Summary about Disease
Bechterew's disease, also known as ankylosing spondylitis (AS), is a chronic inflammatory disease that primarily affects the spine. It can cause stiffness and pain in the spine and other joints. Over time, inflammation can lead to fusion of the vertebrae, limiting mobility. The severity and progression vary among individuals.
Symptoms
Common symptoms include:
Lower back pain and stiffness, particularly in the morning or after periods of inactivity.
Pain and stiffness in the hips, shoulders, neck, and other joints.
Fatigue.
Eye inflammation (uveitis).
Enthesitis (inflammation where tendons and ligaments attach to bone).
In severe cases, difficulty breathing due to rib cage involvement.
Causes
The exact cause of ankylosing spondylitis is unknown, but it is believed to be a combination of genetic and environmental factors. Most people with AS have the HLA-B27 gene, but not everyone with the gene develops the disease.
Medicine Used
Medications used to manage AS include:
Nonsteroidal anti-inflammatory drugs (NSAIDs): To reduce pain and inflammation.
Disease-modifying antirheumatic drugs (DMARDs): Such as sulfasalazine, primarily for peripheral joint involvement.
Biologics (TNF inhibitors and IL-17 inhibitors): Powerful drugs that target specific proteins involved in inflammation. Examples include adalimumab, etanercept, infliximab, certolizumab pegol, secukinumab, and ixekizumab.
Corticosteroids: Occasionally used for short-term relief of severe inflammation.
Pain relievers: Other pain medications may be prescribed to manage pain.
Is Communicable
Ankylosing spondylitis is not communicable. It is not an infectious disease and cannot be spread from person to person.
Precautions
Precautions and lifestyle modifications to manage AS include:
Regular exercise, especially stretching and range-of-motion exercises.
Maintaining good posture.
Physical therapy.
Avoiding smoking.
Applying heat or cold to affected areas.
Using assistive devices as needed.
Consulting with a healthcare professional for personalized advice and treatment.
How long does an outbreak last?
Ankylosing spondylitis is a chronic condition, not an acute "outbreak." Individuals experience periods of increased symptom severity (flares) that can last from a few days to several weeks or even months. These flares are followed by periods of remission where symptoms are less severe. The duration of flares and remissions varies significantly from person to person.
How is it diagnosed?
Diagnosis typically involves:
Physical examination: Assessing spinal mobility and posture.
Medical history: Reviewing symptoms and family history.
Imaging tests: X-rays to look for changes in the sacroiliac joints and spine. MRI may be used to detect early inflammation.
Blood tests: To check for the HLA-B27 gene and inflammation markers.
Timeline of Symptoms
The timeline of symptoms varies widely:
Early Stages: Gradual onset of lower back pain and stiffness, often worse in the morning.
Progression: Symptoms may spread to other joints, such as hips, shoulders, and neck. Fatigue and eye inflammation may develop.
Advanced Stages: In some cases, fusion of the vertebrae can occur, leading to limited spinal mobility and postural changes. The disease progresses differently for each individual. Some may experience slow progression over many years, while others may have more rapid and severe symptoms.
Important Considerations
Early diagnosis and treatment are crucial to manage symptoms and prevent or delay complications.
Treatment plans should be individualized based on the severity of the disease and the specific symptoms.
Long-term management often requires a multidisciplinary approach involving rheumatologists, physical therapists, and other healthcare professionals.
Support groups can provide valuable information and emotional support.
Regular monitoring is necessary to assess disease activity and adjust treatment as needed.