Treatment of ankylosing spondylitis with folk remedies: the best recipes

Ankylosing spondylitis or ankylosing spondylitis

– one of the chronic forms of arthritis, which affects the spine and peripheral joints. The quality of life decreases, moving becomes difficult and painful. Men are often at risk - they get sick 2-3 times more often than women. The age of patients ranges from 15 to 35 years, but some are older. Untimely and incorrect treatment is fraught with complete disability. Let's figure out what ankylosing spondylitis is, what are the signs and how it is diagnosed, and most importantly, how to treat ankylosing spondylitis?

Ankylosing spondylitis affects the spine

Causes of ankylosing spondylitis

Ankylosing spondylitis

– chronic and progressive disease of the joints (usually intervertebral joints). According to statistics, in approximately 80% of cases, ankylosing spondylitis begins with inflammation and back pain, and in 20% with peripheral arthritis.

What is happening in the body in the meantime?

Inflammation occurs outside the joint in places where ligaments and tendons attach to the bone. It mainly affects small joints that are located between the vertebrae. The main feature of ankylosing spondylitis is the gradual restriction of joint mobility, the fusion of bones with each other (i.e. the formation of so-called “ankylosis”), the slow transformation of the spine into one solid bone. In addition, even ligaments ossify. Hence the loss of flexibility, the ability to move normally, up to complete immobility.

However, that’s not all – the inflammatory process often spreads to other joints, various organs and systems of the body. For example, on the eyes, kidneys, lungs or heart. The symptoms of ankylosing spondylitis do not make themselves felt immediately - first the joints are affected, then everything else.

Scientists have not identified the exact causes of ankylosing spondylitis

. The impetus for ankylosing spondylitis can be the incorrect functioning of the immune system and damage to autogenous cells. That is, for unknown reasons, protective cells that should act on pathogens “attack” the joints. Also among the prerequisites are hereditary predisposition. If parents passed on the HLA-B27 gene to their child, the likelihood that he will get ankylosing spondylitis increases 6 times! Approximately 90% of patients with confirmed diagnoses were carriers of this gene.

Risk factors:

• Birth weight less than 3 kg.
• Presence of restless legs syndrome.
• A serious infectious disease experienced at the age of 5-12 years. Especially the intestines or genitourinary system.
• Hypothermia.
• Injuries of the pelvis and spine.

Strains of Klebsiella and other enterobacteria that cause arthritis can also act as a “trigger” for ankylosing spondylitis.

Causes and mechanisms of development of ankylosing spondylitis

The etiology of BD has not yet been fully studied. But in recent years, it has been established that there is a genetic predisposition to this disease, caused by the presence of the HLA-B27 antigen, which is activated mainly in men after puberty. In this regard, their bodies begin to produce specific antibodies, the action of which is aimed at their own connective tissue elements involved in the formation of the ligamentous and articular apparatus. At the same time, inflammatory reactions are formed in the latter, leading to the resorption (resorption) of cartilage with its replacement with fibrous (scar-like) tissue, followed by the deposition of calcium salts in it and subsequently the proliferation of bone tissue. As a result of this, first there is stiffness in the joints, then there is a limitation of movements in them and, finally, ankylosis develops, characterized by fusion of the articulating articular surfaces.

Initially, inflammation is most often observed in the sacroiliac joints, then in the intervertebral joints (connecting the vertebral bodies), and, gradually spreading higher and higher, is already localized in the costovertebral sections of the chest. Much less often, spondyloarthritis simultaneously occurs in large joint structures of the body - shoulder, knee, hip, and very rarely - in small joints of the feet or hands.

As the pathology progresses, the above areas of the human musculoskeletal system are “switched off” from movement, the increased or unusual load compensatory “falls” on the adjacent sections, which contributes to the appearance of degenerative changes in them (osteoporosis, osteochondrosis, spondylosis, spondyloarthritis, synovitis, myositis) . This certainly affects the well-being of patients and their physical activity.

