What is ankylosing spondylitis ?
Bechterew's disease or ankylosing spondylitis (inflammation of the spinal column that causes curvature ') is an inflammation of the joints of the spine. The disease is one of the spondylartropathieën.
The disease is named after the Russian neurologist and psychiatrist Vladimir Bekhterev (1857-1927) who in 1892 first described this (rheumatic) disease. It is a condition in which inflammation of the joints in the spine and pelvis can lead to pain and stiffness. There may also be symptoms in other organs and organ systems. It usually begins between the 15th and 35th year of life, more often in men than in women.
Complaints
Ankylosing spondylitis usually starts insidiously. Sometimes it takes many years before the diagnosis is made. Symptoms may include:
-Low back pain and stiffness (Initial complaints);
-Iridocyclitis or uveitis (inflammation of the iris of the eye);
-A long-lasting, for example, a knee joint inflammation;
-Transient nerve pains in chest, abdomen or legs;
-Tightness in the chest in the night;
-Conduction abnormalities of the heart;
-Aortic insufficiency;
-Respiratory Complaints by apical pulmonary fibrosis;
-Inflammation of Achilles tendons.
-Psoriasis (skin lesions)
-Bowel disease (Crohn's disease, ulcerative colitis)
People with this condition are mornings remarkably stiff in the back, which is also painful. Typically when moving the pain gradually disappear. Inflammation of the sacroiliac joints, which connect the sacrum with the rest of the basin are often seen at an early stage on radiographs.
Diagnosis and causes
Which is made on the basis of:
-The symptoms of pain and stiffness;
-The mobility of the spine;
-Blood tests;
-X-ray examination. MRI often shows rather see the abnormalities than conventional diagnostic radiology.
By abnormal bone formation around the joints that connect the vertebrae to each other, creates the movement restriction of the back. Also harden tendon insertions.
Photos of the lower back can prove this bone formation in addition to demonstrating inflammation of the pelvic joints. With an elevated blood sedimentation rate can be found. People with ankylosing spondylitis are relatively often a carrier of a particular feature in the blood, the so-called HLA-B27. Of people with this leukocyte Approximately 5% of the disease. Of those with ankylosing spondylitis has approximately 95% the antigen.
Despite all of the above research, it often takes more than 10 years before doctors can make a diagnosis.
Ankylosing spondylitis treatment
If nothing is done then the spine can eventually turn into a bony column. This gives an X-ray eventually a characteristic image, the so-called. "Bamboo-spine. It is therefore necessary to practice a person with this disease daily to keep the back as far as possible and in any case movable law. If this is not the most sufferers will eventually grow completely crooked so that they later in life only with difficulty can look forward.
Other treatments are:
-Anti-inflammatory drugs: so-called NSAIDs;
-Physiotherapy or Cesar or Mensendieck benefit of attitude advice and instructions for exercises.
-TNF inhibitor, called biologicals as Remicade, Enbrel, Humira and Golimumab (Simponi).
Other measures that may be needed, such as treatment of an iris inflammation, custom shoes at Achilles tendon inflammation and example adaptation of the furniture.
The disease is incurable but bearable and some serious consequences to be careful handling to avoid that.
Posture Correction
The solid growth of the spine can cause severe kyphosis and / or scoliosis (stooped posture and lateral deviations). However, it is possible to restore the original position by means of a surgical spine correction or improve at least. Better is to ensure that the stiffness does not occur in a bent posture.