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  • Bechterew's disease symptoms

    Bechterew's disease( ankylosing spondylitis) is a chronic inflammatory lesion of the spine with progressive impairment of its mobility. Mostly men of young age are ill. In the development of ankylosing spondylitis, genetically determined disorders of immune processes are attached. This disease is an unusual form of inflammatory arthritis, which primarily affects the joints of the spine. Usually it begins in the sacroiliac joints, where the spine touches the pelvis. The disease begins in the lower back and spreads to the cervical vertebrae.(In 25 percent of cases, especially in women, the disease also grabs peripheral joints.) Cartilages and other tissues between the dorsal joints gradually deteriorate and are replaced by a hard fibrous tissue. In the end, the dorsal vertebrae join and the mobility of the joints is lost. Symptoms of the disease( at first it is usually pain in the lower back and stiffness of the joints) often first appear at the end of adolescence - the beginning of the adult stage. The appearance of symptoms after 45 years is very rare. The earlier the disease appears, the worse the prognosis of its development. The most serious complication is a vertebral fracture after the vertebrae are fully connected;this can lead to paralysis of the hands and feet. However, most patients do not suffer from serious disorders, despite the pain. At any time, the disease can worsen, stabilize, or start again. About 25-30 percent of patients suffer from inflammation and scarring of eye structures;a small number of patients may have an abnormality of the aortic valve or scar tissue of the lungs. Ankylosing spondylitis occurs three times more often in men than in women.

    • The cause of ankylosing spondylitis is unknown, although the heredity factor plays a role here. There is also the suggestion that the association between the presence of bacteria in the small intestine or its inflammation and autoimmune activity( as a result of which the body's defenses attack healthy tissues) may be the cause of deterioration of the joints.

    Joints of the spine and sacroiliac joint are most often affected. The disease begins gradually pains in the lumbosacral region at first only with prolonged stay in one position. The defeat of the thoracic spine may be accompanied by pain in the chest according to the type of neuralgia. As the disease progresses, patients begin to make complaints about constant pain in the spine, gradually a violation of gait and posture develops, the tension of the rectus muscles develops, then their atrophy develops. When tapping on the vertebrae, pain is noted. With further progression in the late stages of the disease, in addition to intensifying the pain syndrome, a pronounced kyphosis of the thoracic spine develops, perhaps, on the contrary, the rectification of all physiological curves of the spine with the development of its immobility. Radiographically, there are changes in the spine with gradually progressing ankylosis of the intervertebral joints, ossification of the fibrous ring of the intervertebral discs, anterior and lateral ligaments with the appearance of a picture in which the spine resembles a bamboo cane. Approximately half of the patients are affected and peripheral joints, which on external manifestations brings this pathology closer to rheumatoid arthritis. In a small part of patients with Bechterew's disease other organs and systems( kidneys, eyes, heart) are involved in the process, irit, iridocyclitis, uveitis can develop. Renal pathology is characterized by nephritis or amyloidosis of the kidneys. The defeat of the heart can be accompanied by the development of myocarditis, aortitis with aortic insufficiency, pericarditis. During the exacerbation of the disease in the blood, there is increased leukocytosis, an increase in ESR and other signs of inflammatory activity. Rheumatoid factor in serum is not found.

    Muscle relaxants( midolcam) are used to eliminate pain syndrome and muscle contractures. Important is the use of massage, physiotherapy exercises, physiotherapy. For the prevention of exacerbation, use delagil or plakvenil for a long time( up to 2 years).

    • There are no special treatments for ankylosing spondylitis;Therapy is aimed at suppressing and removing symptoms.

    • Methods of preventing ankylosing spondylitis are unknown.

    • Consult a doctor if you feel pain in your back all the time.