So, for example, if ankylosis occurs in the costovertebral joints of the chest, then the range of its movements during breathing gradually decreases until it almost completely disappears, and then patients breathe only due to excursions of the diaphragm. This leads to shortness of breath at the slightest exertion and the formation of respiratory failure. One third of patients may experience, to one degree or another, damage to other structures of the body: for example, the development of myocarditis, valvular heart defects or aortitis (if the cardiovascular system is involved in the process), sometimes disturbances in the functioning of the organs of vision (uveitis, iridocyclitis, episcleritis), urinary tract (nephritis, cystitis), etc.

Classification of ankylosing spondylitis

Based on the localization and severity of symptoms of ankylosing spondylitis, doctors have identified 5 forms of the disease:

• Central.
  The lesion is only the spine. About 50% of all cases. There are also kyphotic and rigid spondylitis. The first is characterized by a strong bend in the thoracic region and straightening in the lumbar region, the second by straightening along the entire length.
• Rhizromelic.
  In addition, the large shoulder and hip joints are affected.
• Peripheral.
  In addition to the spinal column, knee, ankle, and elbow joints undergo changes. It is more often found in adolescents 10-16 years old.
• Scandinavian.
  Similar to rheumatoid arthritis. Even small joints suffer.
• Visceral form.
  In addition to joints, problems arise with blood vessels, kidneys, eyes and other organs.

Clinical recommendations for ankylosing spondylitis may also vary depending on the rate of progression of the pathology. There are 3 options:

• Progresses slowly.
• Progresses slowly with alternating periods of exacerbation and remission.
• Progresses quickly.

Late detection complicates the treatment of ankylosing spondylitis - in the early stages it is possible to completely get rid of the symptoms.

It is necessary to diagnose ankylosing spondylitis as early as possible

Possible complications

Gradually, ankylosing spondylitis leads to changes in posture and motor functions. The lumbar spine is flattened, the thoracic spine bends more and more, and a hump is formed. To compensate, the neck is extended and the hip and knee joints are flexed. Due to the hump in the spine, the field of vision may be limited when looking straight ahead. Large joints (hip, knee, shoulder, elbow) may move partially. In 20% of patients, further disorders occur in the body:

• the eyes are affected (iris);
• cardiovascular diseases or inflammation of the large
• arteries of the body (aortitis);
• Possible inflammation of the joints (arthritis) of the fingers, toes, or tendons (enthesitis);
• there is a decrease in bone density (osteopenia) to loss of bone mass (osteoporosis);
• symptoms develop in the intestines, a connection is suspected with chronic inflammatory diseases, Crohn's disease or ulcerative colitis.

Complications from the nervous system are not uncommon. In running forms

there is a high risk of disruption of internal organs.

Symptoms of ankylosing spondylitis

The most common symptom of ankylosing spondylitis is back pain.

. Patients complain of increased pain when immobile (during sleep). Usually with physical activity it goes away or weakens significantly.

Main features:

• Moderate pain in the groin, sacrum and outer thigh.
• Morning/evening stiffness.
• Gradual limitation of mobility, shortening and curvature of the spine, stoop.
• Feeling of chest tightness.
• Dizziness and tinnitus.
• Swelling of the joints.

Associated symptoms of ankylosing spondylitis:

• Increased temperature at the end of the day, weight loss, fatigue.
• Inflammation of the eyes. For example, iritis, iridocyclitis or uveitis. The sensitivity of the eyes increases, they turn red or hurt.
• Heart problems. Ankylosing spondylitis often leads to heart valve failure.
• Difficulty breathing. The lungs continue to perform their function, but breathing volume is limited.
• Complications in the nervous system. For example, myelopathy appears.

Correct diagnosis of ankylosing spondylitis is very important, since similar symptoms occur in patients diagnosed with osteochondrosis, spondylosis, arthrosis and rheumatoid arthritis.

Etiology

The exact reasons for the appearance of symptoms of ankylosing spondylitis in women and men have not been established to date. There is evidence that 96% of patients with it have the HLA-B27 antigen. However, its presence in the body will not necessarily lead to the development of this pathology, although it is a sign of genetic predisposition. It is also customary to identify factors that are provoking in this case:

• prolonged hypothermia;
• inflammation of the genitourinary system;
• disruption of the endocrine system;
• injuries of the pelvic bones (fractures).

Diagnosis of ankylosing spondylitis

With the disease, changes in articular cartilage and bones are always observed, but not always severe pain. Ankylosing spondylitis does not develop in 1-2 months, but over several years. Pain and stiffness in the chest, lumbar pain - all this occurs after the degradation of the intervertebral joints begins.

