Ankylosing spondylitis (ankylosing spondylitis) - symptoms and treatment

Ankylosing spondylitis is a chronic joint disease that occurs systemically primarily in the spinal region. Manifests itself in the form of limited mobility of the affected area. Most often, ankylosing spondylitis occurs in men aged 15-30 years. Women are approximately 7-9 times less likely to get the disease. The disease was first considered by Russian academician V.M. Bekhterev and was named after the researcher.

Description of ankylosing spondylitis

The disease is chronic in nature, manifesting itself systemically in the body. Belongs to the group of seronegative polyarthritis. The mechanics consist of active damage to the joints of the spine, large and rarely small joints of the extremities. There is damage to the connection of the sacrum with the iliac bone of the pelvis. As a result, the patient is completely immobilized. Ankylosing spondylitis ICD 10 affects not only the osteoarticular system, but can develop in internal organs: kidneys, heart, iris. The combination of lesions is different.

Bekhterev's joint disease has the following features:

1. Moderate and moderate pain is observed in the area of ​​the femur, lower back, and back. Occurs in the morning and evening;
2. Due to daily physical activity, back discomfort is somewhat reduced;
3. The first sign that ankylosing spondylitis in men affects the joints appears between the ages of 15 and 30;
4. As the pathology develops, an increase in pain is observed;
5. In approximately 10% of cases, the disease manifests itself at an early age. Children suffer from damage to the knees, hip joints, and big toes. As you get older, your spine becomes affected.

Ankylosing spondylitis code according to ICD 10 manifests itself differently in men and women. In the stronger sex it manifests itself brightly, with a sharp aggravation of pain. Calm periods are short. Small joints are predominantly affected. The period of manifestation before the first signs of pathology lasts from 4 to 5 years. Men are susceptible to damage to all parts of the spine, which leads to curvature and limited mobility. Accompanied by damage to the vascular system and internal organs.

Ankylosing spondylitis develops in women after 40 with mild symptoms and rare acute pain. Long periods of calm occur. The time until the first symptoms appear lasts from 10 to 20 years. Mainly the spine and large joints are affected. Pain and pathology are localized in the sacral and lumbar regions. Damage to internal organs and blood vessels is rare.

Often ankylosing spondylitis ICD indicates the development of concomitant diseases, which include:

• Acute purulent arthritis;
• Inflammation of the bone - osteomyelitis;
• Sepsis;
• Limitation of foot mobility;
• Pathological dislocation.

Most patients testify that ankylosing spondylitis in women and men manifests itself in the form of pain for a period of at least three months. Inflammatory processes manifest themselves in various combinations, up to damage to the iris of the eyes.

Expert opinion

Author:

Andrey Igorevich Volkov

Neurologist, Candidate of Medical Sciences

Difficulties in diagnosing ankylosing spondylitis are associated with the similarity of the pathology in the early stages with other degenerative lesions of the musculoskeletal system. According to world statistics, ankylosing spondylitis is detected in 0.5-2% of the population. The ratio of sick men to women is 9:1. In the structure of disability, ankylosing spondylitis occupies a leading position. Without correct treatment, the pathology leads to persistent impairment of self-care and loss of ability to work.

The Yusupov Hospital uses the latest CT and MRI equipment to diagnose ankylosing spondylitis. In a modern laboratory, blood parameters are determined, changes in which indicate the possible development of ankylosing spondylitis. All necessary tests are prescribed by experienced neurologists. Treatment is selected for each patient, taking into account the characteristics of the disease. The task of doctors is not only to stop the exacerbation of symptoms, but also to select preventive therapy. At the moment, it is impossible to completely get rid of the disease. Doctors have the power to achieve stable remission and prevent the condition from worsening. In the conditions of the Yusupov Hospital, it is possible to carry out innovative therapy using stem cells.

Statistics and etiology of the disease

The first mentions of cases of ankylosing spondylitis are found in medical records of the European Middle Ages. Doctors of that time were quite surprised to discover skeletons with characteristic ossification of the spine, the individual elements of which formed a strong “bone” column. In the mid-19th century, the disease became the subject of general medical study, as evidenced by surviving records of patient complaints and examinations of deceased people. The works of the Russian doctor Vladimir Bekhterev, the German Adolf Strumpel and the Frenchman Pierre Marie are accepted as the basis of etiology and are currently being studied in medical institutions.

