Ankylosing spondylitis (also called spondylosis) is a chronic inflammatory disease that predominantly affects the sacroiliac and spine joints and clinically dominated by back pain and hip pain. It has a prevalence of 1% and is more common in men.
The debut: It is an insidious disease and occurs in late teens or early adulthood younger than 40 years. Is manifested by pain in the lumbosacral or buttocks, with inflammatory character (diminished by exercise, unimproved at rest, usually occurs in the 2nd half of the night). Pain persists more than 3 months. In the morning there is pain in the joints at mobilization (morning stiffness). Back pain can accompany a pain which radiates through thigh and knee. There may be enthesitis (inflammation of the bone insertion of ligaments and fascia). There may be other general signs: fatigue, anorexia, fever, weight loss, night sweats.
The symptoms of ankylosing spondylitis change during disease evolution: pain climbs to the cervical region, pain at compression of hip-joint, paravertebral muscles contractions, morning stiffness lasts more, specific lumbar curvature disappears. It can be seen a limitation of thoracic expansion, difficulty or impossibility of doing specific maneuvers for assessment of joint mobility: finger-ground, chin-chest, occiput-wall, head rotation.
In the advanced stage of ankylosing spondylitis appear coxitis (hip-joint inflammation), spinal kyphosis, ankylosis and joint immobility.
Complications of ankylosing spondylitis
Joints complications: If there is administered no treatment it can occur characteristic changes in posture by spine stiffen joints: lumbar spine without lordosis, buttocks muscles atrophy, thoracic kyphosis, bending forward of the head, knee flexion for compensation of hip damage.
Other organs may be affected simultaneously:
– Acute anterior Uveitis – can precede spondylitis, tends to recur, sequelae (cataract, glaucoma);
– Aortitis with aortic insufficiency, third-degree atrioventricular block;
– Pulmonary fibrosis;
– Neurological manifestations;
Treatment of ankylosing spondylitis
You have to follow a diet with foods rich in vitamins, salt restriction during administration of NSAIDs (anti-inflammatory). We also recommend physiotherapy, sports (swimming) and bed rest (sleep) will be made on a strong plan.
Drugs: indomethacin, phenylbutazone, diclofenac, piroxicam, Movalis, celecoxib (Celebrex 200 mg / 24 hours) – anti-inflammatory. Glucocorticoids orally effects (pills) are small, local administration irritates the skin, best effects appear when are injected intra-articular. Also, It can administered methotrexate, sulfasalazine, cyclophosphamide in severe cases.
There are also cases of ankylosing spondylitis with severe pain of the joints, which were deformed and require orthopedic surgery treatment (osteotomy, arthroplasty).