Ankylosing spondylitis, which is more common in men, is known in society as rheumatism of the lower back or spine. Pain due to ankylosing spondylitis occurs especially at night and when resting. In very advanced cases, the spine is tilted forward and a hump can be seen. Today, ankylosing spondylitis can be controlled with medication and regular exercise before it progresses too much.
Ankylosing spondylitis is an immune system disease
Ankylosing spondylitis is defined as inflammation of the spine and the sacroiliac joint that connects the hip and waist. Ankylosing spondylitis occurs when the immune system works more than necessary and attacks its own tissues. Calcification can occur when the inflammation that occurs in the joints is not treated and progresses. Calcification closes the joint cavity, causing the joints to integrate with the bones and, in this case, loss of movement. When the disease progresses to some degree, it can go from the sacroiliac joint to the spine and affect the joints in the back and cervical vertebrae. In untreated and progressive cases, these calcifications can result in tilting and bending forward and a hunch.
If your lower back pain improves as you move…
Almost everyone can experience lower back pain at some time in their life. Mechanical lower back pain due to causes such as lumbar disc herniation, osteoarthritis, muscle spasm, and lumbar vertebrae displacement are different from those experienced in ankylosing spondylitis. Mechanical lower back pain occurs mainly when moving, and improves when resting. The symptoms that seperate Ankylosing spondylitis from mechanical lower back pain are pain that occurs when resting, especially at night, which awakens the person from sleep, and long-lasting stiffness upon waking up in the morning, and reduction of pain as they move. Inflammation that causes pain accumulates in the joints when a person is resting, causing pain. The person wakes up stiff in the morning. As the patient moves, the stiffness and pain decrease, and they relax. The patient becomes so stiff in the morning that they may not even be able to bend over and put on their socks. This stiffness lasting longer than half an hour is also one of the symptoms of Ankylosing spondylitis. Other lower back pains that are not inflammatory can also experience stiffness, but they last much shorter.
It is more common in men
This disease is seen in young men 2 times more often than in women. This disease should be suspected in cases of lower back pain that lasts longer than 3 months, especially in young men over the age of 18. Pain can last between 3 months and 1 year. The pain is mild at first, but increases over time. Since ankylosing spondylitis is a chronic disease, it is predicted that the pain may continue at certain intervals throughout life. In some cases, ankylosing spondylitis can involve organs other than the joints. It can cause a picture called uveitis, which is characterized by inflammation in one layer of the eye and blurred vision, or it can sometimes be seen together with psoriasis. Inflammatory bowel diseases such as ulcerative colitis or Crohn's disease can also develop sacroiliac joint inflammation similar to the inflammation seen in Ankylosing spondylitis disease. In addition, it is known that in the course of Behçet's disease and familial Mediterranean fever, which are more common in our country than the world average, sacroiliac joint inflammation may develop and ankylosing spondylitis-like complaints and lower back-hip pain may occur.
If ankylosing spondylitis is seen in the family, the risk increases.
· As with any disease, the patient's history is of great importance in Ankylosing spondylitis. Since it is a genetically transmitted disease, the patient's family history is also of great importance. It is also among the questions asked whether there are people in the family who have this disease or have a hunch as a result of this disease.
· In physical examination, the sensitivity of the joints is determined by the pressure maneuvers applied on the sacroiliac joints where this disease begins. If there is a humpback and bending, their degrees must be determined by measuring. These findings are important for diagnosis.
· If necessary, radiological imaging techniques are used. The imaging technique that allows the most accurate diagnosis of ankylosing spondylitis is MRI. X-rays are not always enough for diagnosis. In suspicious cases, MRI can provide clearer information. It can even show edema and inflammation inside the bone marrow at an early stage. In modern days, this makes it easy to make an early diagnosis.
· A number of blood values are also being looked at for the diagnosis of the disease. CRP, which shows the inflammatory value in the blood, is expected to increase in this disease, but it should be kept in mind that there may be active patients where it does not increase.
· One of the auxiliary examinations is a genetic test called HLA-B27, which determines whether there is a predisposition to Ankylosing spondylitis disease. The risk of developing ankylosing spondylitis increases in people with a positive for this gene. Extra-articular involvement is more common in patients with this gene positive. Eye inflammation called uveitis or intestinal inflammation can also be more common. It is known that disease activity may be more intense or complications such as early hunching due to the disease may be seen more frequently in patients carrying the HLA-B27 gene. HLA-B27 gene can be found as negative in 20-30% of patients with ankylosing spondylitis. Most often, the disease progresses more slowly and mildly in these patients, and less out-of-joint involvement is observed.
Treatment of ankylosing spondylitis lasts for life
Ankylosing spondylitis is a lifelong disease. The pain may not always be there and often recurs in the form of attacks. Inflammation in the joints during attack periods is trying to be cleaned with drug treatments. Treatment is started with painkillers, anti-inflammatory drugs that do not contain cortisone. Biological drugs come into play if these drugs do not show benefit when used regularly and the inflammation indicators that are checked in the person's blood do not decrease. These biological drugs are used in patients who do not respond to normal drug treatments.
Weight control is a must, exercise is very important
The disease in which exercise is most necessary among inflammatory rheumatic diseases is Ankylosing spondylitis. While half of the treatment consists of medications, the other half is exercise. Exercises that strengthen the spine, lower back, back, abdomen and chest muscles should be done. Swimming, which exercises the whole body at the same time, is a very beneficial exercise for patients with ankylosing spondylitis. Exercises that strengthen the back and waist muscles such as walking, cycling, pilates and yoga are also very beneficial. Exercise should be done for half an hour at least 4 days a week. But heavy exercise that can damage muscles and joints should be avoided. A sedentary lifestyle leads to the accumulation of inflammation and weight gain. In this disease, the spine is very sensitive and weight control is very important in order not to put a load on the spine. Patients with ankylosing spondylitis should eat healthy, not smoke and not gain excess weight.
Prepared by the Medical Editorial Board. Our health library contents have been prepared for informational purposes only and with the scientific content on the registration date. For all your questions, concerns, diagnosis or treatment about your health, please consult your doctor or health institution.