Current statistics on ankylosing spondylitis indicate a gender link. In men it occurs 4-6 times more often and has a more aggressive, accelerated course than in women. The latter note:

• low degree of pain syndrome;
• preservation of full spinal function for a long time;
• arthritis occurs with long-term remission;
• signs of sacroiliitis (inflammation of the sacroiliac joint) are recorded relatively rarely.

The area of ​​development of the pathological process is the spine, large joints of the lower extremities and the sacroiliac joint. With extra-articular localization, the first signs of the disease are damage to the eyeballs in the form of redness of the sclera, inflammation of the iris or cornea. Characteristic signs are observed in 5-10% of patients, which in some cases makes it possible to make an accurate diagnosis at the initial stage of development of ankylosing spondylitis. Less common is an alternative onset of pathology in the form of inflammation of the walls of the aorta or muscle fibers of the heart muscle, developing against the background of an actively occurring pathological process in the joints of the spinal column.

Causes and mechanisms of occurrence of ankylosing spondylitis

The reasons why the disease progresses are not precisely determined. Most scientists assume the influence of immune cells in relation to joint tissues and ligaments. Additionally, development is associated with genetic predisposition. People suffering from ankylosing spondylitis are carriers of the HLA-B27 antigen. It is this gene that causes pathology in the functioning of immune cells.

Ankylosing spondylitis, the causes of which affect the immune system, can be caused by systematic hypothermia and acute or chronic infectious disease. Factors such as fractures of the pelvis, spine, and frequent sports injuries contribute to the development of pathology.

Immune cells attack not only the spine; large joints and limbs are also affected. The disease affects the functioning of the heart, lungs, kidneys and genitourinary system. Thus, ankylosing spondylitis has the following causes of development:

1. Heredity. The disease affects 2-3 family members;
2. Infectious diseases. The risk factor has not been fully established; However, there has been a connection between joint damage and the functioning of internal organs;
3. Immune disorders. Increased levels of immunoglobulins and immune complexes.

The mechanism of development is the formation of an inflammatory process in the tissues of the joint. The intervertebral discs and ligaments are gradually affected. Gradually, the connective tissue elastic structures are destroyed and overgrown with bone tissue. As a result, the spine completely loses mobility. A similar situation occurs with large and small joints.

Cause of the disease

The cause of ankylosing spondylitis has not yet been clarified. There are certain risk factors:

• Heredity (at least 20%).
• Previous infectious disease of the intestines or genitourinary system.
• Increased activity of one of the species of bacteria Klebsiella pneumoniae and some strains of Yersinia enterocolitica
• restless legs disease - occurs in patients with ankylosing spondylitis almost 3 times more often than in healthy people;
• birth weight less than 3 kg;
• hospitalization with infectious diseases between the ages of 5 and 12 years.

Doctors have long known about the histocompatibility gene HLA-B27, the presence of which increases the risk of developing the disease by 80 times. Research from 2011 identified several genes involved in the development of ankylosing spondylitis by interacting with HLA-B27. For example, some variants of the ERAP1 gene increase a person’s susceptibility to the disease, while others, on the contrary, protect against it.

During this process, immune aggression occurs against the musculoskeletal system (inadequate immune response). The immune system mistakenly and aggressively perceives some body tissues as foreign, which is why ankylosing spondylitis belongs to the category of autoimmune diseases.

Forms of ankylosing spondylitis

Depending on the form of development, certain organs are affected. The following are distinguished:

1. Central. With this form, damage to the spine is observed. Manifests itself in one of the following variants: kyphosis, accompanied by kyphosis of the chest and hyperlordosis in the cervical region; as well as rigid, where the pathology is localized in the lumbar and thoracic regions, which leads to complete straightness of the back;
2. Rhizomelic. Changes are observed in the shoulder and hip root joints;
3. Peripheral. Damage to the spine occurs along with inflammation of peripheral joints, for example, the elbow or knee;
4. Scandinavian. The course of the disease resembles the initial stage of rheumatoid arthritis. Leads to damage to small joints.

Additionally, the visceral form is distinguished. Characterized by damage to the spine and joints. This form is accompanied by disruption of the functioning of internal organs.

Symptoms of ankylosing spondylitis in women and men

At the initial stage, ankylosing spondylitis has no symptoms or they are subtle. However, signs of development may be different. In approximately 70% of cases, patients complain of pain in the lumbar region. In 20% of pain occurs in peripheral joints. And only 5% of patients experience eye damage in the form of iritis or iridocyclitis.

