I believe most men and women have experienced low back pain in their lives, and many have even suffered from it for a long time. There are many causes of low back pain, often attributed to diseases such as “lumbar strain” and “lumbar disc herniation”, while ignoring a relatively unknown disease – “ankylosing spondylitis”. Because it is difficult to distinguish back pain caused by ankylosing spondylitis from back pain caused by other diseases, many young patients tend to think that it is caused by “sports injuries” or “chronic strain” and do not pay enough attention to it or even refuse to see a doctor. This is why patients with ankylosing spondylitis may remain undiagnosed for years after the onset of symptoms such as low back pain.
What is “ankylosing spondylitis”?
Ankylosing spondylitis is a chronic inflammatory disease that mainly affects the sacroiliac joints, spinal prominences, paraspinal soft tissues and peripheral joints, and may be accompanied by extra-articular manifestations. The main clinical manifestations are back, back, neck, hip and hip pain and arthralgias, with a chronic progressive course, alternating between episodes and remissions. In severe cases, spinal deformity and joint ankylosis may occur. In the late stages of the disease, the entire spine progressively develops into fibrous and bony ankylosis, so that the spine gradually loses its curvature and mobility, and in severe cases, X-rays show “bamboo-like” changes in the spine and complete ankylosis of the spine, hence the name “ankylosing spondylitis.
What are the symptoms of ankylosing spondylitis?
1, early onset of ankylosing spondylitis, the patient’s back pain, morning stiffness, serious spinal function activity is limited; ankylosing spondylitis in the early stages of the disease, the symptoms are not very obvious, the patient will feel the spinal pain or mild, the weather a change, such as cloudy days and rain, the patient’s symptoms are more obvious, after the transition of exertion, the symptoms will also be aggravated, sometimes bending will also. Because the spinal activity is not restricted during this period, it is usually thought to be caused by transitional exertion, and therefore often leads to misdiagnosis and mistreatment.
2, ankylosing spondylitis in the middle, the patient’s lower back, lower limb joint pain is heavier, the functional activities of the spine is limited. At this point, if timely diagnosis and correct treatment can be obtained in most cases, good results.
3, late ankylosing spondylitis, patients with spinal ankylosis or hunchback deformity, lost a good opportunity for treatment. In addition to the treatment of the disease is no special drugs, so early diagnosis, early treatment is important for the prognosis, so when back pain is obvious, remind patients to timely treatment, do not miss a good opportunity.
Third, the extra-articular manifestations of ankylosing spondylitis AS.
The extra-articular lesions of ankylosing spondylitis mostly appear after spondylitis, and occasionally extra-articular symptoms occur months or years before skeletal muscle symptoms.AS can invade multiple systems throughout the body and be associated with a variety of diseases, such as: cardiac lesions, eye lesions (such as iritis), ear lesions, lung lesions, neurological lesions and even kidney and prostate lesions.
4. What is morning stiffness?
Morning stiffness is a feeling of stiffness in the early morning without any clear cause, and it can be reduced after activity. Occasionally this symptom can be relieved not only after activity, but also in addition to activity, local massage, hot compresses, hot baths can also make morning stiffness relief. Morning stiffness is not only found in the lumbosacral region, but also in the joints of the spine and body.
What are the most vulnerable groups for ankylosing spondylitis?
The age of onset of ankylosing spondylitis is usually 13-31 years old, with a peak at 20-30 years old; more men than women, with a male to female ratio of about 2-3:1.
The cause of ankylosing spondylitis is uncertain, but it is currently thought to be the result of an interaction of multiple factors, including genetics, genetic variants, and acquired infections. Epidemiological studies have shown that HLA-B27 is closely associated with the development of ankylosing spondylitis, with 90% of patients with ankylosing spondylitis being HLA-B27 positive, compared to about 5% of the general population. The high detection rate of Klebsiella pneumoniae in stool cultures of patients with ankylosing spondylitis suggests that environmental factors such as intestinal bacteria and intestinal inflammation are also involved in the development of the disease.
Ankylosing spondylitis has a significant familial clustering phenomenon, and patients should be alert to the possibility of similar diseases occurring in their next generation.
What are the risks of ankylosing spondylitis?
The disease usually attacks the sacroiliac joints first and then progresses up the spine, involving the lumbar, thoracic, and even cervical spine. The affected spine not only has low back pain, but may also have progressive restriction of movement, and if the disease progresses further, it may result in varying degrees of hunchback deformity or even disability. Misdiagnosis rate is high. About 90% of patients are diagnosed after 3 years of illness, which increases the disability rate of the disease due to delayed treatment.
This disease requires long-term treatment, which not only affects the physical and mental health of the individual, but the high cost of treatment also places a great financial burden on the patient and family.
Is ankylosing spondylitis curable?
At present, there is no cure for ankylosing spondylitis. However, with timely diagnosis and reasonable treatment, patients can achieve symptom control and improve their prognosis. A combination of non-pharmacologic, pharmacologic and surgical treatments are used to relieve pain and stiffness and to control or reduce inflammation, while maintaining good posture and preventing deformation of the spine or joints, as well as correcting deformed joints when necessary, to improve and enhance the patient’s quality of life.
Eight, ankylosing spondylitis needs to be distinguished from what diseases?
Ankylosing spondylitis is a complex disease with a variety of clinical manifestations and requires differential diagnosis with other diseases: non-specific low back pain, gluteal myofasciitis, lumbosacral joint strain, lumbar disc herniation, osteoarthritis, rheumatoid arthritis, etc. In short, when you suffer from low back pain, especially stiffness in the morning after waking up and relieved after activity, or inflexibility of lumbar activities and other symptoms should seek medical attention in time for early diagnosis and early treatment.