ankylosing spondylitis is a chronic, inflammatory disease of the back. The inflammations originate in the spine and lead to ossification of the area around the joints, causing a severe limitation of mobility.
If you are short of time and want to quickly read a summary of the most important facts from this article, please go directly to the end of the text. There you will find a short and concise summary.
1. introduction ankylosing spondylitis
The spine is a central section of the human locomotor system. It is the connecting element between the extremities and ensures an upright gait. Because it is flexible and mobile, it has important functions, but the daily strain also makes it susceptible to illness – back pain is one of the most common causes of visits to the doctor and absences from work. A back disease that, if not recognized and treated, can take a serious course is ankylosing spondylitis. It is an inflammatory, rheumatic disease that causes painful stiffening of the joints. ankylosing spondylitis is usually chronic: the disease is not temporary, but causes long-term pain and severe limitation of mobility. Although it is still considered incurable today, its course can be decisively influenced by early diagnosis and the appropriate treatment methods (DVMB 2017).
See also this contribution of the video visite of dr. Tobias weigl at. Here he explains in a video everything relevant about ankylosing spondylitis: causes, symptoms, diagnosis and of course the therapy and everyday tips for you. A recommended video.
2. What is ankylosing spondylitis?
ankylosing spondylitis is a disease that knows many names. The name ankylosing spondylitis comes from the latin word for disease, morbus, and the russian neurologist vladimir ankylosing spondylitis, who, although not the discoverer of the disease, published a description of the disease in the 1890s that became particularly well-known. As part of the spondyloarthropathies (diseases of the spinal joints), the disease bears the medical designation ankylosing spondylitis or also ankylosing spondylitis. Ankylosans means stiffening (DVMB 2017). From an epidemiological point of view, the disease occurs in around 0.5% of the population and is therefore comparatively rare. Men are affected 10 times more often than women. In most cases, ankylosing spondylitis starts between the ages of 15 and. And 30. Up to 35. Year of life. Since the disease takes a chronic course, it is important to recognize any symptoms early on and to have a doctor check whether it is an ankylosing spondylitis (thieme 2009, DVMB 2017).
The disease primarily affects the joints of the spine. Inflammation develops in the vertebral joints between the vertebrae and the ribs and between the sacrum and ilium, which can lead to stiffening and ossification. The ossification can involve both the area around the joint and the transitions between the joints. Because the joints are no longer as mobile as in a healthy back due to this stiffening, the upper body falls into a more or less bent posture, which is called kyphosis, depending on the severity and stage of the disease. The mobility of the rib cage can also be restricted, which can lead to breathing problems (DVMB 2017).
Although it is a chronic disease, it is not constant but usually occurs in relapses, with phases of severe pain and fatigue or fever alternating with calmer phases in which well-being predominates (DVMB 2017).
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spondylolisthesis – causes, symptoms and therapy. The lead article vertebral slippage to read or watch as a youtube video.
THE MEMORY OF PAIN – how a memory of pain develops. The lead article pain memory to read.
3. causes of ankylosing spondylitis – how does the stiffening develop??
The causes on which ankylosing spondylitis is based are largely unknown, despite many years of research. Based on recent research results, an infection is suspected which, in the case of a hereditary predisposition, triggers a malfunction of the immune system. The defense mechanisms, which in a healthy body have the task of neutralizing pathogens and other foreign substances entering the body or pushing them out of the organism, in the case of ankylosing spondylitis apparently direct their defenses against their own body. Instead of being neutralized in the vertebral joints, the inflammations attack the body’s own tissues, but usually only in combination with a predisposition (d. H. a hereditary susceptibility) to ankylosing spondylitis (apotheken umschau 2014, DVMB 2017).
The inflammatory processes in the area of the vertebral joints are accompanied by a calcification process of the ligaments and transitions between the joints. the further this calcification progresses, the stiffer the spine becomes, and it manifests itself in a more or less pronounced kyphosis, i.e. a convex curve of the back towards the rear. The more severe the disease, the further the upper body falls forward; a complete rounded back can develop. The cervical spine is usually the last to be affected by the stiffening – in extreme cases, this can mean that the person with the disease can no longer look straight ahead (thieme 2009, bomedus 2014).
4. symptoms of ankylosing spondylitis
At the beginning of the disease, ankylosing spondylitis usually progresses insidiously. The symptoms, such as back pain, are in most cases nonspecific and can still indicate many different back diseases at this time, so that initially a definite diagnosis is often not possible. In contrast to other diseases of the spine, some of the symptoms occur mainly at rest. How to aggravate z. B. Back pain, which is one of the classic symptoms of ankylosing spondylitis, not on exertion, but mainly during or after a period of rest (apotheken umschau 2014, DVBM 2017).
Symptoms that can lead to the recognition of ankylosing spondylitis are u. A.:
- buttock pain that alternates between the two sides. They can radiate into the thighs and occur in combination with restricted movement of the lumbar spine.
- Pain in the back and buttocks, especially when resting. The pain improves with movement.
- Stiffness of the back and pain, especially in the morning (so-called morning stiffness, which can last longer than 30 minutes).
- persistence of symptoms for more than 12 weeks.
- Appearance of the first symptoms before the age of 40. age of onset.
