Ankylosing spondylitis

Bechterew’s disease: causes, symptoms and treatment methods

Bechterew’s disease: causes, symptoms and treatment methods

Understanding Bechterew’s Disease: Key Aspects and Causes

Ankylosing spondylitis, or Bekhterev’s disease, is a chronic inflammatory disease that mainly affects the joints of the hip and spinal regions. The primary cause of the pathology is an autoimmune reaction of the body, which results in inflammation in the joints and ligaments, leading to thickening and fusion of the joint surfaces.

Although the exact causes of Bekhterev’s disease are not yet fully understood, it is known that genetic predisposition plays an important role in its occurrence. Hereditary factors, as well as the influence of external triggers such as infections or injuries, can provoke the onset of the disease. An important aspect of understanding Bekhterev’s disease is timely diagnosis and comprehensive treatment involving a rheumatologist and physiotherapist.

Etiology of Bechterew’s disease

Aconitase, a metabolic enzyme, plays a key role in the etiology of Bechterew’s disease. Damage to this enzyme may reduce the production of keto-carbohydrate soluble organic acids, which in turn contributes to the development of inflammation. It has also been found that genetic factors, including associations with HLA-B27 antigens, play a significant role in susceptibility to the disease. These factors interact with environmental elements, such as infections or injuries, which promote the development of Bechterew’s disease.

  • Metabolic defects: Disorders in the function of aconitase can lead to a decrease in the production of ketosoluble organic acids, promoting the development of inflammation.
  • Genetic predisposition: The association with HLA-B27 antigens is a key genetic factor in the development of Bekhterev’s disease.
  • Environmental factors: Infections, injuries, and other external factors can activate the immune system and contribute to the development of the disease.
  • Neuroimmune disorders: The interaction between neurons and the immune system may play a role in the pathogenesis of Bekhterev’s disease.
  • Microorganism influence: Some studies link the onset of Bekhterev’s disease with infections such as Chlamydia, which enhance inflammatory processes.

The clinical picture of Bechterew’s disease

The clinical picture of Bechterew’s disease is characterized by gradual symptoms, such as chronic pain and stiffness in the lumbar area. Patients often face limited mobility of the back, especially after prolonged periods of rest or overnight sleep. Furthermore, the disease can lead to inflammation of the joints, primarily the hip and knee joints, causing pain and discomfort during movement.

Another common symptom of Bechterew’s disease is fatigue and loss of energy, which affects the patient’s quality of life. Some patients also report issues with sleep and psychological disorders, such as depression. Therefore, it is important to consider not only the physical manifestations of the disease but also the psychological aspects for a comprehensive approach to the treatment and management of Bechterew’s disease.

  • Pain and stiffness in the lower back: characterized by chronic pain and limited mobility of the spine.
  • Joint inflammation: hip and knee joints are especially affected, causing pain and discomfort.
  • Fatigue and loss of energy: patients experience general weakness and decreased energy, affecting their activity and life overall.
  • Sleep problems: some patients face sleep disturbances, which can further worsen their physical and emotional state.
  • Psychological disorders: ankylosing spondylitis can be accompanied by depression and other psychological problems that require attention and correction.

Expert opinion on the treatment of Bechterew’s disease

The treatment of Bechterew’s disease is a complex task that requires an individualized approach under the guidance of experienced rheumatologists. Experts emphasize the importance of early initiation of therapy to control symptoms and prevent disease progression. The foundation of successful treatment lies in a combination of pharmacological medications, physiotherapy, rehabilitation, and physical exercises specifically designed to improve the patient’s mobility and overall condition.

Experts also note the importance of educating patients in self-management and supporting them in their efforts to combat the disease. The psychological state of patients and their quality of life play a significant role in the course of the disease, so psychological support and social assistance are also important components of successful treatment of Bechterew’s disease.

Methods of diagnosing Bechterew’s disease

The diagnosis of Bechterew’s disease includes a set of methods, starting with clinical examination and medical history aimed at identifying characteristic symptoms such as limited mobility in the lumbar region and inflammatory changes in the joints. Additional methods include laboratory tests, such as blood tests for the presence of inflammatory markers and the determination of the level of the HLA-B27 antigen, which is often associated with Bechterew’s disease. Typically, modern diagnosis includes X-rays, magnetic resonance imaging, and computed tomography to visualize changes in the joints and spine, allowing for an accurate diagnosis and the initiation of appropriate treatment.