However, after a number of studies, it was possible to prove that the first signs appear in periodic pain localized in small and large peripheral joints. Approximately more than 60% of patients suffer from an unstable form of arthritis. Ankylosing spondylitis symptoms in men occur more often in the form of acute pain in the lumbosacral region, which radiates to the gluteal muscles or heart, depending on the form of the disease.

Thus, the primary localization appears in the area of ​​the peripheral joints. However, the likelihood of this manifestation is insignificant. Rarely, ankylosing spondylitis is indicated by pain in the cervical spine, which appears mainly in the morning. During the day, the stiffness of the section disappears due to mobility. Inflammatory processes in the heels occur less frequently, particularly in the area of ​​the Achilles tendon.

Often during the disease there is a dull, lingering pain that is localized in the lumbosacral region. The first signs of pathology are identified in the form of crises, which then continue for several days and sometimes months. This pain intensifies at night.

The characteristics of the first symptoms are variable, which complicates diagnosis and treatment. On average, there are several variants of signs of pathology. These include:

1. When the sacral area becomes inflamed, pain and accompanying inflammation are observed. Discomfort gradually increases, accompanied by joint damage;
2. In adolescence, ankylosing spondylitis manifests itself in the form of monooligoarthritis, which is unstable and asymmetrical in nature. As inflammation develops, symptoms of sacroiliitis develop;
3. In childhood and adolescence, the onset of the disease occurs in the form of polyarthritis. The pain is of a flying type, slight swelling of the affected area is possible. Small and large peripheral joints are subject to inflammation. There is an increase in body temperature and increased heart rate.

In rare cases, it is characterized by an acute form of fever in a stable form. During the day, sweating, fever, and chills occur. The patient loses weight, trophic disorders develop. At the same time, polymyalgia and polyarthralgia develop. After a few weeks, a type of arthritis occurs.

Extra-articular localization is accompanied by eye damage. Iritis or iridocyclitis develops. In rare cases, carditis and aortitis may occur, which increases inflammation. After several months of development of concomitant diseases, sacroiliitis appears.

Examination of the early stage of development of ankylosing spondylitis is almost impossible to correctly diagnose. It can be determined only by the patient’s characteristic complaints: weak mobility of the spine in the morning, which disappears during the day. During the examination, the patient indicates stiffness of the vertebrae, there is a slight manifestation of dorsal kyphosis, and difficulty performing the respiratory function.

Ankylosing spondylitis in women, symptoms and concomitant diseases, proceeds slowly. Men experience progression three to four times faster. Lack of timely treatment leads to complete loss of joint mobility. Clinical manifestations depend directly on the site of development. Most often, damage occurs from the bottom up.

The main symptoms include the following:

• A sharp increase in fatigue;
• Limitation of vertebral mobility;
• Disturbance in sleep and wakefulness due to pain;
• Discomfort in the back and joints;
• Difficulty breathing due to damage to the sternoclavicular joints;
• Development of arthritis;
• Rachiocampsis;
• Loss of mobility.

Ankylosing spondylitis in women, symptoms and treatment accordingly, manifests itself as a protracted illness, often occurring in the lumbosacral region. The pain occurs at night and intensifies in the morning. They can be described as inflammatory processes.

Symptoms vary according to the stage of the disease. During the first stage, the following pathologies are distinguished:

1. Stiffness of movement, which manifests itself in the morning and after a long stay in one position. Occurs during gymnastics;
2. Discomfort in the area of ​​the sacrum and hip joint;
3. Pain in the chest. Especially when coughing and taking a deep breath;
4. Feeling of lack of air;
5. Fatigue and irritability.

In later stages, the disease is characterized by the following symptoms:

1. Signs indicating radiculitis are observed. There is unbearable pain in the spine, numbness of the limbs;
2. Deterioration of blood supply to the brain;
3. Feeling of suffocation due to decreased movement of the chest. This results in dysfunction of internal organs;
4. Increased blood pressure;
5. There is a change in the shape of the spine, its mobility is lost.

Application therapy Lyapko

Lyapko applicators in various modifications (plates, rollers, application belts, application tapes) are an original, powerful device with many health-improving therapeutic capabilities.

Their action is based on the principles of traditional Chinese medicine - superficial multi-needle acupuncture, as well as on the general physiological mechanisms of life.

