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Ankylosing spondylitis (Bechterew disease)

 

Ankylosing spondylitis (Bechterew disease)

Ankylosing spondylitis (Bechterew disease) — is a systemic disease characterized by chronic inflammatory lesions of the intervertebral joints, the sacroiliac joints and peripheral entheses and joints, formation of kyphosis, the development of stiffness and in severe disease course — complete loss of spinal mobility.

Ankylosing spondylitis, in general, is diagnosed more frequently in males (3:1). However, females may have milder or subclinical ankylosing spondylitis (Bechterew disease).

Ankylosing spondylitis, Bechterew disease, treatment of Bechterew disease, the treatment of ankylosing spondylitis, the diagnosis of Bechterew disease, the diagnosis of ankylosing spondylitis in Moscow

The lumbar spine in a "frozen" position with ankylosing spondylitis (Bechterew disease), rear view.

 

Treatment of ankylosing spondylitis (Bechterew disease)

Therapeutic program for ankylosing spondylitis (Bechterew disease) includes a variety of medical factors (drugs, physiotherapy, etc.) and activities (compliance with treatment, exercise therapy, spa treatment, etc.) and calls from the patients themselves and their families patience.

 

Education of patients with ankylosing spondylitis (Bechterew disease)

Patient with ankylosing spondylitis (Bechterew disease) is recommended to lead a normal active life, to engage in sports such as swimming, tennis, volleyball. Must continuously monitor the bearing. The bed should be rigid, and those engaged in clerical work, must periodically get up from the table to change unfavorable to the spine forced posture.

With acute exacerbation of the disease and of pain patients need bed rest, but even in this period should be continuously engaged with instructor on physiotherapy exercises to prevent serious impairments of the posture and function of the spine. After hospital treatment of patients with Bechterew's disease (ankylosing spondylarthritis) must undergo sanatorium treatment and then observed in the clinic.

Ankylosing spondylitis, Bechterew disease, treatment of Bechterew disease, the treatment of ankylosing spondylitis, the diagnosis of Bechterew disease, the diagnosis of ankylosing spondylitis in Moscow

The lumbar spine in a "frozen" position with ankylosing spondylitis (Bechterew disease), side view.

 

Use of nonsteroidal anti-inflammatory drugs (NSAIDs) in ankylosing spondylitis (Bechterew disease) treatment

NSAIDs have a pronounced anti-inflammatory and analgesic effects, often mild immunodepressantny effect. It is believed that such drugs as indomethacin and phenylbutazone treatment of ankylosing spondylitis (Bechterew disease) (butadion) are almost specific effect in ankylosing spondylitis. Unlike rheumatoid arthritis suppression of clinical symptoms is often rapid and almost complete. Many patients take these funds in the months and years, they improve the well-being even in the later stages of the disease. In connection with a pronounced therapeutic effect of NSAIDs in Bechterew's disease their application even has a diagnostic value.

Patient with ankylosing spondylitis (Bechterew disease) is recommended butadion or reopirin (pirabutol) 1 tablet 4 times a day, with strong pains reopirin can be administered by intramuscular injection of 5 ml. Due to the pronounced side effects pirazolonovyh compounds (leukopenia, gastroenteropathy, hematuria (blood in the urine)) should be applied no more than 2 weeks, then going to receive indomethacin (metindola) oral 50 mg 3-4 times daily or as suppositories 50 mg 2 times day. It is convenient method of preparation metindol retard to 0.075 g, 2 times a day. You can also use Voltaren and other NSAIDs.

Ankylosing spondylitis, Bechterew disease, treatment of Bechterew disease, the treatment of ankylosing spondylitis, the diagnosis of Bechterew disease, the diagnosis of ankylosing spondylitis in Moscow

The lumbar spine in a "frozen" position with ankylosing spondylitis (Bechterew disease), side view on the radiography.

 

Ankylosing spondylitis (Bechterew disease) treatment with glucocorticoids

Glucocorticoids are indicated at high ankylosing spondylitis (Bechterew disease) activity and the absence of effect from NSAID treatment. In this case, intraarticular injection of hydrocortisone, with the active and prolonged arthritis (at 125 and 50 mg in large and medium-sized joints), as well as other long-acting drugs (kenalog 40 and 20 mg respectively). If pronounced polyarthritis with severe pain and swelling of NSAIDs is sometimes added prednisolone (15-20 mg) for a short time. Also in this case we recommend the smaller dose of prednisolone (5-7.5 mg / day).

At very high ankylosing spondylitis (Bechterew disease) activity and treatment failure can be carried out pulse prednisolone therapy (administered intravenously 1 g of prednisolone 1 times per day for 3 days).

 

Sulfasalazine in ankylosing spondylitis (Bechterew disease) treatment

In recent years, as the reference drug, acting on the pathogenic mechanisms of disease, were used sulfasalazine for 2-3 grams a day for several months.

