27.11.2020

Ankylosing spondylitis: diagnosis and treatment

About ankylosing spondylitis, symptoms of the disease and the required therapy edition Conduct.Medicine told Arkady Lvovich Vertkin, M. D., Professor, Director of the therapeutic clinic and head of chair of therapy, clinical pharmacology and ambulance MSMSU named after A. I. Evdokimov.

What is ankylosing spondylitis and how often does it occurs?

Ankylosing spondylitis or ankylosing spondylitis is a chronic inflammatory disease of the spine that strikes young people. Mostly the disease is diagnosed in men who suffer from back pain and, less frequently, the disease occurs in women.

Chronic back pain lasting more than three months, experiencing more than 70% men to 40 years. Only half of them go to the doctor-the therapist, to find out the cause of the pain. Ankylosing spondylitis is not an uncommon disease. Practitioner therapist has a chance encounter with a patient with this disease – the disease affects about 0.1% of the population of the country.

What are the symptoms characteristic for the disease?

In fact, as soon as the inspection younger people, especially men, under the age of 40 years complaining of back pain the physician should treat the patient very carefully.

Students must identify when it arises and increases back pain. In ankylosing spondylitis the pain is worse at rest, and relief comes after physical exertion. This pain is called inflammation and is a characteristic diagnostic sign of this disease.

For radiculopathy and other diseases characterized by the so-called mechanical pain, which usually occurs and is enhanced during exercise, and during rest stops. Mechanical pain always occurs acutely, inflammatory and increases gradually.

Bechterew’s disease in the blood can be observed characteristic changes: increased levels of C-reactive protein, increased ESR (erythrocyte sedimentation rate). Patients with ankylosing spondylitis may present complaints of pain in the joints, buttocks, heels. These and other symptoms are also characteristic of many neurological disorders and often, because of difficulties with diagnosis, these patients are referred not to a rheumatologist, and a neurologist. This leads to the fact that the patient does not put the correct diagnosis and is not prescribed the correct treatment.

What disease is often confused ankylosing spondylitis?

Unfortunately, the therapist may not always accurately determine the cause of the pain, and in most cases he makes a diagnosis, the name of which is known to all – low back pain. From this non-existent disease receive treatment hundreds of thousands of patients across the country, and, among other things, the drugs administered to these patients, not so harmless. Meanwhile, precious time is running out, patients spent on treatment for a nonexistent disease.

What is the prognosis for such patients?

On average, the onset of pain before the correct diagnosis is 5 to 7 years. Patients should consult a rheumatologist, and the appointment of immunotherapy. The prognosis for patients with ankylosing spondylitis favorable now, but the main problem is still a long diagnostics and wrong treatment.

Therapy needed by patients with Bechterew’s disease, includes nonsteroidal anti-inflammatory drugs, physiotherapy, as well as immunotherapy. If the patient does not receive the necessary medications and is not regularly engaged in physical therapy , it can cause serious complications: severe pain, immobility.

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