Ankylosing spondylitis recognize and treat guide health

Recognizing and treating ankylosing spondylitisChronic back pain is widespread – in some patients, it is caused by ankylosing spondylitis, a special form of inflammatory rheumatism. It affects the spine. Back pain is usually harmless. Disappear after days or weeks. But in about five percent of people with chronic back pain-often men-there is more to it than that: Bekhterev's disease, a particular form of inflammatory rheumatism. This disease usually occurs between puberty and 30. The first occurrence of the disease is at the age of two, the incidence in this country is about five affected per 1.000 inhabitants. In this autoimmune disease, the body's own immune cells attack healthy skeletal tie – usually first in the sacroiliac joints. Under certain circumstances, painful bone growths may form up to the spine.

Ankylosing spondylitis has different forms

The disease progresses in episodes and is different for each patient: in some it is so mild that it is not even clearly diagnosed, in others it is so aggressive that life without painkillers is hardly possible. Inflammation of the vertebral joints can cause the joints to stiffen and the back to become immobile. Sometimes the spine is also bent, which leads to a strongly bent forward posture. The disease often also reduces the density of bone mass, so that osteoporosis can occur. In some sufferers, the mobility of the rib cage becomes. So that breathing is impaired.

Occasionally accompany eye inflammation or inflammatory bowel disease. In very rare cases, the disease also affects other organs, for example, the lungs, kidney, heart or aorta. If the heart is affected, heart valve defects can develop.

Symptoms of ankylosing spondylitis

Often, the disease starts in the sacroiliac joints. It is a relatively immobile joint-like connection of the sacrum and ilium, which is stiffened by ligaments. Affected individuals experience recurrent pain in the lower back and buttocks, especially when sitting for long periods of time. As a rule, the pain is worst at rest (especially at night) and improves with movement. Sufferers often also report morning joint stiffness that improves with exercise. In the course of the disease, the spine. The thorax becomes increasingly immobile. When a stiff hunchback develops, the disease is already more advanced.

In almost half of those affected, the middle eye skin becomes inflamed, so that the eye is painful, sensitive to light and reddened.

Bekhterev's disease is an autoimmune disease

In ankylosing spondylitis, the immune system attacks the body's own cells. The causes are not yet clearly understood. Presumably, an infection with certain bacteria must provoke the body's defense system into an excessive reaction and coincide with a hereditary predisposition to trigger the disease.

Rheumatologist can Diagnose at an early stage

Since "quite normal If back pain is the first symptom, ankylosing spondylitis is often diagnosed only after five to ten years. A visit to a rheumatologist is advisable in cases of suspicion. The physician inquires about complaints and previous illnesses, examines the mobility of the spine and measures its curvature. He also checks whether pain occurs during certain movements. A rheumatologist can use a special procedure to determine whether the sacroiliac joint is inflamed.

Special diagnostic procedures for ankylosing spondylitis

recognizing and treating ankylosing spondylitis health guide

Inflammation can cause bone growths to form that extend up the entire spine.

Magnetic resonance imaging (MRI) can reveal early signs of the disease, such as inflammation. If the disease has been present for a long time, X-rays will also show evidence, for example, typical ossifications in the spine. In the X-ray image, a so-called bamboo spine is seen: the bone overgrowth between the vertebrae stiffens them like a bamboo pole. And the X-ray image shows a spinal column comparable to a bamboo pole.

A blood test supplements the diagnosis. If the hereditary trait HLA-B27 is detected, ankylosing spondylitis is likely. The hereditary trait can be detected by a special protein on the surface of white blood cells. This is the case in more than 90 percent of all patients with Bekhterev's disease.

The so-called BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) provides information about the activity of the inflammatory attacks: a score (index) is calculated from information about pain, swelling in the joints and morning stiffness. If the score is above 4, the disease is active.

Medication for ankylosing spondylitis

recognizing and treating ankylosing spondylitis health advisor

Like most rheumatic diseases, ankylosing spondylitis is a chronic disease. However, those affected can slow down the course of their disease or even stop it altogether. The prognosis is particularly favorable if modern drug therapy is started at an early stage. Therefore, people with deep-seated back pain lasting more than three months should not hesitate to see a rheumatologist. The specialist will work out a treatment plan together with the patient, which focuses on anti-inflammatory drugs.

To reduce inflammation and pain, various drugs are used in ankylosing spondylitis, including cortisone and TNF-alpha blockers. The signal substance TNF (tumor necrosis factor) is involved in the control of the immune system. If it is blocked, inflammations can be inhibited, but the body becomes more susceptible to infections. If the drug is discontinued, the inflammation returns immediately. And: the drug does not work forever, often the effect wears off. Up to 25.000 euros per year, but is covered by health insurance.

Alleviating ankylosing spondylitis with nutrition

A special anti-inflammatory diet is an effective additional strategy: less meat, more fish and, above all, lots of vegetables and sufficient fruit. It is also important to use good oils and fats – such as olive oil and linseed oil. This diet also protects the heart.

Helpful sports for Bekhterev's disease

Sufficient exercise is another pillar of treatment: special gymnastics keep the spine flexible and counteract stiffness. Sports such as backstroke, hiking and cycling can also have a supportive effect, but sports that put a strain on the back should be avoided. Even at work, affected persons should, if possible, refrain from all activities that require them to bend forward a lot. Ideally, they can alternate between sitting, walking and standing at work.

Surgery for osteoporosis caused by ankylosing spondylitis

If osteoporosis occurs in the advanced stages of the disease, it is particularly important to keep the risk of falling low. In particularly severe cases of Bekhterev's disease, patients are also operated on, for example in the case of a stiffened back, vertebral fractures or paralysis. Sometimes it is necessary to replace an inflamed hip joint with a prosthesis.

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