Ankylosing spondylitis, Bechterew disease, treatment of Bechterew disease, the treatment of ankylosing spondylitis, the diagnosis of Bechterew disease, the diagnosis of ankylosing spondylitis in Moscow

Ankylosing spondylitis (Bechterew disease) will be limited in spine movement by morning stiffness that lasts more than 30 minutes.

 

Nonhormonal immunosuppressants Ankylosing spondylitis (Bechterew disease) treatment

Indications for nonhormonal immunosuppressive agents (cytostatics) treatment are: severe illness with fever and vistseritami. Used azathioprine (Imuran) to 50-100 mg / day, cyclophosphamide at 50-100 mg / day, hlorbutin (leykeran) 5-10 mg per day. The treatment of ankylosing spondylitis (Bechterew disease) lasts for 2-3 months, the doses are reduced upon the occurrence of significant improvement. The treatment is conducted under the supervision of compulsory blood testing (possible tsitopenichesky syndrome).

 

Neuromuscular blocking agent in ankylosing spondylitis (Bechterew disease) treatment

For a muscle spasm relaxing in patients with ankylosing spondylitis (Bechterew disease) designate izopretan of 0.25 g 2-3 times a day, skutamil - P: 1 tablet 3 times a day and massage the back muscles. The patient is recommended annual treatment of radon baths (Tskhaltubo Khmelnik, Pyatigorsk), hydrogen-sulfide baths (Sochi, Pyatigorsk, Nalchik, Kemer), mud (Saki, Evpatoria). Contraindications to the sanatorium treatment are high disease activity, damage to internal organs.

Patients with ankylosing spondylitis (Bechterew disease) are subject to rheumatologist clinical examination. Patients with peripheral form of the disease examined 1 time in 1-2 months, with a central form — 1 times 4-6 months, with the damage of the eyes and internal organs — a monthly basis.

Radiographic studies of the joints and the spine is held 1 time per year. Occasionally patients are examined by a urologist and oculist. In the presence of acute and inefficiencies out-patient treatment addressed the issue of hospital treatment.

Ankylosing spondylitis, Bechterew disease, treatment of Bechterew disease, the treatment of ankylosing spondylitis, the diagnosis of Bechterew disease, the diagnosis of ankylosing spondylitis in Moscow

MRI or CT scanning of the sacroiliac and peripheral joints in ankylosing spondylitis (Bechterew disease) may reveal evidence of early sacroiliitis, erosions, and enthesitis that are not apparent on standard radiographs.

 

Physical therapy, exercises, massage in ankylosing spondylitis (Bechterew disease) treatment

Exercise program and postural training, should be conducted systematically and daily 1-2 times a day for 30 minutes, thus reducing the functional impairment of the spine and joints. A good therapeutic method is gymnastics in the pool that allows you to achieve muscle relaxation and exercise therapy in the office "ugul" ("Dry Pool"), when the patient does the exercises, being suspended on special suspensions, in the supine or sitting position (while fully relax muscles, removes pain, increases mobility in the affected joints).

Massage therapy the muscles reduces back pain in the spine, reduces muscle stiffness, strengthens muscles.

Ankylosing spondylitis, Bechterew disease, treatment of Bechterew disease, the treatment of ankylosing spondylitis, the diagnosis of Bechterew disease, the diagnosis of ankylosing spondylitis in Moscow

In the treatment of ankylosing spondylitis (Bechterew disease) elimination of inflammation, pain, restore range of motion in joints and muscles of the lumbar accelerating the use of physiotherapy.

 

Physiotheraty appointed with minimal activity or in an inactive phase of the disease: ultrasound, phonophoresis with hydrocortisone, currents Bernard inductothermy, reflexology, magnet therapy. In recent years, with great effect applied laser therapy.

Ankylosing spondylitis, Bechterew disease, treatment of Bechterew disease, the treatment of ankylosing spondylitis, the diagnosis of Bechterew disease, the diagnosis of ankylosing spondylitis in Moscow

In the treatment of ankylosing spondylitis (Bechterew disease) elimination of inflammation, pain, restore range of motion in joints and muscles of the neck accelerating the use of physiotherapy.

 

Ankylosing spondylitis, Bechterew disease, treatment of Bechterew disease, the treatment of ankylosing spondylitis, the diagnosis of Bechterew disease, the diagnosis of ankylosing spondylitis in Moscow

In the treatment of ankylosing spondylitis (Bechterew disease) elimination of inflammation, pain, restore range of motion in joints and muscles of the thoracic spine accelerating the use of physiotherapy.

 

Ankylosing spondylitis (Bechterew disease) spa treatment

At a low ankylosing spondylitis (Bechterew disease) activity and the stage of relative remission good effect give balneotherapy (hydrogen sulfide, radon baths) and mud therapy.

In the inactive stage of ankylosing spondylitis (Bechterew disease), while maintaining the patient's ability to show self-spa treatment.

 

If you have any questions on the diagnosis or treatment of ankylosing spondylitis (Bechterew disease), you can ask them to our neurosurgeon or neurologist: (499) 130–08–09

 
 

 

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