable in episodes. Anyone who notices typical symptoms of ankylosing spondylitis should have them examined by a specialist in inflammatory rheumatic spinal disease. In this way, complaints can be alleviated. Symptoms can be treated early.