Mechanisms of action of the applicator

The high healing effect of Lyapko applicators is due to a combination of intense reactions:

• reflex-mechanical;
• galvano-electric;
• immunological.

Application therapy has a pronounced analgesic and antispasmodic effect. Improves blood circulation, lymph flow, microcirculation, reduces tissue swelling. Activates tissue mechanisms of immune defense, increases the level of its own opiate peptides and anti-stress hormones in the blood, reduces the level of sensitivity of pain receptors, has a positive psycho-emotional effect and, as a result, stimulates general human adaptation mechanisms. In contact with the skin, the applicator needles stimulate the release of a person’s internal medicines, engaging his “inner doctor” in the work.

Applicators are widely used in medical institutions, health centers and sanatoriums, and are compatible with all types of medication and physiotherapeutic treatment.

Ease of use, safety, high efficiency with minimal effort allow us to recommend applicators for independent use at home.

It is important to note that local (local) improvement of blood circulation during application therapy occurs without additional stress on the heart, since the work of peripheral circulation increases and the heart rests at this time. This is very important for all categories of patients and, especially, with coronary heart disease, circulatory failure of 1-2 degrees, and elderly people.

The therapeutic effect of the applicators is enhanced if they are applied to the skin, previously moistened with water, a hypertonic solution, or on a gauze pad with a decoction of medicinal herbs, water-based medications. After removing the applicator, all skin pores at the site of its application are opened and the application of medicinal oils, ointments and compresses is most effective.

How to use the applicator, application zones

In 90% of cases it is necessary to act on the pain zone, and to increase efficiency on additional and auxiliary zones.

The general formulation should always include the core area (spine area).

The main zones are located on the back surface of the torso, head, and neck.

They are named the main ones due to the fact that the areas of skin on both sides of the spine and directly above the spine are closest to the exits of the roots of the cranial and spinal nerves and other structures.

Auxiliary zones are the anterior surface of the torso, head and neck.

Due to the fact that the internal organs and endocrine glands are located directly under the anterior abdominal wall, under the chest, in the neck, face, exposure to them or to individual skin areas (metameres) in these areas using different metal needle applicators helps regulate, normalization, restoration, improvement and activation of the activities of these bodies. The result is achieved faster when using auxiliary zones simultaneously with the main and additional zones.

Accessory zones: zones of the skin of the lower and upper extremities, which are secondary (peripheral) in relation to the (central) structures of the spinal cord and brain.

Important. Since a common cause of all autoimmune diseases is past infectious diseases of the intestines or genitourinary system, it is imperative to restore the movement of lymph and blood in the abdomen.

Lyapko's application therapy is indicated for improving the functioning of the abdominal organs and intestines, where the largest amount of lymphoid tissue responsible for the functioning of the immune system is located.

To do this, it is recommended to use flat applicators on the lower thoracic and lumbosacral spine, in addition to the auxiliary area - the anterior abdominal wall (simultaneously or alternately), you can also wrap these areas with the “Health Magic Tape” for 20-30 minutes or roll these areas with application rollers for 10-15 minutes.

Lyapko's application therapy is used both as an independent procedure and as a preparation for relaxing the muscles of the anterior abdominal wall for visceral abdominal massage.

These procedures improve the functioning of internal organs, relieve congestion and inflammation in them, restore the functioning of the lymphatic system, and increase immunity.

It is recommended to use flat applicators of large sizes on the back area: Applicator “Large Mat”, “Large Needle Massage Mat”, “Chance 6.2x4”, “People’s”.

“Chamomile M”, “Quadro”, “Duet”. The larger the impact area, the better the effect.

It is also possible to use flat applicators of smaller sizes: “Needle massage pillow”, “Insoles plus”, “Chance”, “Sputnik plus”, which are placed on the pain area. In addition to the back area, to enhance the effect, it is recommended to use applicators on auxiliary zones on the front surface of the body, in the area of ​​pain projection. For example: pain in the lumbosacral spine - place the applicator on the lower abdomen. In addition, the use of applicators on the kidney area, adrenal glands (under control of blood pressure - do not use with high blood pressure), and on the abdominal area improves the functioning of the immune system. The exposure time is 20–30 minutes, the course of treatment is 10–14 days, which can be repeated after a break after 1–2 weeks. Such procedures can be used in courses for a long time.

It is better to complete the session by treating the feet using the Insole Plus applicator, which can also be used on all parts of the body.

