Ankylosing spondylitis: causes, symptoms, treatment

An estimated 350,000 Germans suffer from Bechterew’s disease. A condition in which the spine becomes inflamed. This particular type of inflammatory rheumatism mainly affects young people.

People with Bechterew’s disease not only struggle with spinal pain, but other joints can become inflamed as well. A stiffening of the spine is also part of the clinical picture. Complaints can severely limit the patient’s quality of life. FITBOOK provides an overview of the symptoms, causes and treatment of the disease, also known as ankylosing spondylitis.

What are the symptoms of ankylosing spondylitis?

Symptoms of Bechterew’s disease are difficult to classify, especially early in the disease. Since the condition usually occurs in young people before age 45, the pain is often attributed to excessive stress.

Here is an overview of the characteristic symptoms:

  • backache
  • morning stiffness in the joints lasting more than 30 minutes
  • joint inflammation
  • Difficulty sleeping due to pain
  • Pain relief through movement
  • joint swelling

In most cases, the pain begins in the lower spine and spreads to other parts of the body as the disease progresses. Symptoms differ slightly when women are affected. For example, pain often begins in the cervical spine.

The disease affects not only the spine and joints. A variety of accompanying symptoms may also occur. These include, among other things:

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How does Bechterew’s disease progress?

For most patients, the condition begins between the ages of 16 and 45. The disease is insidious, with symptoms developing over the course of months or years. Typically, ankylosing spondylitis occurs in episodes, and symptoms can worsen from one episode to another. Meanwhile, some patients can live with almost no pain.

At the onset of the disease, most of those affected complain of pain in the lower back and buttocks, which occurs mainly in the second half of the night, in the morning or after lying down for a long time. Additionally, patients report pressure sensitivity in certain parts of the body such as ribs and vertebrae. If the disease remains unnoticed and without proper treatment, the spine becomes more and more deformed and stiff. Movement is also becoming more and more painful for many people.

As the disease progresses, the spine becomes severely deformed and ossified. If the ankylosing spondylitis has reached its advanced stage, this process stops. In some extreme cases, patients develop a so-called “bamboo spine”, which means complete stiffening of the spine. On the other hand, the formation of a hump or a change in posture is not uncommon. The cervical spine tilts forward, which can also lead to breathing difficulties.

Theoretically, ankylosing spondylitis can stop at any stage. However, the disease accompanies most patients throughout their lives. However, the extent to which those affected are limited by the disease varies.

Beach field frame 1

What are the causes of ankylosing spondylitis?

The background of the disease is not fully understood. Morbus Bechterew is assigned to autoimmune diseases, so the body’s defense system is disturbed.

The HLA-B27 gene is an important marker of possible Bechterew’s disease. Although the gene does not automatically lead to a diagnosis of the inflammatory type of rheumatism, 95% of patients are carriers of HLA-B27. On average, the gene can be detected in eight out of 100 people. They are most at risk, but most of them will not develop Bechterew’s disease for life.

Morbus Bechterew and the HLA-B27 gene are inheritable. If you have the disease yourself and are a carrier of the gene, the chance of passing it on is 50 percent. In fact, 5 to 20 percent of children will also develop Bechterew’s disease in their lifetime.

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How is ankylosing spondylitis treated?

So far, there is no way to cure the disease. There are a variety of options for relieving symptoms or slowing the progression of the disease.

Early diagnosis is important for a good prognosis, because the damage that has already occurred cannot be reversed. However, the path to diagnosis can take years. Women have to wait up to eight years to find the cause of their symptoms. Ankylosing spondylitis has long been considered a male disease, which is why men are diagnosed with the disease even more quickly today.

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One of the most important measures in the fight against ankylosing spondylitis is sport. Although exercise may be associated with pain, patients are encouraged to exercise as much as possible. It is the best way to reduce pain and stiffness in the long term. Physiotherapy should also be used as a supplement. Targeted exercises and massages are used to train the mobility of the spine.

The use of drugs is also part of the therapy of Bechterew’s disease. They can relieve pain and reduce inflammation. If the joints are severely damaged or if extreme curvatures of the spine need to be corrected, operations are required in rare cases.

In general, sufferers should eat a balanced diet, as being overweight means additional stress on the joints. The consumption of tobacco and alcohol should be avoided.


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