To diagnose ankylosing spondylitis, the following are used:

• Radiography.
• Magnetic resonance imaging.
• Testing for the presence of histocompatibility antigen (HLA B-2 gene, which is responsible for predisposition to ankylosing spondylitis).
• Ultrasound examinations of hands and feet.
• Laboratory tests for ESR, C-reactive protein (CRP). Ankylosing spondylitis is characterized by an increase in erythrocyte sedimentation rate (ESR).

You should also conduct a full examination to determine extra-articular foci of manifestation (blood test, fluorography, electrocardiography and others). For example, kidney failure and vision problems may occur, including iris fusion, cataracts or glaucoma.

It is difficult to understand in the initial stages that we are dealing with ankylosing spondylitis. The doctor may order an X-ray of the pelvis to examine the sacroiliac joints (if the changes are mild, a repeat X-ray is performed after 2 years to monitor their nature and course). MRI is a more sensitive method for diagnosing ankylosing spondylitis. Subsequently, the obtained tomograms are analyzed by a rheumatologist.

Of all laboratory methods, the most important is the determination of ESR and CRP

, since this way the doctor can obtain expanded information about the current stage of the inflammatory process.

After diagnosing ankylosing spondylitis, you can begin therapy. It is prescribed depending on the stage and form of the disease.

Individual treatment plan

A therapeutic exercise program is developed individually. Exercises are performed every day. To strengthen the muscle corset, skiing and swimming are necessary.

Pharmacological treatments

Medications are prescribed without fail: first-line therapy is NSAIDs, followed by individual selection of genetic engineering therapy. You should take medications only as prescribed by your doctor. The specialist selects the dosage taking into account the characteristics of the patient’s body and the complexity of the disease.

• NSAIDs. To relieve pain at the initial stage of the disease, the doctor prescribes non-steroidal anti-inflammatory drugs (NSAIDs) (ibuprofen, diclofenac, meloxicam, naproxen, nimesulide, celecoxib, etoricoxib). These drugs are recommended to be prescribed in long courses, but in the minimum required dosage. This is due to the fact that they contribute to the onset and maintenance of remission of the disease, and thereby reduce the risk of developing spinal immobility. NSAIDs should be prescribed with caution for diseases of the gastrointestinal tract, kidneys, liver, as well as for persons with an increased risk of cardiovascular complications.
• Hormone therapy and sulfasalazine. If NSAIDs are insufficiently effective, local (intra-articular, periarticular, enthesis area) administration of glucocorticosteroid hormones (dexamethasone, diprospan) is advisable. In the peripheral form of the disease (primarily affecting the joints of the extremities), the use of sulfasalazine is effective. However, this basic drug has virtually no effect on the progression of spinal column damage.
• Genetically engineered biological products. If, in severe cases of the disease, it is not possible to suppress the activity with the above-mentioned drugs, the prescription of biological (genetically engineered) drugs - TNF-α inhibitors (infliximab, etanercept, adalimumab, golimumab, certolizumab pegol) or interleukin 17 inhibitors (secukinumab) is indicated. These drugs have shown high efficiency and a significant improvement in prognosis for ankylosing spondylitis.

Non-drug treatments

Of particular importance for ankylosing spondylitis are non-drug treatment methods - physiotherapeutic treatment, therapeutic physical training, extracorporeal hemocorrection, rehabilitation measures. In severe stages of the disease, surgical treatment may be considered.

An important aspect of treatment is the timely correction of cardiovascular risk factors (smoking, hypertension, high cholesterol), as well as the prevention of osteoporosis (calcium and vitamin D supplements).

Massage, reflexology and magnetic therapy are recommended only in the absence of inflammatory activity. Patients with ankylosing spondylitis are also prescribed nitrogen, hydrogen sulfide and radon baths.

Innovative therapies

• Interstitial electrical stimulation (ITES). Low frequency current pulses are used. Stimulates self-healing of affected tissues, improves blood supply, and relieves pain.
• Shock wave therapy (SWT). Used to prevent tissue calcification and fibrosis. Blood microcirculation improves, regenerative processes intensify, and the functions of ligaments and muscles are restored.
• Photodynamic therapy. With the help of light radiation, biochemical reactions are triggered. Pain and swelling are reduced, motor functions are restored.

