Characteristics and Therapeutic Options of Ankylosing Spondylitis

The Bechterew’s disease, also known as ankylosing spondylitis, is a chronic inflammatory condition that affects the joints of the spine and sacrum. The disease develops slowly and gradually, with symptoms becoming increasingly severe over time, leading to restricted movement. The joints and ligaments between the vertebrae of the spine become calcified, ultimately resulting in the stiffness of the spine. During this process, the patient may experience bamboo spine syndrome, which can lead to complete fusion of the spine.

This disease is considered relatively rare, affecting a small fraction of the population, and is most commonly seen among young adults. Genetic predisposition may play a role in the development of Bechterew’s disease, as the presence of the HLA-B27 antigen is strongly associated with the onset of the condition. In the early stages of the disease, symptoms are often nonspecific, making diagnosis difficult. Establishing an accurate diagnosis can take several years, which can delay the initiation of appropriate treatment.

Bechterew’s disease impacts the patient’s quality of life, and various symptoms such as pain, fatigue, and restricted movement pose significant challenges in daily life.

Symptoms and Complaints of Bechterew’s Disease

The symptoms of Bechterew’s disease often appear gradually and insidiously. Early signs include pain in the lower back, which typically worsens at night or during rest. The pain often starts around the sacrum and can radiate to the thighs. Over time, the pain can become chronic, significantly hindering the daily lives of patients.

Inflammation can affect not only the spine but also cause pain in other large joints, such as the hip joint. Restricted movement of the chest and stiffness of the spine are also common problems. Patients often find that the thoracic and lumbar regions become painful, and the movement of the spine becomes limited. In advanced stages of the disease, complete fusion of the spine can occur, drastically reducing mobility.

Other general symptoms of Bechterew’s disease include low-grade fever, fatigue, and weight loss. It is worth noting that the disease affects not only the musculoskeletal system but also other parts of the body. About a quarter of patients may experience symptoms unrelated to the musculoskeletal system, such as eye inflammation, heart disease, and kidney problems.

Diagnosis of Bechterew’s Disease

The diagnosis of Bechterew’s disease is a complex process that requires various examinations. In the early stages of the disease, detecting sacroiliac and vertebral changes can be challenging; however, appropriate imaging techniques, such as X-rays or MRI scans, can aid in establishing the diagnosis.

During physical examinations, the doctor assesses the stiffness and mobility of the spine. This is done through measuring the patient’s forward bending and the chest volume. Measuring the distances between different sections of the spine is also an important part of the diagnosis. A thorough review of the medical history and consideration of the family history are also essential for making an accurate diagnosis.

Establishing the diagnosis of Bechterew’s disease not only aids in understanding the condition but also allows for the initiation of appropriate treatment, which is crucial for slowing the progression of the disease.

Treatment and Therapeutic Options for Bechterew’s Disease

Treatment of Bechterew’s disease is challenging, as the disease is currently considered incurable. However, early diagnosis and appropriate treatment can significantly slow the progression of the disease. Therapeutic approaches include medication, physical therapy, and home exercises.

Medications include anti-inflammatories and pain relievers that help reduce pain and moderate inflammation. It is important to use medications for the shortest duration possible to avoid long-term side effects.

Physical therapy, including physiotherapy and underwater exercises, plays a significant role in treatment. These exercises improve spinal mobility, strengthen the back muscles, and help maintain the patient’s functional abilities. Breathing exercises can also contribute to improving chest expansion.

In advanced cases, when pain and inflammation worsen, corrective spinal surgery or hip joint replacement may be considered. Mud packs and other alternative treatment methods can also help alleviate symptoms.

Overall, the treatment of Bechterew’s disease requires a multidisciplinary approach focused on improving the quality of life of patients. Early detection and regular treatment are key to effectively managing the disease.