Bechterew's disease: symptoms, treatment, gymnastics

Bechterew disease, or ankylosing spondylitis( ankylosing spondylitis) is a chronic inflammatory disease of the spine and joints of

. It is accompanied by severe pain, stiffness of movements and gradual deformation and ossification of the joints, until irreversible changes and complete immobility are formed.

Bechterew's disease( ankylosing spondylitis): causes ^

The causes of ankylosing spondylitis have not been thoroughly studied, but it is known that people who carry the HLA-B27 gene have a genetic predisposition to Bechterew's disease( BB).

The immune system of such people "mistakenly" considers the tissues of joints and ligaments to be foreign and attacks them, causing inflammation and damage.

However, even with the presence of this gene, not everything that is a mystery and the subject of further research for rheumatologists is ill with Bekhterev's disease.

Additional changes in the immune status due to hypothermia, colds, viral and infectious - allergic diseases, as well as trauma to the pelvis and spine are considered additional factors that can trigger the development of Bechterev's disease.

In addition, the latest studies of scientists have shown that Bekhterev's disease is also a psychosomatic disease, since more than a third of the patients first symptoms began to appear after severe and prolonged stress.

Diagnosis and distinctive symptoms of Bechterew's disease ^

Because some of the symptoms of Bechterew's disease are very similar to the symptoms of osteochondrosis, in the initial stage these diseases are often confused, because ankylosing spondylitis often begins as normal osteochondrosis - pains in the lumbar region and painful strain of the back muscles.

Therefore, in order to establish the correct diagnosis and start timely treatment, it is very important to determine the disease at the very beginning of its development, in order not to allow complete immobilization of the spine and the development of severe co-occurring complications.

The most dangerous complications of Bechterew's disease are:

• amyloidosis - renal degeneration leading to kidney failure;
• lesions of the heart and aorta, leading to shortness of breath and provoking pain behind the sternum and irregularities in the heart;
• tuberculosis and other lung diseases, resulting from reduced mobility of the chest;
• uveitis - inflammation of the choroid of the eye, leading to blurred vision, eye pain and photosensitivity;
• anemia and inflammation of the intestines.

Among the primary symptoms of Bechterew's disease, the most typical is periodic low back pain( in 75% of cases).But, if in osteochondrosis pain has a constant character and intensifies with movements, then with Bekhterev's disease it happens differently - the pains are greatly amplified at night and somewhat abate during the day, after the onset of active movements.

If in osteochondrosis a person can tilt at least one way or turn left or right, then with Bechterew's disease, the movement is usually broken in all directions. In addition, a frequent sign of Bekhterev's disease is swelling and tenderness of the joints, as well as a characteristic change in posture, called the "supplicant" posture

. When forming the supplicant's posture, the patient gradually straightens the normal curvature of the spine - the loin becomes straight and flat. A little later, the thoracic region freezes, a strong stoop appears, and the legs instinctively bend at the knees. Over time, the stiffness of the spine reaches such a degree that a person begins to move as if he had an unbending stick in place of his spine.

Timely diagnosis of ankylosing spondylitis

The following methods help to correctly diagnose ankylosing spondylitis:

• X-ray of the spine, on which an experienced doctor can notice early signs of bone and joint changes,
• magnetic resonance imaging( MRI),
• blood test for C-reactive protein, erythrocyte sedimentation rate( ESR), and HLA-B27 antigen presence.

The ESR index above 30 mm / h and the presence of HLA-B27 antigen confirm the correctness of the diagnosis of Bechterew's disease.

Bechterew's disease: treatment ^

rehabilitation As the basis of therapy for the treatment of Bechterew's disease, the following medications are prescribed to patients:

• long courses( 1 to 5 years) of non-steroidal anti-inflammatory drugs that help significantly slow the progression of the disease,
• antirheumatic drugs,
• corticosteroids,
• blockers of necrosis factor.

Sometimes, with a particularly severe course of the disease, the appointment of immunosuppressants is indicated.

In addition, it is very important to sanitize all foci of chronic infections in the body and perform general restorative therapy - this helps to prevent cases of exacerbations.

As an alternative treatment for Bechterew's disease,

• acupuncture,
• reflexotherapy,
• magnetotherapy,
• Beebotherapy,
• hirudotherapy,
• physiotherapy,
• massage are very successfully used.

Hirudotherapy( treatment with leeches) with Bechterew's disease

Hirudotherapy with ankylosing spondylitis has a good anti-inflammatory, analgesic and antibacterial effect. This is explained by the fact that the enzymes( hirudin, ellines, destabilase) contained in the saliva of the leech soften and make the ossified spine more ductile, reduce inflammation and damage to the tissues of the joints and ligaments, and normalize the blood flow.

