What is ankylosing spondylitis (Bechterew)?
Ankylosing spondylitis (Bechterew's disease) is a chronic rheumatic disorder that particularly affects the spine but may also cause complaints in other parts of the body. The disease mostly starts in young male adults aged between 20 and 30 years.
The precise cause of ankylosing spondylitis is not yet known, but it is closely associated with a particular substance in the blood (HLA-B27), which is found in 90% of the patients.
Signs and symptoms
The main complaints that patients with ankylosing spondylitis report are chronic pains in the neck and back, especially in the buttock area, which started gradually before the age of 40 years. Patients also suffer from morning stiffness, which improves as they start to move around. Patients typically also have pains during the night, especially during the second half of the night, and often have inflammations of the sacroiliac joint. Some patients develop deformities of the spine, which may restrict the mobility of the spine as a whole. In addition to the spinal complaints, patients also frequently have inflammations of the arm and leg joints, or may suffer pains due to other inflammations, for instance of the Achilles tendon. Patients with ankylosing spondylitis also frequently have pains in other parts of their body than the spine and the arm and leg joints.
How is ankylosing spondylitis diagnosed (Bechterew)?
A thorough examination of the spine, especially of the mobility of the cervical, thoracic and lumbar parts of the spine, is essential to establish the diagnosis of ankylosing spondylitis. In addition to the spine, the doctor also examines the hips, shoulders and other joints.
Do I need additional examinations?
- Diagnostic examination for other non-physical factors important for your pain, have already been done by yourself trough filling out your pain questionnaires.
- The doctor may order blood tests to detect inflammation.
- The doctor can check for inflammation of the sacroiliac joint by means of an X-ray or MRI or CT scan.
What are my treatment possibilities?
Depending on the cause of your pain, your pain specialist will decide whether or not to embark on physical treatment. Based on the results of the completed pain questionnaire, additional examinations can be carried out and, apart from physical treatment, other methods of treatment will be suggested.
If the results of your pain questionnaire are abnormal, your pain specialist will offer you one of the non-physical treatments listed below:
- Psychological Treatment
- Depression Treatment
- Cognitive-Behavioural Treatment
- Rehabilitation Treatment
- Special rheumatological medication prescribed by your rheumatologist