In addition to flat applicators, you can roll the area of ​​the back, front surface of the body, arms, legs with the “Large Roller M” or “Universal Roller M” until the skin becomes uniformly pink in color. They can also be used to warm up the body before a massage.

First, roll along the spine, along the intercostal spaces on one side, until a uniform pink color appears. Then we roll the second side in the same way. Exposure time is 3–7–10 minutes depending on the individual skin reaction.

Belt “Baby”, Belt “Universal M” is attached across and along the spine to areas of pain or applied in a lying position, like a regular applicator.

You can also wrap the pain area with the “Health Magic Tape”.

The “Speck” applicator can be fixed on the pain area. Considering the small area of ​​influence, wearing is long - 1 - 3 hours.

You can use either a manual back massage or a massage using the Pharaoh massager, which can be used through thin fabric or over the body lubricated with oil or cream. The duration of the massage and its intensity determines the desired effect. Long lasting, up to 15 minutes. and more, massage promotes complete relaxation of muscles and creates a sedative (calming) effect.

After the massage, we recommend laying on a flat applicator for rest and relaxation.

For joint pain

If the joints of the upper extremities are affected, you need to use the applicators on the cervical-collar spine, from where the innervation comes to the upper extremities, then on the joint area.

If the joints of the lower extremities are affected, apply applicators to the lumbosacral spine, from where the innervation goes to the lower extremities, then to the joint area.

You can act simultaneously or alternately.

The “Chamomile M” applicator is especially convenient to use, which, thanks to its flexible “petals,” acquires relief for any part of the body. They can have an impact on any part of the spine, hip and knee joints (fixed with an elastic bandage); apply to calves and feet.

The exposure time for flat applicators is 20-30 minutes.

You can also use static-dynamic applicators: “Magic tape “Health”, belt “Universal M”, belt “Baby”. Uniform pressure to the surface of the body and ease of fixation allows you to move freely, do normal activities and receive treatment at the same time.

It is recommended to fix the applicator to the areas of damaged joints for 20-30 minutes; Additionally, you can use the areas of the opposite healthy side for 10-15 minutes. The procedure time is 20–40 minutes, the course of treatment is 1–2 weeks, treatment can be repeated after 2–4 weeks.

It is also necessary to massage the upper and lower extremities, the corresponding areas of the spine, joints, for example, using the Pharaoh massager, but you must avoid direct impact on the diseased joint, as this can increase the inflammatory reaction in it, work above and below the joint .

Diagnostics

Diagnosis and treatment are carried out under the supervision of the following specialists:

• Therapist;
• Vertebrologist - a doctor who deals with diseases of the vertebrae;
• Orthopedist;
• Rheumatologist.

Ankylosing spondylitis, the diagnosis of which involves a number of tests, is determined as a result of a preliminary examination, study of the medical history and the results of the study. Patients are prescribed the following measures:

1. Patients are prescribed an X-ray examination of the spine, CT and MRI;
2. A general blood test is taken to determine ESR levels;
3. Carrying out, if necessary, tests to determine the HLA-B27 antigen.

Additionally, a consultation with an orthopedist or neurologist is carried out. The disease must be differentiated from degenerative spinal problems. These include spondylosis and osteochondrosis. If ankylosing spondylitis develops at an early age, then DZP manifests itself from the age of 30. The Scandinavian form of the disease must be distinguished from rheumatoid arthritis, which usually manifests itself in women.

Treatment of ankylosing spondylitis

Therapy for ankylosing spondylitis involves an integrated approach. Treatment is lengthy and requires responsibility. Is it possible to cure ankylosing spondylitis? It is impossible to completely get rid of the disorder in the body. All measures are aimed at eliminating pain and reducing inflammation. Drug therapy involves:

1. The use of non-steroidal anti-inflammatory drugs such as Diclofenac, Indomethacin;
2. Glucocorticoids such as Prednisolone;
3. Immunosuppressants - Methotrexate, Leflunomide and others. Immunosuppressants are used to prevent tumor necrosis. Prescribed in cases where basic therapy has not produced results;
4. Drugs to normalize the functioning of the immune system: TNF-a inhibitors, inhibitor of B-cell activation.