Organization of a sleeping place

Patients with ankylosing spondylitis should sleep only on a flat, hard surface without a pillow to prevent the development of a proud or supplicant posture.

How to deal with ankylosing spondylitis?

Treatment of ankylosing spondylitis consists of non-drug and drug methods. The strategy is selected individually by a rheumatologist - there are no general clinical recommendations for ankylosing spondylitis.

The goal of treating ankylosing spondylitis is to relieve pain , relieve inflammation and slow down the progression of the disease.

Modern methods for ankylosing spondylitis: exercises, physiotherapy, medications, diet, and in extreme cases, surgery.

There are 4 methods of treating ankylosing spondylitis.

Surgical treatment of ankylosing spondylitis

An operation with such a diagnosis is considered complex and risky, and is prescribed only in the later stages in cases where the patient is at risk of disability.

The main types of surgical treatment for ankylosing spondylitis:

• Joint endoprosthetics.
  Joint replacement – ​​replacing the damaged joint with an implant.
• Spinal fusion.
  Fixation of vertebrae, separation of fused ones.
• Vertebrotomy.
  Straightening a deformed spine.

After surgery, therapeutic exercises and physiotherapy are indicated.

Physiotherapy

Physiotherapy

– auxiliary methods. Among them: ultraviolet irradiation (analgesic and anti-inflammatory effect), UHF therapy on joints, electrophoresis of Parfenov liquid or novocaine. Additional treatment of ankylosing spondylitis with moderate and low activity is carried out using inductothermy, microwave therapy, ultrasound, ultraphonophoresis with hydrocortisone, salt and hydrogen sulfide baths. Massages and paraffin therapy also improve the condition. In the inactive stage, balneotherapy may be recommended. The above methods can be combined!

Exercise therapy for ankylosing spondylitis

Physical therapy is very useful in rehabilitation.

A set of exercises for ankylosing spondylitis includes stretching, strengthening posture and muscle corset, increasing muscle tone, training to improve mobility and restore coordination. It is advisable to exercise at least 1 hour a day.

Options for exercise therapy for ankylosing spondylitis:

• Spinal stretch. Bend forward, backward and sideways.
• Nordic walking and swimming.
• Doing yoga or strength training with light weights in the gym.
• Exercises with a gymnastic stick.

Attention! Performing exercise therapy for ankylosing spondylitis should not be accompanied by severe discomfort. If it is, you need to consult a doctor.

Drug treatment of ankylosing spondylitis

There are no specific drugs as such. Clinical recommendations for ankylosing spondylitis most often include:

• NSAIDs (non-steroidal anti-inflammatory drugs). Some of the most effective and safest are indomethacin (metindole) and the drug diclofenac (Voltaren). They do not cure, but reduce pain and inflammation. Minus - they can provoke gastrointestinal problems (ulcers, gastritis). This can be avoided by taking gastroprotectors.
• Hormonal drugs.
• Immunosuppressants. With an autoimmune nature of the disease.
• Inhibitors of TNF-alpha and B-cell activation.

Chondroprotectors play an important role in eliminating symptoms and treating ankylosing spondylitis.

Is it possible to be completely cured?

Unfortunately, it is impossible to completely cure ankylosing spondylitis. However, if all the doctor’s recommendations are followed and the patient takes a responsible attitude to therapy, the process can be slowed down and prevented from worsening the condition of the joints. A person with such a diagnosis will have to be constantly monitored by a specialist, and during periods of exacerbation should be hospitalized in a traumatology or rheumatology department.

Why do chondroprotectors really help?

Chondroprotectors

– drugs that contain
glucosamine
and/or
chondroitin
. These are natural substances in our body. With a decrease in their production, metabolic processes in the joints are disrupted, then degenerative changes occur in the cartilage tissue. The result is sore joints. Treatment of ankylosing spondylitis with chondroprotectors in the early stages will help slow down the degradation of joints, speed up the restoration of cartilage, and relieve pain.

Treatment with chondroprotectors can be effective in the early stages of Ankylosing spondylitis.