Ankylosing spondylitis is a systemic disease characterized by a chronic inflammatory lesion of the joints of the spine, the parotid tissue, and the sacroiliac joint with ankylosing of the intervertebral joints. In men, this disease occurs much more often than in women, in about 3 to 1 cases (Eashwar et al. 2759). Symptoms include aching indistinct pain in the sacrum, or on the outer surface of the thighs, especially at night; stiffness in the back after a long period of rest. Later, there is pain and stiffness in the thoracic, cervical spine. The pain appears with deep breathing, coughing, sneezing. There is an increasing restriction of the mobility of the spine. There may be arthritis symptoms, mainly of the lower extremities joints, and recurrent inflammatory diseases of the eyes.
The history of Ankylosing Spondylitis begins around the same time when the skeleton with various spinal deformities was discovered. The clinical features of the structure of the spine and the pathological ones were compared, as a result of which this disease was found. Further studies were conducted by studying genetic and epidemiological data, which revealed the connection of certain conditions with Ankylosing spondylitis.
During the disease study, various treatment methods were discovered based on the data found on inflammatory pathways. Garcia-Montoya et al. claim that despite all the current achievements in the field of methods of treating this disease, it is still not thoroughly studied, and new information is emerging (4). In the future, it is necessary to continue studying the cause of the disease, preventive measures, and treatment methods at late stages.
Most often, the disease begins with sacroiliitis, which is manifested by pain in the lower back (lower back area). Sometimes, a person may feel pain in the neck or at the thoracic spine level. Often people note pain, limited mobility, and swelling in the peripheral joints, for example, the shoulder, hip, small joints of the hands and feet, temporomandibular. The disease can also cause extra-articular manifestations – lesions of organs: heart, kidneys, eyes. The latter is most common and is manifested by uveitis (pain, photophobia, redness of the eye). Among the associated conditions is the presence of psoriasis, inflammatory bowel diseases, intestinal or genitourinary infections.
In ankylosing spondylitis, reflex syndromes often occur, caused by irritation of the receptors in response to changes in the spine’s discs, ligaments, and joints. Impulses from the receptors reach the motor neurons of the spinal cord, which is accompanied by an increase in the tone of the corresponding muscles. One of the symptoms of such dysfunction is a symptom caused by a spasm of the long muscles of the back. Spasmodic muscles lead to limited mobility of a particular segment of the spine and become a secondary source of pain, contributing to the formation of the myofascial syndrome.
Treatment is carried out in several stages; therefore, it requires an integrated approach and the availability of the necessary equipment for diagnosis and rehabilitation programs. After confirming the diagnosis, it is essential to relieve pain and stop the inflammatory process by taking non-steroidal anti-inflammatory drugs (Zhu et al. 8). They can inhibit ankylosing of the spine, reduce the inflammatory response, improve the prognosis of the disease, increase the volume of movements, and at the same time can be used as painkillers. Xi et al. also suggested using corticosteroids, that is, hormones, as an anti-inflammatory agent (8527).
The drugs block the self-sustaining inflammatory process and stop the mechanism of the disease. To relieve pain, physiotherapy methods can be used: massage, acupuncture, physical exercises and other methods (Mahmood & Helliwell 137). Their disadvantage is that they do not give a long-term stable effect.
Surgical treatment may be required to correct conditions associated with a complication of the course of the disease, for example, with pronounced deformities of the spine, vertebral fractures, destruction of the hip joints, and heart damage. When planning an operation, it is necessary to pass all the appropriate examinations. Nevertheless, doctors primarily strive to help non-surgically stop the disease and minimize its negative impact. Different treatment methods are suitable for other cases, and in some of them, there is simply no possibility not performing the surgical intervention.
Side effects from treatment occur with prolonged use of certain medications, as well as with dose increases. For example, when taking nonsteroidal anti-inflammatory drugs without control, people have problems with the gastrointestinal tract, drowsiness, and weakness. Taking corticosteroids is even more dangerous in terms of side effects. They cause diabetes, cataracts, thinning of the skin, and destruction of the hip bones. Therefore, until now, the effectiveness of corticosteroids in ankylosing spondylitis has not been fully proven.
In conclusion, ankylosing spondylitis is a serious disease of the spine. There are still no methods of a complete cure for this disease, which is the goal for further research. This disease causes prolonged severe pain to a person, and therefore a certain treatment was formed. Treatment is aimed at relieving pain, as well as facilitating existence. Despite the fact that quite a lot of surgical solutions have been invented, it is still necessary to fully study how this disease manifests itself in a person primarily.
Arthritis National Research Foundation. Ankylosing spondylitis of the spine. 2020. Web.
Eashwar, Anantha, Dinesh, Telaganeedi & Gopalakrishnan. “Ankylosing Spondylitis – A Review Article.” Drug Invention Today, vol.12, no.11, 2019, pp. 2759-2763.
Garcia-Montoya, Leticia, Gul, Hanna & Emery, Paul. “Recent Advances In Ankylosing Spondylitis: Understanding The Disease And Management.” F1000 Research, vol.7, no. 1512, 2018, pp. 1-11.
Mahmood, Farrouq & Helliwell, Philip. “Ankylosing Spondylitis: A Review.” European Medical Journal, vol.2, no.4, 2017, pp. 134-139.
Xi, Yanhai, Jiang, Tingwang, Chaurasiya, Birendra, Zhou, Yanyan, Yu, Jiangmin, Wen, Jiankun, Shen, Yan, Ye, Xiaojian & Webste, Thomas. “Advances In Nanomedicine For The Treatment Of Ankylosing Spondylitis.” International Journal of Nanomedicine, vol.14, 2019, pp. 8521-8542.
Zhu, Wei, He, Xuxia, Cheng, Kaiyuan, Zhang, Linjie, Chen, Di, Wang, Xiao, Qiu, Guixing, Cao, Xu & Weng, Xisheng. “Ankylosing Spondylitis: Etiology, Pathogenesis, And Treatments.” Bone Research, vol.7, no.22, 2019, pp. 1-16.