ankylosing spondylitis

Bechterew's disease is one incurable, rheumatic-inflammatory disease, which primarily affects the vertebral joints and nearby joints. In Bechterew's disease, the body's own immune defenses are directed against bones and cartilage. The vertebral joints gradually stiffen and ossify. The severity and speed of progression of ankylosing spondylitis is different for each affected person. We will give you a brief overview of the disease and tell you how radon therapy in the Saxon State Baths positively supports the treatment of Bechterew's disease.

What is Bechterew's disease?

The Latin name for Bechterew's disease is ankylosing spondylitis, which means bending or stiffening inflammation of the vertebrae. The disease affects the spine or vertebral joints and, in later stages, nearby large joints such as the hip. Diagnosing the disease is not easy because it initially manifests itself in back pain and muscle tension and is therefore not recognized by those affected for a long time. As the disease progresses, the musculoskeletal system becomes restricted as the joints, usually starting in the lower part of the spine, become stiff. Bechterew's disease is chronic and cannot yet be cured. However, there are various forms of therapy that slow down the progression of the disease and alleviate the symptoms.

Thanks to written records and anthropological studies, the disease has been documented at least as far back as the time of Pharaoh Ramses II (1304 – 1214 BC). However, it was Vladimir Bekhterev who first described the disease in detail in the 19th century, which is why ankylosing spondylitis is popularly named after him.

Symptoms of Bechterew's disease

As a rule, the course of the disease begins between the ages of 15 and 35. However, the diagnosis is usually only made many years later, as back pain is usually explained by poor posture or one-sided strain and rarely does anyone immediately think of Bechterew's disease. Usually The symptoms begin in the sacroiliitis, the sacrum joint, i.e. in the lower back area and can radiate into the entire hip area. Typically, the symptoms are mainly present in the second half of the night or in the morning, accompanied by a feeling of stiffness - especially in a lying and resting position.

The earlier in life the disease begins, the worse the prognosis. The course of the disease also tends to be more severe in men than in women. Symptoms often appear in fits and starts. The slow ossification of the vertebral joints is not directly due to Bechterew's disease, but rather to the body's immune response to the chronic inflammatory processes. Bone bridges form between the individual vertebrae, particularly in the area of ​​the vertebrae, which is known in technical language as syndesmophyte formation. In the x-ray image, the spine visually resembles bamboo as it becomes more ossified, which is why it is also referred to as a bamboo spine.

Causes of ankylosing spondylitis

The causes of Bechterew's disease are not yet fully understood. It will be one Interaction between certain genetic predispositions and environmental influences is suspected. Although this disease turns the body's own immune system against itself, Bechterew's disease does not show the typical characteristics of an autoimmune disease. Some experts therefore call them: immune-mediated, autoinflammatory disease, i.e. a disease mediated by the immune system. Hereditary factors, in particular the genetic marker HLA-B27 (Human Leukocyte Antigen B27), play a role in the onset of the disease, but not necessarily.

90% of all people affected by Bechterew's disease carry the HLA-B27 marker. However, only a small proportion of those who carry this marker suffer from Bechterew's disease. In addition to HLA-B27, the gene markers ERAP1 and IL23R are also suspected of promoting the outbreak of Bechterew's disease. Ultimately, various environmental influences and previous infections are also part of the list of factors that can trigger this spondylitis.

Treatment of ankylosing spondylitis

It has already been mentioned that Bechterew's disease is currently not curable. However, there are comprehensive therapeutic measures that provide significant pain relief and slow the progression of the disease. The different Therapy methods are determined by the doctor depending on the severity and severity of Bechterew's disease and can be combined with each other.

movement therapy

Gentle sports such as swimming, cross-country skiing, hiking or cycling are recommended for exercise therapy, which should be exercised for at least 20 minutes a day. Hard sports such as jogging, tennis, handball or football are not recommended. In general, you should avoid training at peak performance levels in any sport. Instead, gentle and continuous training is desirable. Special physiotherapy prescribed by a doctor can also provide relief.