In addition, the treatment with leeches has a beneficial effect on the entire body - due to improved blood supply and better oxygenation of the blood, blood clots dissolve, metabolism normalizes, sleep, appetite and mood improves, and immunity rises.

Therapeutic gymnastics for Bechterew's disease: video ^

Therapeutic physical training in Bekhterev's disease is of great importance, as regular physical exercises and training strengthens the blood flow in the joints, helps to keep the mobility of the spine and lower extremities, stop the progression of the disease and avoid disability.

However, it should be remembered that physically loads for patients with Ankylosing spondylitis should be feasible and sparing so as not to lead to deterioration of well-being:

• Thus, patients with BB are categorically contraindicated in running, jumping, shaking in transport and hypothermia. And on the contrary, it is very useful to walk calmly( up to 3 - 5 kilometers), including skiing on flat terrain.
• Swimming in ponds and swimming pools is allowed at a water temperature of at least 23 - 22 degrees, and leave is recommended in areas with a warm and dry climate.
• If you have to stay in the same position for a long time, you need to change your body position every hour. During the day it is advisable to lie down on a hard bed several times without a pillow in the supine position with straight legs. If you can not straighten up in this position, you can put a small pillow under your stomach.

Gymnastics classes should become an obligatory daily procedure, even if you feel bad and there is no hope of restoring the mobility of the spine. The fact is that because of the fusion and immobility of the chest joints, pulmonary ventilation deteriorates sharply, which can lead to pneumonia, fibrosis and other pulmonary diseases.

Therefore, to prevent serious complications, a patient with Bekhterev's disease is vitally important elementary breathing exercises( daily, 3-4 times a day blowing a balloon) and regular walks in the fresh air.

Complex of therapeutic gymnastics with ankylosing spondylitis

Initial position( in.) - sitting on a chair

• Turns the head to the right and left, semicircles head and tilt the ear to the shoulder.
• Hands on the belt, the shoulder blades are brought together, the back is straight - chin stretch forward.
• Hands are dilated to the sides, fingers are compressed into a fist - press against the neck with your chin and connect the scapula.

Starting position - lying on the back

• Raise your head and stretch your chin to your stomach.
• Hands stretch along the body, legs join together - leaning on the heels, the back of the head and hands, lift the pelvis as high as possible and bend.
• Put your hands behind your head, legs together, feet on yourself - raise the body by 45 degrees, stay a little in this position and smoothly go back to the starting position.
• Raise your straightened legs and make circular motions alternately in different directions.
• Bend your legs, get your hands behind your head - lift the basin, bend and smoothly sink.

Starting position - lying on the side

• Both knees lead to the chest and try to reach them to the forehead. Then straighten your legs and bend back.
• Perform alternately swings the straight leg forward and back and the straight leg lifts up.
• Bend the leg in the knee and perform circular movements in the hip joint.

However, it is worth noting that the complex of physical exercises can not be made independently, it must be agreed with the attending physician, which will take into account the individual features of the course of Bekhterev's disease and the general state of the body.

Massage, diet and prevention of complications with Bechterew's disease ^

Massage with Bechterew's disease, applied in conjunction with exercise therapy, well relieves pain and muscle fatigue, strengthens the muscle corset, normalizes the tone and helps maintain the motor ability of the vertebrae.

However, massage is shown only outside the stages of exacerbation, should be light and gentle, without rigid receptions( chopping, beating) and be performed by a qualified specialist. The total duration of massage procedures should not exceed 25 minutes, after a treatment course( 20 - 25 sessions) a break is necessary within 3 to 4 weeks.

Proper nutrition with Bechterew's disease, as with any other inflammatory chronic disease, should be balanced, but not excessive, so as not to lead to obesity.

The caloric content of the diet should clearly correspond to the physiological needs of the organism and the physical loads of the patient, since overweight creates a dangerous additional burden on the joints of the spine and lower limbs.

• The menu should contain a sufficient amount of protein food, especially fish and low-fat dairy products, salads from fresh vegetables with the addition of unrefined sunflower or corn oil, fruits and herbs.
• Conventional table salt should be replaced with a marine salt containing many useful micronutrients. Dietitians advise instead of salt to add to the ready-made meals sea kale powder, which contains all the necessary for the proper functioning of bones and cartilage microelements.
• In addition, from the diet should be excluded from sharp, smoked, fried and salty foods, alcohol and refined foods, preferring healthy home foods - whole grains, stewed and wiped vegetables and soups.

Doctors say that if you adhere to proper nutrition, start treatment on time and begin to actively engage in physical therapy, then the inflammatory process in joints will be able to slow down considerably and you will be able to lead a full-fledged lifestyle.