The symptoms of ankylosing spondylitis are associated with inflammation in the joints of the spine, other joints of the body, and organs. The most common symptom of active joint inflammation is fatigue. Inflammation in the joints of the spine causes pain and stiffness in the back, upper buttocks, neck, and sacrum. Pain and stiffness usually develop gradually and get worse over time. Rarely, the onset of spondylitis can be sudden. Typically, these symptoms are usually worse in the morning or after a long period of inactivity. In this case, pain can often be relieved by movement, heat, or, for example, a warm shower in the morning.How to treat ankylosing spondylitis
Since ankylosing spondylitis often occurs at a young age, its manifestations are mistaken for possible injuries in young athletes.
With prolonged chronic inflammation in the joints of the spine, complete immobility of the spine may occur due to the “fusion” (ankylosis) of the intervertebral joints. At the same time, the following fact is noted – the pain no longer bothers the patient, but the mobility of the spine is lost. These vertebrae are usually fragile and more prone to fracture. Sudden mobility and pain in the spine in these patients may indicate a fracture. In most cases, fractures occur in the lower cervical spine.
Chronic spondylitis and ankylosis result in a forward bulge in the thoracic spine, which restricts breathing movements of the chest. In addition, spondylitis can also spread to the area of the junction of the ribs with the thoracic vertebrae, which further restricts breathing movements of the chest.
Inflammation in ankylosing spondylitis can spread to the lung tissue. In this case, there may be coughing and shortness of breath, especially with physical exertion or a cold. Therefore, respiratory failure can be the most serious complication of ankylosing spondylitis.
Patients may also have arthritis in other joints, and not only in the joints of the spine – the hip, knee or ankle joints. In this case, all the classic signs of joint inflammation are observed: pain, swelling, redness, increased temperature in the joint area and impaired movement in it. Sometimes the small joints of the toes can also be affected, and they become in the form of a “sausage”.
Inflammation can affect the cartilage of the sternum (costochondritis) and tendons where they attach to the bones (tendonitis). Some patients with ankylosing spondylitis may have inflammation of the Achilles tendon, which leads to pain and limited mobility in the heel, especially when the patient climbs stairs. They may also have inflammation of the plantar fascia, the thin, tough tissue that covers the muscles and tendons of the foot on the plantar side (plantar fasciitis).
With ankylosing spondylitis, both articular and extra-articular manifestations are noted. The latter is associated with inflammation in other tissues and organs, for example, in the tissues of the eye, heart, kidneys, lungs.
In case of inflammation in the tissues of the eye, the so-called. iritis – inflammation of the iris. It is characterized by redness and pain in the eye, especially when the patient looks at the light. Recurrent cases of iritis can affect both eyes. In addition to iritis, inflammation of the tissues of the eye can affect the ciliary body and the choroid. This inflammation is called uveitis. Iritis and uveitis can be serious complications of ankylosing spondylitis that lead to visual impairment.Modern principles of treatment of ankylosing spondylitis
It should be noted that damage to the joints of the spine and eyes can also occur in other forms of arthritis, for example, reactive arthritis (Reiter’s syndrome), psoriatic arthritis, etc.
A rare complication of chronic inflammation in ankylosing spondylitis can be damage to the heart tissue, which is manifested by a violation of the heart rhythm, namely, a slowdown in the heart rate. In such patients, it may be necessary to install an artificial heart rate driver – a pacemaker. In addition to the conducting system of the heart, inflammation can also affect the initial section of the aorta, which leads to the occurrence of insufficiency of its valve with the ensuing problems (heart failure).