The patient will have to perform a number of measures, the purpose of which is to prevent the process of ankylosis of the joints and spine, namely:

1. During the period of pain subsiding, therapeutic exercise therapy is carried out for ankylosing spondylitis. It is recommended to go skiing and practice in the pool;
2. If possible, carrying out balneological procedures;
3. It is necessary to attend phonophoresis with hormonal drugs, as well as paraffin therapy, ultrasound treatment;
4. It is important to regularly monitor your posture during treatment and rehabilitation;
5. Sleep only on a flat, hard surface;
6. The patient is prohibited from static loads on the spinal column, as well as any physical activity or exercise. Especially lifting weights.

The administration of corticosteroid hormones into the joint cavity is prescribed. Liquid nitrogen cryotherapy is performed on the spinal column. It is used to suppress pain and alleviate the patient's condition. Auxiliary procedures include back massage and hirudotherapy. However, they are allowed only in the remission stage. Treatment of ankylosing spondylitis with drugs aimed at relieving symptoms is selected individually.

A positive effect is observed from paraffin therapy and trips to the bathhouse. However, a hot bath or shower aggravates the disease. Most methods are selected on an individual basis in accordance with the nature of the disease and tolerability.

Diet preparation

Doctors recommend sticking to a protein diet. You should exclude flour products from the menu, refuse potatoes, pasta and any fatty foods. Nutrition for ankylosing spondylitis includes foods such as red grouse, eggs, cottage cheese, boiled meat, and vegetables.

Patients who frequently drink alcohol, sweet carbonated drinks, chips, etc. completely eliminate their use. This applies to smoking and drug use.

Exercise therapy and massage

Gymnastics for ankylosing spondylitis is a mandatory procedure in complex treatment. It is important that all exercises are vigorous and work the joints in amplitude. Turns, tilts and rotations are required. The joints should be used as much as possible. So, if you do it regularly for 30 minutes, you will see a positive effect.

Water aerobics has a quick positive effect. As an alternative, training in a dry pool using the Ugul apparatus is suitable. Massage is allowed to be used only in the remission stage. So the impact on the joints will not be too intense.

Organization of a sleeping place

The correct sleeping place will prevent the progression of the disease. Ankylosing spondylitis during the period of treatment and remission should completely abandon the pillow. Such measures will prevent the development of cervical lordosis. It is recommended to sleep on your stomach. As ankylosing spondylitis is eliminated by treatment, it is permissible to place a cushion under the head. Legs are kept straight.

Features of taking NSAIDs

The newest medications for ankylosing spondylitis are nonsteroidal anti-inflammatory drugs. Appointed for a year or more. The maximum course of treatment is five years. During the acute period, the maximum dosage is prescribed. As a positive effect is obtained, the amount of the drug decreases. Medicines are prescribed on an individual basis. In the absence of remission, a complete review of the diagnosis is carried out.

Other therapies

Medicine does not stand still. New treatment methods are regularly introduced. Ankylosing spondylitis, clinical recommendations have shown, can be overcome with the following alternative techniques:

1. Reducing inflammation in joints with Sulfasalazine. However, the therapeutic result is not noticed immediately, but only after 2-6 months;
2. Muscle tension is reduced with Tolperisone or Mydocalm;
3. Severe inflammatory processes are relieved by glucocorticoids. It is prescribed only in advanced forms, as it has a high risk of developing complications of the digestive system. high risk of diabetes, osteoporosis. I received positive reviews of sulfasalazine for ankylosing spondylitis. The result is noticeable after a month of use;
4. In the final stages, cytostatics and corticosteroids are prescribed.

Innovative therapies

In modern medicine, ankylosing spondylitis is treated according to the latest news and discoveries. Stem cell therapy is a new technique with positive effects. It is prescribed in the early stages of the disease, before the final deformation of the spinal column and large joints occurs. How to treat ankylosing spondylitis with stem cells?

Stem cells stop further progression of the disease and stop the spread of bone tissue. At the same time, pain gradually disappears and motor function improves. The patient indicates an improvement in his condition. When additional exercise therapy is used, remission occurs faster.

Is ankylosing spondylitis treated using innovative methods? It is impossible to completely get rid of the pathology. However, achieving remission and slowing down the progression is quite possible. The main thing is to regularly conduct examinations and exercises for ankylosing spondylitis.

Application of physiotherapy

It is carried out in accordance with the stage of disease progression. With active development, ultraviolet irradiation of the affected area is prescribed. It has an analgesic and anti-inflammatory effect. The course of therapy consists of 10-12 procedures.

Physiotherapy for ankylosing spondylitis of moderate and low progression activity is widely used. Ultrasound, decimeter therapy, microwaves, inductothermy, ultraphonophoresis and other procedures are prescribed in accordance with the nature of the disease. in rare cases, balneotherapy is used.