  • Clinical examination and history: the doctor conducts an investigation of the symptoms and asks the patient about their complaints and medical history.
  • Laboratory tests: include a blood test for inflammation markers, such as C-reactive protein (CRP) and a test for the HLA-B27 antigen.
  • X-ray: used to visualize changes in the joints and spine, such as joint fusion and inflammatory processes.
  • Magnetic resonance imaging (MRI): provides a more detailed image of the spine and joints, allowing for the detection of inflammatory changes and deformities.
  • Computed tomography (CT): used for a more accurate examination of the spine and joints, especially in the presence of deformities and changes that may not be visible on X-rays.

Methods of treating Bechterew’s disease

Treatment of Bechterew’s disease usually involves a combination of pharmacological and non-pharmacological methods. Non-steroidal anti-inflammatory drugs (NSAIDs) are often used to reduce inflammation and alleviate pain. Short courses of oral glucocorticoids may also be used to manage symptoms during flare-ups. Physiotherapy and exercises to improve the mobility of the back and joints are also important components of treatment.

In addition, it is important to lead a healthy lifestyle with regular exercise, maintain a normal weight, and avoid adverse habits such as smoking. In some cases, when conservative therapy is ineffective, surgical intervention may be considered, especially in the presence of severe joint deformity or significant deterioration of the patient’s quality of life.

  • Non-steroidal anti-inflammatory drugs (NSAIDs): Used to reduce inflammation and alleviate pain in patients with ankylosing spondylitis.
  • Physical therapy and exercises: Aimed at improving the mobility of the back and joints, which helps reduce symptoms and improve the quality of life.
  • Oral glucocorticoids: Short courses may be prescribed to control symptoms of disease flare-ups.
  • Healthy lifestyle: Includes regular physical activity, maintaining a normal weight, and avoiding harmful habits such as smoking.
  • Surgical intervention: Considered in cases where the patient does not respond to conservative treatment and has severe joint deformities or significant deterioration of quality of life.

Prevention of Bechterew’s disease

Prevention of Bekhterev’s disease is aimed at reducing the risk of occurrence and progression of the disease. Regular moderate physical exercises, maintaining a healthy weight, and proper body posture while sitting and standing can help reduce the strain on the spine and joints, which contributes to the prevention of Bekhterev’s disease. Avoiding harmful habits, such as smoking, also plays an important role, as it can exacerbate the inflammatory process.

In addition, early consultation with a specialist at the first signs of the disease, regular monitoring by a rheumatologist, and adherence to prescribed therapy can help in controlling and managing the disease. It is important to follow the individual treatment plan and adhere to the doctor’s recommendations to maintain overall health and prevent the development of complications.

  • Regular physical exercise: Moderate physical activity helps strengthen muscles and ligaments, as well as improve joint mobility.
  • Maintaining a healthy weight: Excess weight puts additional stress on the joints, so it is important to monitor body mass.
  • Correct posture: Maintaining the correct body position while sitting, standing, and walking helps prevent unnecessary strain on the spine and joints.
  • Quitting smoking: Nicotine and toxic substances in tobacco smoke can exacerbate inflammation and affect cartilage tissue, so avoiding smoking is crucial for disease prevention.
  • Regular check-ups with a doctor: Regular medical examinations by a rheumatologist can help detect early signs of disease and initiate treatment at an early stage.

Interesting aspects of Bekhterev’s disease

Ankylosing spondylitis, although classified as a rheumatic disease, has a wide range of symptoms, including back pain, limited mobility, and inflammatory changes in the joints. One interesting aspect of this disease is its association with the HLA-B27 antigen, which is found in most patients with ankylosing spondylitis. This genetic connection highlights the importance of hereditary factors in the development of the disease.

Another interesting aspect is that ankylosing spondylitis is more often diagnosed in men and frequently starts at a young age. Patients with this condition may face not only physical limitations but also psychological aspects, such as depression due to chronic pain and disruptions in daily life. Thus, studying the interesting aspects of ankylosing spondylitis may help in understanding its features and developing personalized approaches to diagnosis and treatment.

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