Ankylosing spondylitis. Diagnostics & Therapy
Medical examination and treatment of ankylosing spondylitis.
Usually, the first sign of ankylosing spondylitis is back pain. For this can have many causes, the disease is often detected lately. Today, it takes about six years to the time of diagnosis. For permanent pain in the joints, muscles or bones, the presence of a rheumatic disease should be checked. Specialized rheumatologist can best interpret the complaints.
If ankylosing spondylitis was diagnosed, it usually can be treated conservatively. Various therapeutic applications, such as physiotherapy, exercise or physical measures, and the use of drugs can have a good influence on the course of disease. Only in severe damage to the joints and the spine, surgical treatment is necessary.
Diagnostics, treatment & therapy of ankylosing spondylitis.
Diagnostics. How ankylosing spondylitis is detected
How is ankylosing spondylitis diagnosed?
To determine the disease ankylosing spondylitis, in addition to a medical interview various other tests are performed. Also, imaging procedures are used for this purpose.
The following diagnostic procedures are used:
- Medical history, e.g., current back pain, worsening stiffness, reduced mobility in the spine and ribcage
- Family history (frequency in the family)
- Clinical assessment (see symptoms)
- Lab tests (blood sedimentary rate, HLA-B27)
- X-rays: Of the spine, incl. changes in the vertebral bodies (increase in vertebral height, box-shaped vertebra, Andersson lesion (nonbacterial inflammation of the vertebral body and/or intervertebral disk)) and Romanus lesion (inflammation at the front of the spine)
- X-rays: So-called bamboo spine due to bone growing between several vertebrae (syndesmophyte growth)
- X-rays: Stiffening (ankylosis), a flattening of joint structures or an increase in erosion (destruction), and a hardening of the bones (sclerosis) may occur at the joints between the tailbone and pelvis (sacro-iliac joints, SIJ), for example
- X-rays: Bony growth at the joints and in the joint capsule, incl. in the hips, and the joints between the ribs and spine
Astoundingly, even nowadays it still usually takes 6 years before a diagnosis is made.
Therapy. Treatment of ankylosing spondylitis
Conservative treatment for ankylosing spondylitis.
The goal of conservative treatment is prevention, aimed at avoiding the problematic stiffening in the spine and joints resulting from ankylosing spondylitis, as well as improving breathing techniques.
Education of patients with ankylosing spondylitis
Abstaining from nicotine is recommended. Patient's with ankylosing spondylitis should undergo consistent daily physiotherapy at home, active physical exercise and training in how to breath.
Drug treatment for ankylosing spondylitis.
These drugs are often used in ankylosing spondylitis for the treatment of pain and discomfort:
- Nonsteroidal anti-inflammatory drugs alongside H2 blockers to protect the stomach
- Muscle relaxants
- Antirheumatic drugs/so-called basic therapy, including sulfasalazine
- Selective infiltration of the sacroiliac joint, tendon attachment sites or in joints
- Good results are currently being achieved with the use of tumour necrosis factor alpha blockers
Physiotherapy & physcal therapy for ankylosing spondylitis.
Warm baths, as well as electrotherapy, massages and hydroelectric baths may be used, although their effectiveness has yet to be proven.
In this respect, particular emphasis must be placed on daily physiotherapy. Additional group therapy under the direction of a physiotherapist is recommended.
Surgical treatment is rare for ankylosing spondylitis.
If the chronic inflammation progresses so far that a joint is destroyed or badly damaged, a joint replacement may be necessary. Especially the hip joints are affected, which can be replaced in an operation with an artificial hip joint.
In case of strong curvature of the spine, vertebrae can be joined together to restore the spine's erection - for example, if eye contact with other people is no longer possible.
Ankylosing spondylitis is a non-infectious inflammation of the spine and joints and is a member of the rheumatoid family of diseases.
Our specialised clinics for diagnostics, treatment & therapie of ankylosing spondylitis and deformities of the spine.