Ankylosing spondylitis (AS) is an inflammatory arthritis that targets the joints of the spine, particularly the sacroiliac joints that connect the spine to the pelvis. It is relatively common in Caucasians (Caucasians), with a male to female ratio of about 2:1. The first attacks tend to occur between the ages of 14 and 40 years, with the first attacks after the age of 40 being extremely rare.
AS is not curable and is a progressive disease, but medical treatment and improvement of lifestyle habits such as exercise can improve the prognosis of patients.
Damage to the spine
Inflammation leads to destruction of the spine. Accordingly, the bones repair this damage by overgrowth of bone tissue. Over time, this process leads to abnormal osteophytes (ligamentous bones) and the creation of intervertebral connections. The fusion of the spine produces pain and limited motion, especially in the low back. 7 out of 10 patients with AS will eventually develop varying degrees of spinal fusion.
Etiology
The exact cause is not known, but genetic factors play a partial role. Studies have found that most people with AS have the gene called HLA-B27. Some HLA (human leukocyte antigen) genes suggest that these people are more likely to develop autoimmune diseases.
Since the presence of this gene does not necessarily lead to the development of AS, there must be other factors. Current theories suggest that people with the gene must be exposed to specific environments to trigger the development of arthritis. However, these triggering mechanisms are also unknown.
Childhood symptoms
Symptoms in children are often overlooked and assumed to be growing pains. Specific symptoms in children include chronic pain in the back or neck and chronic pain in the knee, ankle or foot. Joint stiffness after a period of decreased joint activity Pain and stiffness decrease with or after exercise
Adult symptoms
The severity and progressiveness of AS varies widely in adults from person to person. Usually, symptoms in adults include
1. chronic back pain, especially in the low back and hips
2. Pain in other joints, such as the knee, shoulder or foot.
3. Poor posture, as standing upright can be uncomfortable or even painful.
4.Stiffness of the back.
5.Decreased mobility.
6.Difficulty in standing up when sitting.
7.Difficulty in walking.
8.Increased stiffness after a period of reduced activity.
9.Reduction of pain and stiffness during or after exercise.
10.Fatigue that cannot be reduced by rest or sleep.
Inflammation of other parts of the body
Ankylosing spondylitis may lead to inflammation in other areas, including
l . Tendon (onset and stopping point inflammation)
2, eye (uveitis or iritis)
3, intestine (colitis)
4, lung (fibrosis)
5. Heart (aortitis)
Complications
Severe spondylitis can lead to a range of complications, including
l , skeletal deformities, such as: fixed hunchback (in severe cases patients are unable to raise their heads)
2, complete fusion of the spine (bamboo-like spine)
3, easy to fracture
4, fusion of the rib joints, resulting in breathing difficulties
5.Lung damage and periodic lung infections
6 Chronic inflammation causing anemia
Diagnosis
Studies have shown that OCD may go undiagnosed for many years, especially in children. In contrast, it takes an average of 7 years to finally be diagnosed in adulthood. This is unfortunate, as early diagnosis and early treatment can improve the long-term prognosis of patients. Tests to diagnose AS include
l .Medical history
2.Physical examination
3. X-rays
4. CT or MRI plain scan
5.Blood test
6.Gene test
Treatment
Ankylosing spondylitis is not curable. The goal of medical treatment is to reduce pain, decrease complications, and improve quality of life. Treatment includes.
1. Anti-inflammatory treatment, such as aspirin
2. Anti-rheumatoid drugs
3. Steroids (cortisol hormones)
4, other agents such as TNF (tumor necrosis factor) blockers (often used to treat similar rheumatoid diseases)
5, physical therapy, including exercise to improve flexibility and increase range of motion
6. In rare cases, surgery is required to repair the damaged joint.
Some suggestions for self-help
Most people with OCD will develop some degree of spinal fusion. A key goal of treatment is to encourage proper posture so that the spine can also fuse in an upright position rather than a hunched position. It is important to follow the advice of your physician, but general suggestions for self-help include
l. The most important management tool is regular exercise (including stretching exercises) to maintain the mobility and flexibility of the spine. You can ask your doctor or physical therapist for more information.
2. Strong abdominal muscles help maintain good posture. Follow your doctor’s or physical therapist’s advice by exercising strong abdominal muscles.
3, pay special attention to remind yourself of your posture every day. Keep reminding yourself to “stand up straight”.
4, if you like to sit hard in a chair, consider buying an ergonomic chair, lumbar support cushion or other devices. Consult with your doctor or physical therapist.
5, bed is to avoid curling up into a ball; instead, to maintain a flat or prone position.
6. Quit smoking.