Ankylosing spondylitis, also known as hunchback, is a rheumatic disease affecting the spine that occurs at a young age and is mostly seen in young people. It is a condition in which the spine loses its flexibility over time, resulting in hunchback. Although it is not only in the waist and spine in the body, it can cause inflammation in the area where it is located and cause restriction of movement. When left untreated, ankylosing spondylitis can greatly affect the quality of life of the person and can cause difficulty in performing daily routine activities. Therefore, early treatment is important for the course of the disease.
What is ankylosing spondylitis (hunchback)?
Ankylosing spondylitis (hunchback), also known as spinal or lumbar rheumatism, is a rheumatic, inflammatory and painful disease that targets the spine. It causes the vertebrae to fuse with each other over time, fusing into a single bone and the spine becomes less flexible and the bone forms a curved form.
The lower part of the spine, between the sacroiliac joint and the pelvic bones, is the first part of the spine to be affected. While the entire spine can be affected over time, the disease can also spread to areas such as the hips, knees, neck, ankles and ankles in addition to the lumbar region, causing inflammation in these areas and restriction of movement in these areas.
Ankylosing spondylitis (AS) can be a disease that can significantly reduce an individual's quality of life. Although most people with AS can cope with the disease, in cases where the disease progresses, the movement of the spine can be restricted and the bone can be greatly affected. Ankylosing Spondylitis is a less common disease compared to kyphosis, and it is often confused with other conditions such as herniated discs, osteoarthritis and osteoporosis. Ankylosing spondylitis differs from these diseases in that it develops in young adulthood.
There is no definitive and permanent treatment for ankylosing spondylitis, which is more common in men than in women. However, there are some treatment methods that can be done to reduce symptoms and prevent the progression of the disease.
What Causes Ankylosing Spondylitis?
Genetic factors play an active role in Ankylosing Spondylitis. Among these hereditary factors, the gene known as HLA-B27 is known to be effective in developing AS disease. However, the HLA-B27 gene is not seen in every patient with ankylosing spondylitis. Age and gender also play a decisive role in AS.
What are the Complications of Ankylosing Spondylitis?
- The symptoms of ankylosing spondylitis, the damage it leaves or the severity of the disease on the person will vary from person to person.
- The loss of flexibility of the spine can cause difficulty in moving the head, neck and body. At the same time, flattening of the lower back, hunchback and calcification in the areas where the disease affects the body can be seen.
- Ankylosing Spondylitis can cause eye inflammation and is one of the most common complications of this disease. It is usually seen in one eye. It may occur with symptoms such as redness, tenderness and blurred vision.
- As a result of the inflammation and restriction of movement in the spine in AS, there is a decrease in mineral density in the bone, i.e. osteoporosis. This leads to a collapse-induced fracture in the spine. This can lead to hunchback, severe pain and loss of function due to pressure on the spinal nerve.
- People may experience shortness of breath due to the involvement of the lung capacity. Due to inflammation of the ligaments that hold the ribs to the rib cage, the rib cage cannot flex sufficiently with breathing. In rare cases, inflammation of both lobes of the lung can be observed.
- In rare cases, kidney involvement may also occur as a complication of uncontrolled AS over a long period of time. There is an increase in protein excretion in the kidneys called amyloidosis. This disease can cause kidney failure.
- Inflammatory bowel disease can also be seen in patients with ankylosing spondylitis.
- Skin rashes similar to psoriasis can be seen.
- Rarely, aortic valve insufficiency and consequent heart failure may occur.
- Cauda equina syndrome may occur with severe nerve compression. This rare neurological disorder requires surgical intervention.
What are the Symptoms of Ankylosing Spondylitis?
Symptoms of ankylosing spondylitis can be brought to the agenda with low back and hip pain caused by staying in the same position for a long time or inactivity. It is accompanied by neck pain and fatigue. These pains can become severe, occurring at irregular intervals. From time to time, the pain may ease or stop completely.
It has been observed in frequent cases of ankylosing spondylitis that the most affected parts of the body are the joint between the base of the spine and the pelvis, the vertebrae in the lower part of the spine, especially the parts of the spine where tendons and ligaments are located and connected to the bones up to the back of the heels of the feet, the sternum and ribs, hip and shoulder joints.
How is Ankylosing Spondylitis Diagnosed?
Ankylosing spondylitis is diagnosed after an orthopedist or physical therapist performs a physical examination and listens to the patient's medical history. In cases such as failure to respond to herniated disc treatment, the patient is referred to a specialist in the field of rheumatism with suspicion of ankylosing spondylitis and this physician makes the definitive diagnosis.
The patient's history plays an important role in the diagnosis of AS. Low back pain lasting 3-4 months or longer may be inflammatory low back pain. In this case, the patient will be diagnosed with AS. However, radiological imaging methods and laboratory tests are often used to make a definitive diagnosis.
How is Ankylosing Spondylitis Treated?
In cases where Ankylosing Spondylitis is not serious, patients with sacroiliac joint and spine involvement are treated with painkillers that do not contain cortisone. If there is no positive response, anti-rheumatic drugs are used to change the course of the disease. If there is still no response to treatment, some biologic agents can be used. These drugs help to prevent pain and joint swelling. While the main aim of AS treatment is to relieve pain, stiffness or swelling, it is also aimed at preventing complications of the disease. Other main goals include preventing deformation of the spine and slowing its development.
In the treatment of ankylosing spondylitis, the treatment process can be successful if the disease is prevented before it causes serious damage to the joints.
Apart from medication, physical therapy also plays an important role in the treatment of AS. Physical therapy applications are important in preventing or reducing pain and restoring lost strength and flexibility. However, surgical intervention may be used in patients with severe pain and joint damage or in cases where the hip joint needs to be replaced. However, most patients with ankylosing spondylitis do not require surgery.
What are the lifestyle changes for ankylosing spondylitis and how should home care be?
- People with AS should visit their doctor regularly, take the medications prescribed by the doctor regularly and avoid using medications that are not recommended by the doctor as much as possible.
- An active lifestyle is also beneficial for these patients. Regular exercise and sports will be effective in relieving pain, maintaining flexibility and preventing posture disorders.
- Ankylosing spondylitis patients should not smoke. Since AS disease compresses the lungs and makes breathing difficult, not breathing fresh air in smokers can cause extra problems.
- It is important to correct posture by maintaining a correct posture during the day. For example, standing upright or sitting upright during the day will be healthy to prevent progression of ankylosing spondylitis and complications of the disease.
- Heat compresses to relax muscles and joints can help prevent pain and stiffness. Heat patches, hot towels, taking a hot shower are among the methods that can be good.