Ankylosing spondylitis (ankylosing spondylitis) - a systemic chronic inflammatory disease of the joints and spine, referring to the group of seronegative polyarthritis.The disease mainly exposed to men between the ages of fifteen and thirty years, and their number exceeds the number of cases of women at five - ten times.Although it is believed that in fact ankylosing spondylitis in women is not such a rarity, simply by its stream it is usually much easier than men, because and diagnosed more difficult
Causes of ankylosing spondylitis
is for certain at present cause ofAnkylosing spondylitis is unknown.However, we know that the disease most commonly occurs in people with a certain genetic predisposition, and specific genetic characteristics.After many observations and studies have shown that most often suffer from Bechterew's disease people carry the gene HLA-B27.However, this does not mean that people without the presence of this gene may not get sick ankylosing spon
Until now, scientists - rheumatologists remains a mystery why some carriers of HLA-B27 gene become ill, while others do not.It was assumed that an important role in the development of the disease play a viral infection, a cold, a variety of injuries and latent infections.Indeed, all of these factors are in a position to trigger the development of ankylosing spondylitis and aggravate its course.But modern scholars have only recently become clear that ankylosing spondylitis is largely psychosomatic disease, the occurrence of which can be triggered by the peculiarities of the nervous system and the psyche of the patient, as well as prolonged stress or strong enough.
After a psychological analysis of patients with ankylosing spondylitis was made arguable assumption that the disease generates in some cases permanently pent-up anger, and in others - lack of mental flexibility in the amount of disappointment in family relationships, work, or life.In such situations, a person keenly aware of the impossibility of both - either to change the situation, burdened by the feeling (even if it no one did) that to him as - to impose unloved work, life partner and so on. In this emotional background bright enough blossoms self-pityand constantly repressed anger at life's circumstances
How is ankylosing spondylitis
In this disease inflammation of the initially affected joint area of the sacrum and ilium, and then to apply first in the lumbar spine and up the entire spinal column.In the case of the further development of the inflammatory process may cover any joints of the human body - from the knuckles to the hip joints.However, most often with ankylosing spondylitis inflamed ankle or knee joints, and Achilles tendons or "spur" (tendon podpyatochnoy area).Achilles tendons at the same time can be hard enough to swell, getting spindle shape.In some cases, failure podpyatochnyh or Achilles tendons, as well as pain in the heels, are the initial symptoms of ankylosing spondylitis, significantly outperforming the inflammation of the joints and spine.
If inflammation and pain in the Achilles tendon and heel occur before the age of thirty years (whether a man or a woman) - should be especially wary.If this was not preceded by an inflammation of the injury and it is accompanied by swelling of the tendon strong enough - almost 90% of the cases it indicates an inflammatory nature of the disease and the patient is mandatory should be checked against rheumatoid, psoriatic arthritis or reactive, and ankylosing spondylitis.
Fortunately, the inflammation of the tendons and in the ankylosing spondylitis is very rarely as strong as in psoriatic or rheumatoid arthritis.In most cases, it can be fairly easy to suppress by means of drugs.Much worse is that in ankylosing spondylitis develops so-called ossification of the spinal ligaments how and its intervertebral discs and joints.Proceeds gradual process of 'fusion' between a vertebrae, resulting in the spine loses its mobility and flexibility.Without adequate adequate treatment, a few years since the beginning of the disease, there may come the phase of total immobility of the spine when all his vertebrae fused, forming a stiff bony structure.This condition is called "ankilozirovaniya»
Ankylosing spondylitis symptoms
Ankylosing spondylitis in about 10% of cases starts with the cervical or lumbar sciatica - the patient feels the so-called cross of the neck in the arm or waist of one / both legs.Although more often, ankylosing spondylitis begins gradually.At the beginning of symptoms very similar to the symptoms of regular osteoarthritis.The patient concerned moderate pain, worse after rest or peace, as well as in cases of weather fluctuations.But after heating, and even minor physical exercise, discomfort in the back are greatly reduced.
Initially, back pain without problems are eliminated with nonsteroidal antiinflammatory drugs, and in most cases they do not even cause the vast majority of physicians doubt that this is a pure low back pain.Doubts begin much later, when carried out in the months of this therapy, "degenerative disc disease" not only reduces pain, but even there they gradually rise.In this situation, an experienced doctor should note that back pain are inflammatory in nature: the pain subside a little bit during the day (usually in the afternoon) and on the other hand noticeably worse at night, after midnight (peak pain accounts for 3 - 5 am).
addition quite typical rhythm of pain, a possible diagnosis of ankylosing spondylitis indicates pronounced observed in morning stiffness waist, virtually disappearing for dinner, as well as relatively young age of the patient (low back pain is usually diagnosed in older people, and ankylosing spondylitis most commonly begins in the twenty- Twenty-seven years).