Which doctor should I contact?

You need to figure out which doctor treats ankylosing spondylitis. In fact, everything is not so simple here. Since the pathology is often accompanied by disorders of other organs and systems (heart, kidneys), the patient will have to consult with several specialists at once. However, the leading doctor in the treatment of ankylosing spondylitis is a rheumatologist and orthopedist.

Therapist

If you have any complaints about feeling unwell, you should first consult a therapist or family doctor. This specialist does not treat ankylosing spondylitis, but conducts a general examination and can rule out a number of other disorders accompanied by loss of strength, decreased performance and back pain.

In general, in any situation, you need to start visiting doctors with a therapist. As a rule, this doctor conducts a general examination, listens to the heart, measures blood pressure and pulse, and then sends for basic tests - a general blood and urine test.

Neurologist

The advisability of visiting a neurologist is determined by the family doctor, based on the general picture of the course of the disease.

A neurologist is the doctor who must rule out osteochondrosis and other degenerative diseases of the back. This doctor does not treat ankylosing spondylitis, but may suspect the disease based on the specific symptoms, exclude other pathologies, and refer to the right specialist. However, a therapist usually refers you to a neurologist, and if he does not see a reason to be examined by this doctor, you do not need to contact a neurologist.

Rheumatologist

Those who doubt which doctor should treat ankylosing spondylitis should go to a rheumatologist, although after visiting other specialists.

It is the rheumatologist who prescribes treatment, monitors the dynamics of the disease and, in general, is the attending physician of each patient who is faced with ankylosing spondylitis.

Traumatologist-orthopedist

Individual treatment for ankylosing spondylitis is selected by a rheumatologist - this is the answer to the question of which doctor treats the disease. However, the pathology is within the competence of the orthopedist, because it is associated with poor posture. Thus, not one doctor will undertake to cure ankylosing spondylitis, but two at once - a rheumatologist must treat the pathology with medication, and an orthopedist will select a system of exercise therapy to maintain the flexibility of the spine and joints.

As the disease progresses, the patient will have to periodically consult with a cardiologist, urologist, neurologist and ophthalmologist, since ankylosing spondylitis often leads to various complications, which are treated by these specialists.

Prognosis and prevention

On average, it takes 5-7 years from the appearance of the first symptoms to the correct diagnosis. Patients require consultation with a rheumatologist and immunotherapy. Ankylosing spondylitis has a favorable prognosis for the patient's life. New treatment methods make it possible to stop the destruction of joints in the body. The main problem is timely correct diagnosis.

Patients are recommended to regularly undergo physical therapy and immunotherapy. Otherwise, complications will progress sharply in the form of severe pain and immobility, as well as disruption of the functioning of internal organs. The development of fibrosis, nephropathy, and failure of the kidneys and intestines is observed. In the absence of treatment, disability is prescribed for ankylosing spondylitis.

Methods for primary prevention of the disease have not yet been discovered.

Treatment of ankylosing spondylitis in Moscow

Treatment of ankylosing spondylitis in Moscow is available at the Yusupov Hospital medical institution, you can get detailed advice on the characteristics of pain in the lower back, shoulder girdle and in any other department. Using the latest equipment, doctors make an accurate diagnosis and conduct a detailed examination of the body. As a result, a detailed picture of the therapy method and the nature of the rehabilitation is formed.

The work of doctors is based on the experience of Slavic and foreign doctors and scientists in this field. During treatment, patients are provided with a comfortable hospital, intensive care, and a diagnostic center. You can make an appointment or ask questions by phone.

How to make an appointment with a specialist at JSC “Medicine” (clinic of Academician Roitberg) in Moscow

You can make an appointment with the specialists of JSC "Medicine" (clinic of Academician Roitberg) on ​​the website - the interactive form allows you to select a doctor by specialization or search for an employee of any department by name and surname. Each doctor’s schedule contains information about visiting days and hours available for patient visits.

Clinic administrators are ready to accept requests for an appointment or call a doctor at home by calling +7 (495) 775-73-60.

Convenient location on the territory of the central administrative district of Moscow (CAO) - 2nd Tverskoy-Yamskaya lane, building 10 - allows you to quickly reach the clinic from the Mayakovskaya, Novoslobodskaya, Tverskaya, Chekhovskaya and Belorusskaya metro stations .