The mighty pharaoh Ramses II in Egypt suffered just as much as people in Palestine at the time of Jesus - medical historians are certain that the disease is not a disease of civilization, but already 4, 000 years ago mischief drove. And it's probably no coincidence that in ancient Egyptian papyrus scrolls called "Ramesseum V" not only medical incantations, but also recipes for stiffening and writhing were found.
Ankylosing spondylitis as a synonym
The disease named after the Russian neurologist Bechterew (1857-1927) has many other names. But even under its most common synonym spondylitis ankylosans (SPA), it is hardly known in public, until the diagnosis pass even today, often a few years. And although it is as common as rheumatoid arthritis, it is known to almost everyone as rheumatism. Similar to rheumatism, ankylosing spondylitis is a chronic inflammatory disease of the joints, which primarily affects the spine.
It is thought that inherited plants and environmental influences initiate pathological immune reactions. In 95 percent of those affected, there is a specific genetic tissue trait (HLA-B27) that is held responsible (but also occurs in healthy people!). The recurrent inflammatory processes lead to slowly progressive curvature of the spine and increased restriction of movement to the stiffening of the joints.
Ankylosing spondylitis: Who is affected?
Until just a few years ago, it was thought that three to five times as many men as women get ill. Recent studies have shown, however, that the sexes are about equally affected. Meanwhile, due to the refined diagnostic methods, it is easier to make early diagnoses. It turned out that there are many more people affected in Germany than previously thought. So one assumes by now that every 100th suffers from this disease. It usually starts between the ages of 16 and 45.
Ankylosing spondylitis: symptoms of the disease
At the beginning months of deep low back pain are typical, which are the worst in the morning and at rest. They radiate into the buttocks and thighs and strengthen when coughing or sneezing. Less common are pain in other joints, especially the hips, knees and shoulders. Unspecific early signs are fatigue, weight loss and mood swings.
The disease runs in spurts, sometimes favored by wet and cold. Over time, the curvature of the spine changes: The lumbar spine becomes flat, in the area of the thoracic spine a hump forms. Hips and knees bend, the neck stretches. This leads to a changed posture and reduced mobility.
The curvature can be so pronounced that the patient can no longer look properly straight. The inflammatory episodes can also affect other large joints as well as the iris of the eyes (iritis), the artery (aortitis) or the mucous membranes of the intestinal and genitourinary tracts.
Diagnosis of ankylosing spondylitis
In addition to the signs of disease, the detection of the characteristic HLA-B27 in the blood is typical. Groundbreaking are X-ray examinations of the spine and pelvis, in which the joint changes show. Other imaging techniques, such as magnetic resonance imaging and scintigraphy, may be appropriate for each patient.
Treat ankylosing spondylitis
The disease can not be cured. Therefore, pain control and maintenance of spinal mobility are at the forefront of treatment. A central role is played by the physiotherapy. The exercises taught by the physiotherapist must be carried out independently by the person concerned on a daily basis. Depending on individual preferences, cold or heat applications also help.
The chronic pain can be controlled with painkillers and anti-inflammatory drugs (eg ibuprofen, diclofenac). In acute relapses, cortisone may be indicated - either in tablet form or injected by the doctor into the joint space. With drugs that affect the immune system (eg sulfasalazine, methotrexate), success is achieved, but they often have stronger side effects.
Since 2003, a newly approved drug (infliximab) has been given as an infusion in certain cases. It blocks a messenger that promotes inflammation (tumor necrosis factor). It works very well and is well tolerated by most patients; however, tuberculosis that has gone through in the past may resurface. Long-term data are still pending.
In case of severe mobility, the patient can sometimes be helped with an operation in which the stiffened joint is replaced by an artificial one. With pronounced curvatures, the spine can be surgically erected and associated field of vision limitations improved.
What must the sufferer pay attention to?
The active participation of the person concerned is a mandatory requirement for him to remain mobile for a particularly long time. The following points should be noted: The exercises must be carried out consistently - they should be part of the daily routine like brushing your teeth. It is important to pay attention to posture in every situation in life - whether working, sleeping, driving or relaxing. The ambient conditions should be adjusted accordingly (eg mattress, seats, clothes, shoes).
It is important to take the prescribed medication. General health and sensible lifestyles are just as important as watching what is good and what is not and learning from it. Promoting and demanding are important, overwork is bad.
4 popular rehab ideas for ankylosing spondylitis
- Exercises with the Pezziball
- Nordic Walking
- Learn diaphragmatic respiration or abdominal breathing
- Storage therapy (initially under supervision)
Ankylosing spondylitis: history and prognosis
In just over a third of patients, the disease is limited to the spine. The pronounced shape with severe deformation and complete stiffening of the spine occurs only in about 10-20 percent of sufferers - usually the disease comes to a halt before. Most sufferers can continue to pursue their profession. The prognosis depends not only on the severity and frequency of the attacks but also on whether and which other joints or organs are affected.