Ankylosing spondylitis

Ankylosing spondylitis is a rheumatic condition and causes inflammation in various joints in the body. Many people do not know exactly what the disease entails and others have never even heard of it. What exactly does this disease mean, what are the symptoms and how can it be treated?

Ankylosing spondylitis

Ankylosing spondylitis is an inflammatory rheumatism. In most cases of this disease, the vertebral and pelvic joints are regularly inflamed, but joints such as shoulders, hips and knees can also become inflamed. These inflammations cause pain, become stiff and in some cases curvature of the spine can occur.

On average, almost one in a hundred people develops Ankylosing Spondylitis. The disease is more common in men than in women and the symptoms are often more severe in men. The disease usually develops between the ages of 15 and 35. The progression of the disease varies from patient to patient, depending on how severe the inflammation is and what is being done to combat the disease (treatments, medication).

Causes

Little is known about the origins of ankylosing spondylitis, although it is certain that a hereditary factor plays a role. In certain families the disease occurs in several people. More than ninety percent of people who suffer from ankylosing spondylitis have the hereditary factor HLA-B27 in the blood. However, this does not say everything, because eight percent of people in the Netherlands have this factor in their blood, but do not have the disease.

Ankylosing spondylitis can be caused by infections of the urinary tract or intestines. The body naturally defends itself against these infections, but as a result it turns against its own body. This would cause inflammation in the joints.

Complaints

Ankylosing spondylitis has a slow onset and can take years to diagnose. The first complaints are often stiffness and pain in the lower back and buttocks. These complaints often occur at night and in the morning, when the person in question lies in the same position for a long time. These complaints can also occur in the joints of shoulders, hips and knees. The complaints cause pain, fatigue and can cause insomnia at night. Pain in the chest and neck also often occurs. What also occurs in people who suffer from Ankylosing spondylitis is inflammation of tendon attachments. An inflamed Achilles tendon is the most common example of this. About five percent of people with ankylosing spondylitis develop inflammation of the intestinal mucosa. A consequence of this can be diarrhea, which sometimes contains blood. Skin conditions are also a symptom of the disease, in the form of Psoriasis. This causes flaky spots on the skin. In addition to the above complaints, more problems can occur. The eyes, heart and other organs can also become inflamed, although these complaints often occur at a later stage.

Diagnosis

Making the diagnosis is often difficult. The rheumatologist bases his diagnosis on the patient’s history and physical examination. Diagnosing the disease is difficult because X-rays show little or nothing in the early stages of the disease. At a later stage of the disease, damaged joints and possible inflammation become visible.
The rheumatologist will have the blood tested and look at the mobility of the back. He also pays attention to any signs of inflammation in joints or tendon attachments. The data from the blood test results can support the diagnosis. If the hereditary factor HLA-B27 is present in the blood, the chance of having ankylosing spondylitis is much greater.

Course

Ankylosing spondylitis shows that the older a person gets, the worse the symptoms become. However, there are also patients who have little to no complaints and little pain for a long time. Unfortunately, the disease is very unpredictable. Someone can feel good for a week, only to have a setback the following week and suddenly be in a lot of pain. Everyday things that do not cause problems for other people can be difficult for people with ankylosing spondylitis. Things like cleaning the house or other chores should be done in parts.

As we get older, a curvature can develop in the spine, which must be prevented as much as possible. In the past, there was even more uncertainty about ankylosing spondylitis than there is now, and patients were advised to take a lot of rest. The result was that the spine became crooked. Nowadays people know better and patients are advised to exercise a lot and to adopt a good, upright posture.

Therapy

The treatment of ankylosing spondylitis focuses on slowing down your complaints and continuing to function as best as possible. People with the disease are prescribed medication by their rheumatologist. These medications will have an analgesic and anti-inflammatory function. The pain will decrease and you will see a positive change in the mobility of the joints. In addition to medication, daily exercise is very important. This way the joints are kept flexible. A manual therapist can help patients with exercises.

People with ankylosing spondylitis are recommended to exercise a lot. It doesn’t matter which sport, as long as there is enough exercise. The patient can decide for himself how often he or she will exercise and which sport he or she practices. In the event of serious damage to certain joints, the rheumatologist may recommend surgery.

The symptoms and course of ankylosing spondylitis differ from person to person. One person always suffers a lot, while the other has fewer complaints and less often. As long as everything is done to slow down the disease, such as medication and exercise/sports, you cannot do anything else and you have to wait and see how things turn out.