Heat-cold treatments or radon therapy as part of a bath therapy with water containing radon have been proven to relieve symptoms of Bechterew's disease. The effect also lasts for several months.

Operation

Surgery should always be considered as a last resort. Here, a hip joint damaged by Bechterew's disease is usually replaced. Surgery is also conceivable if nerves are damaged by the stiffening of the joints.

In severe cases of forward curvature caused by spinal ossification, the spine can be straightened surgically. This means those affected can breathe much better and no longer have to tilt their heads back excessively in order to be able to see straight ahead.

The effect of radon

Radon therapy relieves pain in various diseases of the musculoskeletal system, including Bechterew's disease. We, the Saxon State Baths, use the Wettin spring, which bubbles to the surface in Bad Brambach, for radon therapy: It is the world's strongest known source of the natural remedy radon.

The source was discovered over 100 years ago. Since then, bathing and radon therapies have been integrated into the medical plan of action as gentle therapy methods in the form of bathing and drinking treatments for all kinds of complaints. In addition to the natural remedy radon, the spring water from the Wettin spring and other healing springs in Bad Brambach also contains carbonic acid and various minerals such as calcium and sodium. Every single component has a positive effect on the body.

Water containing radon has been proven to have a pain-relieving and anti-inflammatory effect when combined with a bathing treatment or drinking treatment. In a natural process, the noble gas radon decays after a certain time. The radon contained in drinking and bathing water is increasingly absorbed through the skin and gastrointestinal tract thanks to the carbon dioxide content. If it breaks down after absorption, high-energy particles are released. These in turn eliminate a number of functional disorders and lead to stimulation of the metabolism. They also activate the repair mechanism of the body's own cells. As a result, increased levels of endorphins are released, which have been proven to alleviate pain and its perception.

Are you experiencing symptoms of ankylosing spondylitis?

Radon – the natural remedy helps!

Radon drinking cure

A drinking treatment with water containing radon helps to stimulate the cells affected by inflammation and destruction to repair. It supports the therapy because the healing components of the water are absorbed directly into the bloodstream via the gastrointestinal tract and have an effect there.

The other components in the spring water support the effect of the noble gas radon. Hydrogen carbonate reduces the level of inflammation in Bechterew's disease. Manganese is involved in the formation of bone and cartilage cells and also increases cell protection. Fluoride, another essential component of the healing water in Bad Brambach, has also been proven to be involved in bone formation.

Radon bath treatment

A bath treatment with water containing radon usually consists of 10 to 12 sessions in a full bath and primarily affects our largest organ: the skin. Your therapy is always accompanied by our spa doctors.

According to various expert opinions, the relief of symptoms lasts up to nine months after completing radon therapy. Overall, many of our patients can reduce their medication requirements in this way.

Diagnosis: Bechterew's disease

Early detection of Bechterew's disease is difficult because the symptoms are usually viewed as normal back pain or tension. However, you should pay attention at the latest when there are already diagnosed cases of Bechterew's disease in the family. In addition, if the back pain lasts for a long time, is inflammatory and occurs primarily at night or when lying down. You should also go to your family doctor if you have joint inflammation, psoriasis, inflammatory bowel disease, iris inflammation or tendon or muscle inflammation. He or she will make an initial diagnosis or refer the potential Bechterew's disease sufferer directly to a rheumatologist.

Four stages of the progression of Bechterew's disease

Phase I: Suspicious stage

In this initial phase, also called the prodromal or suspected stage, the main symptoms include deep back pain. Inflammatory processes in the spine begin

Phase II:Stiffening of the spine

This phase is characterized by increasing, irreversible stiffening of a section of the spine. A constant ossification of the fibrous rings of the intervertebral discs in the lumbar spine area can also be seen.

Phase III: Difficulty breathing

In the third stage, not only the sacroiliac joint but also the costal vertebral joints gradually stiffen. This is accompanied by a restriction in breathing, as the expansion of the chest when inhaling is increasingly reduced. Increased abdominal breathing is typical. The pain now also spreads to the large joints.

