Ankylosing Spondylitis
What is ankylosing spondylitis? Information about the causes, symptoms, diagnostic methods, and treatments for this disease.
Symptoms and Causes
Ankylosing spondylitis, or ankilopoietic spondylitis, is a type of arthritis, a chronic inflammatory disease, that affects the joints of the spine. It primarily affects the lower back, where the vertebrae connect with the pelvis.
This disease typically manifests between the ages of 20 and 40, and over time, it can cause the vertebrae to fuse, resulting in a loss of flexibility in the spine and a tendency to curve, producing stiffness in that area.
Currently, there is no cure for ankylosing spondylitis. Treatments focus on relieving symptoms and slowing its progression.
Symptoms
The characteristic symptoms of ankylosing spondylitis are:
- Pain in the spine, especially in the lumbar region, which tends to worsen in the morning and improve with exercise.
- Stiffness.
- Joint swelling.
- Difficulty breathing (when the disease affects the ribs).
- Eye inflammation.
Causes
The exact causes of ankylosing spondylitis are unknown. However, it is believed that genetic factors may play a role, as individuals with the HLA-B27 gene are more likely to develop the disease. Nonetheless, it is important to note that not everyone with this gene develops the disease.
Risk Factors
Ankylosing spondylitis is more common in:
- Men.
- Young adults (mainly between the ages of 20 and 40).
- Individuals with the HLA-B27 gene.
Complications
When ankylosing spondylitis worsens, it can lead to:
- Vertebral fusion: the new bone material that the body generates to try to repair damage progressively accumulates, shortening the distance between the vertebrae. Over time, the bones fuse, and the affected part of the spine becomes rigid.
- Breathing problems: rib and sternum movement becomes limited when the disease affects the thoracic region of the spine.
- Eye inflammation (uveitis): in addition to pain, it can cause vision loss.
- Aortic enlargement: increases the risk of heart disease, as it impairs heart function.
Prevention
Ankilopoietic spondylitis cannot be prevented.
Which doctor treats ankylosing spondylitis?
Rheumatologists, pain specialists, and specialists in physical medicine and rehabilitation are involved in the diagnosis and treatment of ankylosing spondylitis.
Diagnosis
To confirm the diagnosis of ankylosing spondylitis, specialists rely on two types of criteria:
- Clinical criteria: pain that does not improve with rest, improves with exercise, limits mobility, and lasts for more than three months.
- Radiological criteria: inflammation of the spine joints (sacroiliac joint). X-rays of the lower back are taken to examine the state of the vertebrae or MRIs to obtain a complete image of the area.
Additionally, blood tests are used to assess the patient's overall health and detect the presence of inflammation and the HLA-B27 gene.
Treatment
The goal of ankylosing spondylitis treatments is to alleviate symptoms to improve the patient's quality of life and slow down the progression of the disease. The most effective treatments are:
- Medications: Anti-inflammatory drugs reduce swelling and alleviate pain. In some cases, corticosteroids are injected to enhance the benefits.
- Physiotherapy: A personalized exercise plan is prepared to strengthen the trunk muscles, increase range of motion, and improve posture. Rest should be avoided.
- Physical activity: Swimming is one of the most recommended exercises.
- Surgical treatment is only used in rare cases when joints are severely damaged, and mobility has been lost or pain is unmanageable.