Almost 50% of patients at the outset of the disease observed weight reduction, improving overall body temperature, inflammation of the eyes ("sand in the eyes", redness).In about 60% of patients with the disease spondylitis inflammation of the spine at the same time combined with the defeat of the joints, and when one form primarily inflamed ankle and knee joints, while the other (rizomielicheskoy) - hip and shoulder.
There is also a so-called "Scandinavian version" of ankylosing spondylitis, in which, as in rheumatoid arthritis inflamed small joints of the feet and hands.However, the joints in the ankylosing spondylitis are not subject to such a tough destruction as rheumatoid arthritis and sufficiently well to therapy.In 40% of cases, patients infected ankylosing spondylitis joints do not become inflamed, and the inflammatory process affects only the spine.
addition to all of the above symptoms of the disease, perhaps the most characteristic symptom is gradually increasing stiffness of the spine, as well as the restriction in breathing mobility of the chest, which leads to a variety of stagnation in the lungs and provokes various complications: pneumonia, bronchitis and so forth. Ossificationspine gradually causes the spin that eventually almost entirely or completely loses its original flexibility.The patient begins to move as if he had to place the spine stiff stick (rotate and tilt a person can only whole body).
appearance of the patient is quite typical.In the initial stage of the disease disappears normal lumbar curvature of the spine, resulting in lower back becomes straight and flat.In a later stage of the thoracic spine freezes and forms a kind of "supplicant posture."When walking the feet of the patient are always slightly bent at the knees.
Signs on which a patient with the disease spondylitis can be accurately distinguished from a person suffering from osteochondrosis:
- The first sign.A person suffering from osteochondrosis without lifting feet from the floor and standing on straight legs, in most cases can be deep enough to bend to the side - left or right.But a patient with the disease spondylitis, do not stop taking the floor to bend away side will not be able, as lumbar flexion in this disease is violated in all directions: sideways, backwards, forwards.In addition, he suffers from spondylitis man with great difficulty can produce rotational motion (rotation of the body left / right) on the axis of the legs without interruption from the floor
- second sign.At the initial stage of development of ankylosing spondylitis, the use of non-steroidal anti-inflammatory drugs in the need for adequate dosage, almost always immediately (in the first hours after administration) gives albeit temporary, but potent analgesic effect.But in osteochondrosis, nonsteroidal anti-inflammatory drugs gives the desired effect is very rare, and even if the pain relief seen, it is seldom complete and is gradually
complications caused by the disease spondylitis
greatest danger is aortic and heart that develop20% of patients and manifest faults of the heart, chest pain, shortness of breath.In 30% of patients develop amyloidosis - leading to renal failure, kidney degeneration.By decreasing the mobility of the chest are developing a variety of lung diseases may develop tuberculosis.To prevent the development of such complications, it is important to identify, diagnose and start the appropriate treatment of the disease at the earliest possible time.
At the slightest suspicion of ankylosing spondylitis, the patient is mandatory as soon as possible directed to the X-rays of the spine and sacrum.In addition, it conducts clinical analysis of blood and blood from a vein for the accurate determination of inflammatory markers
Treatment of ankylosing spondylitis
main component of the treatment of ankylosing spondylitis are the nonsteroidal anti-inflammatory drugs that are appointed in ankylosing spondylitis continuous courses lasting from one to five years.In periods of acute illness, the patient shows a nonsteroidal anti-inflammatory drugs to the maximum dosage, and after the recession of acute need to return to support mode: take 1/3 or 1/4 of the maximum permissible dose (specified in the annotation to the drug).The maximum effect is given nonsteroidal antiinflammatory drugs such as ketoprofen, indomethacin, phenylbutazone, diclofenac, and anti-inflammatory drug Movalis.
These funds quickly enough reduced stiffness and pain in the joints and spine, improves their mobility, there is a positive trend in the overall health of the patient.
Like rheumatoid arthritis, ankylosing spondylitis at as basic therapy used antimicrobial sulfasalazine.Despite the fact that the therapeutic effect of its admission have to wait a long time (about two - three or more months), it makes about 60 - 70% of patients.
Suffice well established enzyme preparation Wobenzym.After receiving the drug, its constituent enzymes very rapidly absorbed in the intestine and then into the bloodstream.The enzymes, moving through the blood vessels to penetrate into the inflammatory focus and start to accumulate therein.The enzymes contained in Wobenzym have anti-edema, anti-inflammatory and immunoregulatory effects on the body.In addition, this preparation increases the decreased activity of the spine.
Injections of corticosteroids directly from the joint cavity and compresses Dimexidum administered directly to the inflamed joints for local impact.
When ankylosing spondylitis stunning effect produces liquid nitrogen cryotherapy back.Patients in 90% of cases there comes a clear quick relief, reduced pain and stiffness of the spine is reduced.It should be noted that cryotherapy at home using improvised practically fails.
quite useful when ankylosing spondylitis is a massage, which has a beneficial effect on lesions of the spine, and in general the whole body.In some cases, the disease is well help medical leeches.Good enough when ankylosing spondylitis proven specially designed protein diet.In addition, people suffering from this disease is a physiotherapy and health - spa treatment.