On an ordinary morning, Mr. Li, a 60-year-old retired worker, walked into my office. His gait was stiff and his brow furrowed. He told me that this was the third time he had sought medical attention for the same problem: persistent, unbearable back pain. When he first started this symptom, he thought it was just a common condition with age, but as time went on, the pain did not lessen, but became more severe. After a detailed physical examination and necessary imaging tests on Mr. Lee, we found out that this was not ordinary back pain, but a chronic inflammatory disease called "ankylosing spondylitis".
Ankylosing spondylitis: an often misunderstood condition
What is ankylosing spondylitis?
Ankylosing spondylitis, a long-term chronic disease, primarily attacks the spine, causing inflammation and stiffness of the joints in the spine. The disease is characterized by a gradual progression, with the initial symptoms usually pain in the lower back, especially at night and early in the morning. As the disease progresses, the patient's spine gradually loses flexibility, which seriously affects daily life.
Why is ankylosing spondylitis difficult to diagnose?
One of the challenges of ankylosing spondylitis is that its early symptoms are often similar to ordinary back pain and can be easily overlooked or misdiagnosed as something else. In addition, the rate at which the disease progresses varies from person to person, with some patients progressing slowly while others worsen rapidly. An accurate diagnosis usually requires a combination of the patient's medical history, physical examination findings, and imaging tests, such as X-rays or MRI scans.
Pathogenesis: Wrong reaction of the body
The exact cause of ankylosing spondylitis is still unknown, but research suggests that genetics play an important role. The disease is related to a gene called HLA-B27, but not everyone who carries the gene develops. It is widely believed that the disease may be caused by the body's immune system mistakenly attacking the spine and other parts of the body, causing inflammation and pain.
Ankylosing spondylitis: a hidden crisis
Ankylosing spondylitis, as a chronic inflammatory disease, primarily affects the spine and pelvis. While it may start out as mild back pain and stiffness, it can't be ignored that it can gradually evolve into a serious health problem. The dangers of this disease are not limited to spinal deformities or functional limitations, but more seriously, it can lead to a range of complications, including ophthalmia, heart problems, and even complete stiffening of the spine. These complications can seriously affect a patient's quality of life, including work, social activities, and the ability to perform daily activities. What is even more worrying is that ankylosing spondylitis is often difficult to identify in the early stages, and many patients have already progressed to a more severe stage by the time they are diagnosed.
The Mystery of Diagnosis: Demystifying Ankylosing Spondylitis
Diagnosing ankylosing spondylitis is not an easy task. Its early symptoms, such as chronic low back pain and morning stiffness, are often misinterpreted as ordinary back pain or muscle strain, leading to a great deal of misdiagnosis and delayed diagnosis. An accurate diagnosis is based on medical history, physical examination, and ancillary tests. During the physical examination, the doctor will pay special attention to the range of motion and flexibility of the spine. X-ray or MRI imaging is a key tool for ancillary examinations to visualize inflammation of the spine and pelvis. In addition, blood tests are also essential, and the detection of HLA-B27 is helpful in diagnosis, although not all patients will be positive.
Based on these tests, the doctor will make a final diagnosis based on the patient's symptoms and test results. It is important to note that since the development of this disease varies from person to person, diagnosis and treatment plans also need to be individualized to achieve the best possible outcomes.
Non-pharmacological therapies: self-management in everyday life
People with ankylosing spondylitis can take a range of non-pharmacological therapies in their daily lives to improve their symptoms and quality of life. These methods include regular physical therapy and proper exercise, which are important for maintaining range of motion and reducing stiffness.
A physical therapist can instruct patients through specific stretching and strengthening exercises to maintain the flexibility of the spine and the strength of the muscles. The focus is on strengthening the muscles in the back and abdomen, as these muscles support the spine. In addition, swimming and hydrotherapy are considered joint-friendly exercises that help improve overall physical condition without putting a strain on the joints.
Postural adjustments in daily life are also key. Maintaining proper posture and using an ergonomic chair and mattress when standing or sitting for long periods of time can all help reduce symptoms. Adjusting your sleeping position, such as using a firm bed and low pillows, can also help reduce morning stiffness and pain.
Pharmacotherapy: effective in controlling symptoms and disease progression
Medication is another important aspect of managing ankylosing spondylitis. The most commonly used medications are nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and niproxine. These medications are effective in reducing pain and inflammation. With long-term use of NSAIDs, doctors monitor for potential side effects, such as gastrointestinal problems.
For patients with high disease activity, biologics such as TNF inhibitors may be an effective option. These drugs reduce symptoms by targeting specific inflammatory pathways and may slow the progression of the disease. However, due to their immunosuppressive effects, doctors carefully assess each patient's indications and potential risks.
Finally, regular medical evaluations are essential for effective management of ankylosing spondylitis. Treatment regimens need to be adjusted based on disease activity and the patient's response to treatment. Working closely with your healthcare professionals and following their guidance can help patients better manage their condition, reduce symptoms and improve their quality of life.