Phase IV: Complete ossification and accompanying symptoms

In this fourth and final stage, the spine ossifies, the chest and often nearby joints slowly stiffen. The sacroiliac joint is now also completely ossified. In addition to the typical back and joint pain as well as the increasing stiffness of the vertebral joints, other side effects are possible.

Anmanese

During the anamnesis, the doctor focuses on the area of ​​the spine and nearby joints and also asks about typical accompanying symptoms.

Magnetic resonance imaging

Through MRT (Magnetic resonance imaging) current or subsided inflammation in the sacroiliac joint and the spine can be detected in the early phase.

X-ray

At the  X-ray On the other hand, changes typical of Bechterew's disease can be recognized in an advanced stage.

Blood samples

The doctor also takes an anamnesis if Bechterew's disease is suspected Blood samplesto determine whether there are increased levels of inflammation. In the case of Bechterew's disease, however, these can be within the normal range, which is why a combination of different symptoms and accompanying symptoms must be proven. The presence of the gene marker HLA-B27 provides an important clue.

Menell's test

Continue to be taken by the doctor Measurements of spinal mobility as well as chest expansion and posture were measured. These include Menell's test, in which pain is localized using a thigh hyperextension test and pressure on certain areas.

In around 5 to 10% of cases of chronic, deep-seated back pain, Bechterew's disease is the underlying cause, especially if it occurs before the age of 45 and especially when at rest.

Risk factors of ankylosing spondylitis

Genetic factors

  • Gene marker HLA-B27
  • confirmed cases in the family

Diseases that promote Bechterew's disease

Certain bacterial infections that trigger autoinflammatory processes

Questions about Bechterew's disease

How common is Bechterew's disease?

It is estimated that around 0,5% of adults in Central Europe suffer from Bechterew's disease. This includes unrecognized cases that are so mild that they are not diagnosed or recognized. Diagnosed cases affect approximately 0,1% to 0,2% of the adult population. In concrete terms, this means for Germany: Around 350.000 people are affected by Bechterew's disease, of which only around 150.000 have symptoms so severe that Bechterew's disease has been diagnosed.

Does ankylosing spondylitis affect life expectancy?

No, Bechterew's disease per se does not lead to a reduced life expectancy. Only the quality of life can become increasingly limited. Other factors play a role here that have an influence on health. With regular check-ups and the resulting therapeutic measures with a healthy diet and an adapted lifestyle, there is nothing that speaks against a normal life expectancy.

What can I do myself to relieve the symptoms?

Regular medical check-ups should be part of this, as should lifestyle adjustments. On the one hand, health-promoting foods should be consumed. Obesity and alcohol should be significantly reduced or, ideally, avoided entirely. Cigarettes and the like are absolutely taboo for those affected by Bechterew's disease. An optimal upright posture can reduce excessive curvature of the spine as the disease progresses.

How does Bechterew's disease affect my ability to work?

Most jobs can be continued with a diagnosis of Bechterew's disease. If complaints become noticeable, it helps to discuss with the employer to what extent the work processes and the workplace could be adjusted accordingly. For example, ergonomically shaped workplaces or rehabilitation measures help. In severe and very advanced cases of ankylosing spondylitis and in jobs that are physically demanding, retraining may be necessary.

Can I travel with ankylosing spondylitis?

The ability to travel depends on the severity of the illness. As a rule, people affected by Bechterew's disease can travel like anyone else. However, care should be taken to ensure that enough breaks are planned during arrival, departure and stay in order to have time to move around. Sitting for long periods of time can cause pain. For medications that require refrigeration, it makes sense to contact the tour operator beforehand to find out to what extent the cold chain can be maintained.

What should you pay attention to when pregnant?

The same applies here: those affected by Bechterew's disease can become pregnant quite normally. Pregnancy does not pose any particular risk. In most cases, the birth also proceeds completely normally. Only in severe cases of Bechterew's disease with extreme immobility of the hip joints and pelvic bones can a cesarean section be unavoidable. Talk to your doctor about this.

What costs does the health insurance company cover?

The health insurance company covers the costs of all necessary and appropriate diagnostic and therapeutic measures. Depending on the health insurance company and the need for certain services, there may be an out-of-pocket cost.

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