Ankylosing spondylitis
Ankylosing spondylitis (another common name - Bechterew’s Disease) - a chronic inflammatory disease of the small joints of the spine and sacroiliac joint. The disease is an inflammation of the intervertebral joints, which leads to their ankylosis (fusion), because of which the spine is like a hard case, limiting movement. The number of patients is 0,5-2% in different countries. Mainly occur in young men, often 15 - 30 years. The 9:1 ratio of male / female.
Causes of Ankylosing spondylitis is genetic (inherited some feature of the immune system). It is important the presence of chronic infections (mainly the intestine and urinary tract infections). Aggravating factors shall generally gastrointestinal, genital infections, stress and injuries of musculoskeletal system.
In advanced forms of diagnostic difficulty is. But the main problem of people suffering from Ankylosing spondylitis, exhibited a late diagnosis. Therefore focused on the manifestations of the disease and distinguish it from other names in the early stages.
On what is worth paying attention?
- Stiffness and pain in the sacroiliac area, which can be given in the buttocks, lower limbs, increase in the second half of the night.
- Persistent pain in the heel bones in young people.
- Pain and stiffness in the thoracic spine.
- Increased ESR in the analysis of blood up to 30-40 mm per hour and above.
In the case of conservation of such symptoms for more than three months need immediate consultation rheumatologist!
Not always the disease begins with the spine, it can begin and with the joints of hands and feet (recalling rheumatoid arthritis), with inflammatory eye diseases, with lesions of the aorta or heart. Sometimes there is a slow progression, when the pain is practically not expressed; the disease is detected by chance during X-ray examination.
Over time, limited mobility of the spine is growing, difficult and painful tilts to the side, forward, backward, there is a shortening of the spine. Deep breathing, coughing, sneezing can also cause pain. Peace and immobility increase the pain and stiffness, and movement, and moderate physical activity - decreases. If untreated, can complete immobility of the spine, the patient gets a pose "supplicant" (arms bent at the elbows, his back stooped, his head bent, legs slightly bent at the knees).
As to what diseases must be distinguished Ankylosing spondylitis?
The first step is to distinguish from degenerative diseases of the spine (PCRs) - osteochondrosis, spondylosis. Diagnosis will know the following:
1. Ankylosing spondylitis is mainly occurs in young men, and PCRs, in spite of the tendency to "rejuvenate" them recently still predominantly occur after 35-40 years.
2. When Ankylosing spondylitis exacerbated by pain at rest or during prolonged stay in one position, especially in the second half of the night. In PCRs, on the contrary, the pains occur or intensify after physical exertion at the end of the day.
3. One of the earliest signs of Ankylosing spondylitis - stress the back muscles, they atrophy and progressive stiffness of the spine. When PCRs limitation of motion occurs at the height of pain and sciatica, with pain spinal mobility is restored.
4. Early characteristic of the disease Ankylosing spondylitis radiographic changes in sacroiliac joints of the spine do not occur in PCRs.
5. When Ankylosing spondylitis is often observed increase in ESR in the analysis of blood, the other positive signs of biochemical activity of the process, which does not happen in the PCRs.
Often, lesions of peripheral joints appear before the defeat of the spine, so it is necessary to distinguish the primary form of Ankylosing spondylitis and from rheumatoid arthritis (RA). It must be remembered:
1. RA often affects women (75% of cases).
2. For the RA is characterized by a symmetrical lesion of the joints (primarily of hand joints), rarely encountered in Ankylosing spondylitis.
3. Sacroiliac disease (inflammation of the sacroiliac joints
4. Rheumatoid factor in serum is found in 80% of RA patients and only 3-15% of patients with Ankylosing spondylitis.
5. Subcutaneous rheumatoid nodules found in RA in 25% of cases, is not the case with Ankylosing spondylitis.
6. HLA-27 (specific antigen, which detects the study of blood) is characteristic only of Ankylosing spondylitis.
How to treat Ankylosing spondylitis?
Treatment should be comprehensive, lengthy, landmark (hospital - health center - Hospital). Used nonsteroidal anti-inflammatory drugs, if severe immunosuppressant; widely used physiotherapy, manual therapy, and therapeutic exercises. Therapeutic exercises should be conducted twice a day for 30 minutes; the physician selects the exercises individually. In addition, you need to learn muscle relaxation. In order to retard the development of immobility of the chest, it is recommended a deep breath. In the initial stage it is important to prevent the development of perverse postures of the spine (posture proud, pose petitioner). Showing skiing and swimming, strengthen back muscles and buttocks. Bed should be hard, the pillow should be removed.
The disease is progressive, but with competent therapy can resist it. The main task - to delay progression of the disease and not allow it to move. Therefore, you should regularly undergo inspections rheumatologist, and acute exacerbations go to the hospital. The goal is pain relief and the development of stiffness of the spine.
Of course, Ankylosing spondylitis - a very serious disease and the purpose of the article in any case does not call for self-healing. Knowledge should only send to an attentive attitude to their own health and help avoid the terrible consequences of this disease ....
|
