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Bechterev’s disease (Ankylosing spondylitis)
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What Is Ankylosing Spondylitis (Bechterev’s Disease)
Ankylosing spondylitis is a chronic inflammatory disease that primarily affects the spine and sacroiliac joints. The inflammatory process leads to pain, stiffness, and progressive loss of mobility.
Over time, the condition may involve costovertebral joints, limiting chest expansion and affecting breathing. In some cases, internal organs such as the heart, lungs, and kidneys may also be affected.
Disease Progression
The condition typically begins in the sacroiliac joints and gradually spreads to the lumbar, thoracic, and cervical spine.
As it progresses:
- ligament elasticity decreases
- joint mobility becomes limited
- chronic pain and stiffness develop
In advanced stages, ankylosis (fusion of joints) may occur, significantly restricting movement.
Systemic Nature of the Disease
Ankylosing spondylitis is a systemic condition and may affect multiple body systems.
Some patients may develop:
- peripheral joint involvement (hips, shoulders, knees, ankles)
- cardiovascular complications (heart and aorta)
- respiratory limitations due to reduced chest mobility
- kidney involvement in long-term cases
Risk Factors
The disease often begins between the ages of 15 and 30.
Risk factors include:
- genetic predisposition
- male gender (more commonly affected)
- immune system dysregulation
Important
Without proper management, ongoing inflammation can lead to progressive stiffness and serious complications.
Early diagnosis and a structured treatment approach are essential to preserve spinal function and maintain quality of life.
Symptoms of Ankylosing Spondylitis (Bechterev’s Disease)
Symptoms of ankylosing spondylitis often develop gradually and may be overlooked in the early stages. The most characteristic feature is inflammatory back pain and stiffness, especially in the lower spine.
Early Symptoms
- intermittent lower back pain, especially in the morning
- stiffness after sleep or prolonged inactivity
- pain relief with movement or physical activity
- increased fatigue
- low-grade fever
In some patients, early stages may include eye inflammation (uveitis), causing redness, pain, and a “gritty” sensation.
Main Symptoms
- chronic lower back pain
- reduced spinal mobility
- joint swelling and tenderness
- chest pain, especially during breathing
- decreased chest expansion
Peripheral Joint Involvement
The condition may also affect other joints:
- hips
- shoulders
- knees
- ankles
This can further limit mobility and increase discomfort.
Advanced Symptoms
As the disease progresses:
- kyphosis (forward curvature/postural changes)
- spinal deformity
- reduced hip mobility
- significant stiffness
General Symptoms
- chronic fatigue
- loss of appetite
- fever
- weight loss
Important
A key feature is that pain:
- worsens at rest
- improves with movement
If symptoms persist for several weeks, medical evaluation is essential for early diagnosis.
Diagnosis of Ankylosing Spondylitis (Bechterev’s Disease)
Diagnosis of ankylosing spondylitis is based on a comprehensive approach that includes symptom assessment, clinical examination, and imaging studies. Since the disease develops gradually, early detection is crucial for controlling inflammation.
What Diagnosis Includes
At the initial stage, the specialist:
- reviews the patient’s medical history
- evaluates the nature of pain and stiffness
- assesses spinal mobility
- checks for systemic involvement
Imaging Methods
To confirm the diagnosis, the following are used:
- X-ray imaging — helps detect structural changes in sacroiliac joints and spine (more effective in later stages)
- MRI (magnetic resonance imaging) — the most sensitive method for early detection of inflammation and soft tissue changes
- CT scan — used for detailed evaluation of bone structures
Laboratory Tests
Additional blood tests may include:
- inflammatory markers (ESR, C-reactive protein)
- genetic marker HLA-B27 (when indicated)
Important
No single test is sufficient to establish the diagnosis.
Only a comprehensive evaluation allows to:
- confirm the condition
- determine its stage
- assess disease activity
Early diagnosis enables timely treatment and helps slow disease progression.
Treatment of Ankylosing Spondylitis
The key principle in managing ankylosing spondylitis is early intervention — ideally at the first signs of symptoms. At this stage, it is possible to effectively influence spinal function and preserve mobility.
Treatment should be comprehensive. Medication helps control inflammation, while physical therapy focuses on maintaining mobility, muscle balance, and overall spinal function.
Role of Physical Therapy
At “Ambulatoria Spyny,” emphasis is placed on non-pharmacological methods that help:
- reduce pain and stiffness
- maintain spinal mobility
- improve tissue metabolism
- support proper posture
Regular movement-based therapy helps slow functional decline and maintain quality of life.
Exercise and Its Effects
Controlled exercises and MOK-based sessions provide safe conditions for movement:
- gentle spinal decompression without axial load
- reduced muscle and joint tension
- improved chest mobility
- support of respiratory function
Slow, controlled movements help reduce pain, preserve range of motion, and improve flexibility.
Importance of Consistency
Consistency is essential.
Daily activity helps maintain spinal function and reduce progression of stiffness.
Developing a habit of proper posture and regular movement is key to long-term management.
Conclusion
Ankylosing spondylitis requires continuous management and a structured approach.
Combining medical supervision with physical therapy helps:
- reduce symptoms
- maintain mobility
- support an active lifestyle
👉 Consult a specialist to receive a personalized recovery plan.
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This site is for educational purposes only; no information is intended or implied to be a substitute for professional medical advice.