Not all symptoms necessarily occur with the same intensity or at the same time. Especially at the beginning of the disease, only individual symptoms may occur, which can lead to misinterpretation due to their non-specific form. In addition to the pain in the back and buttocks, ankylosing spondylitis can also cause other symptoms that lie outside the spinal column:
- Pain above the breastbone, associated with restricted movement and/or breathing difficulties
- Inflammation of individual joints (often not symmetrical, only one side)
- Heel pain
- iris in the eye
(apotheken umschau 2014, DVBM 2017)
In this tutorial, dr. T. Weigl what it is with the sog. Rheumatoid factor has on itself. In which diseases this is positive and it also explains why one can have an elevated rheumatoid factor but still not be ill.
5. Diagnosis of ankylosing spondylitis
Because of the initially non-specific symptoms, the first signs of ankylosing spondylitis are often misinterpreted and misinterpreted. In the early stages, even mild low back pain can be an indicator of incipient ankylosing spondylitis and should be checked for a possible ankylosing spondylitis diagnosis, especially in men. However, if the disease is already more advanced, the symptoms can usually be clearly distinguished from other back diseases. In order to be able to make a diagnosis, a doctor can check for any hereditary predispositions, perform a physical examination, and use imaging methods such as X-rays and MRIs (magnetic resonance imaging) as well as blood tests (thieme 2009, apotheken umschau 2014).
To gradually reduce the symptoms to the clinical picture of the ankylosing spondylitis to be able to limit the diagnosis and exclude other diseases, the doctor usually begins the diagnosis with an interview with the patient and a physical examination. Questions about acute symptoms and family history are part of the medical history – if there have already been cases of ankylosing spondylitis in the family, the probability increases that the affected patient also has a predisposition to the disease, but this does not necessarily mean that it will also occur. If the physical examination reveals restrictions in spinal mobility in general and in the thoracic spine in particular, it is reasonable to suspect ankylosing spondylitis (thieme 2009).
Blood tests can provide further indications: although most findings are usually unremarkable, since the disease does not bring with it the usual symptoms of a rheumatic disease, 95 % of the blood of ankylosing spondylitis patients shows an elevated level of the protein HLA-B 27. As soon as ankylosing spondylitis is suspected, the family doctor or ophthalmologist who is treating the patient will usually consult a rheumatologist, depending on where the first symptoms occur, who will make the final diagnosis on the basis of the individual findings. MRI is a comparatively unambiguous method for determining ankylosing spondylitis: early signs of the disease can be read from the images, because inflammation in the early stages can be seen, for example, in the sacroiliac joint. If the disease is already more advanced, clear indications can also be obtained from an x-ray image. There z. B. Ossification of the spine beyond normal dimensions; in extreme cases, the structure of the spine even resembles a bamboo pole. the extent of ankylosing spondylitis can be measured by the curvature of the spine (thieme 2009, apotheken umschau 2014, gesundheit.De 2013).
How small fiber matrix stimulation (SFMS®) works
6. Therapy options for ankylosing spondylitis
The causes of ankylosing spondylitis are currently considered incurable. The treatment of spinal column disease is therefore primarily concerned with counteracting the further progression of the disease or, in the case of severe cases, with reducing the number of vertebrae. To slow this down. Consequently, the therapy is composed of various components that can be prescribed depending on the course and severity of the disease. If the therapy measures are used in a targeted manner, they can have a positive influence on the course of the disease – the intention and the goal are to support the spine in its mobility and to counteract the curvature of the back in the form of a hunchback. However, in combination with physiotherapy and physiotherapy, medications are also used. Primarily non-steroidal (d. H. Cortisone-free) anti-inflammatory antirheumatic drugs can help relieve the pain and improve the inflammation in the joints (thieme 2009, apotheken umschau 2014, health.De 2013).
In the long term, those affected are obliged to work regularly on the mobility of their spine: physiotherapy and physiotherapy serve to maintain the mobility of the spine and can thus preserve performance over many years. The increasing stiffness of the spine can be significantly reduced with consistent exercise and back school (thieme 2009).
In rare cases, the treating physicians decide on an operation to achieve the straightening of the spine. However, surgery is only used in very complex cases of the disease, such as when there is a vertebral fracture or paralysis. But even a very severe curvature of the spine can have a significant negative impact on the quality of life – if a patient with ankylosing spondylitis can no longer walk upright or even look forward, surgery can also be considered to straighten the spine again. Various surgical methods can be used to achieve this goal; both individual vertebral bodies and several vertebrae can be operated on – either bone fragments are removed or a screw-rod system is used (apotheken umschau 2014).
Although the disease is not curable in the strict sense, with targeted therapy and regular mobilization of the spine, ankylosing spondylitis patients can live quite well with their condition. Depending on the stage and phase of the disease, the treating physician can provide valuable tips for dealing with ankylosing spondylitis in everyday life.
7. summary: short& just under
ankylosing spondylitis is a chronic inflammatory back disease. The inflammations occur in the spine and lead to ossification of the area around the joints, which severely restricts mobility. The causes of ankylosing spondylitis are currently considered incurable. The treatment of ankylosing spondylitis is therefore primarily aimed at counteracting the further progression of the disease or at preventing it from spreading. To slow down this. Consequently, therapy is composed of various building blocks that can be prescribed depending on the course and severity of the disease.
8. Further links and sources
DVMB german ankylosing spondylitis association, 2017
thieme: orthopedics and trauma surgery, chapter ankylosing spondylitis, p. 183 ff, 2009
pharmacies review: ankylosing spondylitis, 2014
bomedus: specific back pain – causes of back pain& spinal injuries, https://bomedus.Com/knowledge/editorial/46_specific-back-pain-causes-of-back-pain-spine-injuries/, 2014
health.En: ankylosing spondylitis, 2013
image source: fotolia file: #82779209 | copyright: zerbor
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This article was published on 02.04.2017 in the blog articles section .