Ankylosing spondylitis in men causes, symptoms and treatment

Men at a young age, even without any obvious reason, may suffer from pain in the spinal column and joints of the legs or arms. Most often, ankylosing spondylitis in men is confused with osteochondrosis or arthritis. However, sometimes women also suffer from this pathology. However, the number of patients relative to the male population is 10-12 times less. What kind of disease is this that poses a threat to the whole body, and which is so difficult to determine without a special diagnosis?

What is this pathology?

Ankylosing spondylitis usually develops in male patients and originates at a fairly early age. Up to 30 years, a person may be subject to this ailment. Characteristically, in the early stages, the man does not even suspect that he has problems with joints and back.

And only after 7-8 years, clinical symptoms make themselves felt by soreness and other signs. The disease is manifested by the accumulation and deposition of calcium salts, which are not able to react with other mineral components. As a result, mobility is impaired.

The risk of the onset of the disease persists until about 40 years of age, therefore, only by 47-48 years the patient will begin to experience all the severity of such disorders in the body.

For the first time this pathology was described by a Russian doctor V.M. Bekhterev, which is why she got her current name. This happened in 1892. However, in official medical terminology, there are other names for it – ankylosis and spondylitis.

The insidiousness of this disease is manifested in the fact that it is absolutely identical in the signs and course of osteochondrosis.

This similarity often leads to negative consequences:

  • Untimely correct diagnosis;
  • Unproductive methods and treatments delaying the achievement of a therapeutic effect;
  • Excessive costs of treatment;
  • The transition of pathology into a chronic form;
  • Gradual manifestation of stiffness in movements;
  • The decline of physical activity and energy;
  • Loss of fullness of life sensations;
  • The occurrence of irreversible pathological processes in the body.

The disease manifests itself for a long time and is characterized mainly by the development of the focus of the inflammatory process. Most often, there are several such lesions. They are localized in one of the parts of the spinal column and in several joints at the same time.

As development and as a result of neglect, the disease begins to manifest in various forms and stages, the patient’s condition is aggravated by secondary signs and diseases.

Development implications

Spreading along the entire axis of the spine, ankylosing spondylitis in men covers different areas of the back, limbs and even internal organs. Inflammation quickly affects all adjacent organs and tissues.

As a consequence of this, the probability of the onset of such pathological conditions is high:

  • Problems of the peripheral nervous system, up to the onset of the effects of osteoporosis, progressing against the background of spondylitis;
  • Abnormal physiology in the work of the respiratory system – air chambers form in the lungs in the distal bronchioles and other diseases appear;
  • A third of patients with ankylosis are forced to suffer from concomitant kidney diseases – amyloidosis, renal failure, and others;
  • The whole cardiovascular system is susceptible to diseases with this pathology – there are signs of shortness of breath, rapid heart rate and palpitations, pericarditis, myocarditis, and myocardial dystrophy begin to progress. Up to 25% of those suffering from this disease are exposed to such consequences;
  • Out of every 10 patients, about 3-4 people experience complications that appear in the organs of vision – it worsens, iridocyclitis, uveitis, and iritis appear.

And quite naturally, the disease covers articular elements in a variety of joints, as well as vertebrae in the back, tissue and spinal cord. These consequences are manifested by inflammation and loss of tendon functionality, peripheral arthritis, impairment of the roots of nerve receptors. At the same time, there is a risk of curvature of the back, kyphosis in the thoracic spine, and compression of the blood spinal arteries. As a result of this, the characteristic signs of ankylosing spondylitis in men are supplemented by strong and frequent migraines, sudden jumps in blood pressure, stable tension of the vertebral muscles, rapid fatigue and a deterioration in the quality of life in general.

Causes

It is not by chance that an ailment with such dangerous consequences arises precisely among patients in the male population. The basic theory of its occurrence is based on the fact that this disease has an autoimmune nature. In other words, pathology develops as a result of violations in the immune system when there is no proper interaction of the protective cells of the body. Against the background of this anomaly, an excess of HLA B27 type antigen occurs – it is this component that provokes inflammatory processes, and, unlike many other factors and diseases, inflammation manifests itself simultaneously in several areas of the musculoskeletal system.

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The basis for the initial development of ankylosing spondylitis in men is usually the following disorders and pathologies:

  1. Violations of the functional activity of the reproductive and urinary system, including urethritis, prostatitis, cysts, infectious streptococcal infections;
  2. Open or closed fractures, especially in the area of ​​the hip joints;
  3. Infections in a variety of tissues and organs, usually of bacterial origin. Although viral diseases also affect the appearance of spondylitis.

The last item includes dozens of contagious diseases, including salmonellosis, tuberculosis, infectious hepatitis, chlamydia, brucellosis, bacterial infections of the digestive tract, viral respiratory diseases, including infectious pneumonia, as well as leptospirosis and cancer.

Medical scientists have confirmed as a result of examination of patients diagnosed with “Ankylosis” a number of other causes of this problem.

  • Instability of a psychological nature and emotional mood swings;
  • Back problems due to spinal cord injuries;
  • The effect of progressive mycoplasmosis and other fungal forms of diseases;
  • Frequent and severe hypothermia;
  • Protracted stressful circumstances and depressive states;
  • Serious disorders in the work of the endocrine system, including inflammation of the lymph nodes, thyroid pathology.

In individual episodes, the influence of primary factors in which ankylosing spondylitis in men is a complication or a clinical sign is noted. Such cases include the development of sepsis with blood poisoning and pathologies of its components and fractions. This also includes dislocations of the joints, in which the head of one or both bones extends beyond the synovial sac. As a secondary disease, this ailment develops against the background of progressive osteomyelitis, as well as purulent or rheumatoid arthritis.

This disease can occur due to contracture – reduced mobility caused by mechanical damage, injuries, low temperatures, infectious pathologies.

Clinical presentation of symptoms

About 5% of all patients suffering from an ailment felt their full severity in the childhood period. More than half of those suffering from ankylosing spondylitis learned about its presence in the body under the age of 30-35 years. The first thing that indicates the likelihood of its development is problems with the hip and knee joints, as well as the joints of the phalanges of the fingers on the lower extremities.

At the age of 12-18 years, the disease already covers the entire region of the spinal column, and by that time it may be manifested by its usual symptoms – pain, swelling, and immobility.

From this age, the ailment intensively spreads to joints with peripheral localization – wrist, joints of the feet, phalanges of the hands and others.

A characteristic clinic for ankylosing spondylitis is:

  • Soreness of a moderate or intense nature, with cutting, aching, dull sensations. Pain is usually accompanied by irrigation to adjacent parts of the body. Most often they are felt in the buttocks and different parts of the legs;
  • Stable pain in the feet, especially during physical activity and during physical exertion;
  • Stiffness, especially in the lumbar region and the lumbosacral region of the spine;
  • Reduced mobility of all joints and back.

In the joint itself, the cartilage tissue is thinning, the bones form a single structure, connecting with each other.

Treatment

With this pathology, the prognosis is usually either cautious – with intensive therapy of inflammatory processes and treatment of consequences, or – unfavorable (with untimely or incorrect diagnosis and delayed treatment).

During treatment and even after it, the patient still has dizziness and migraine for some time, backache, backache, swelling of the joints. In addition, ankylosing spondylitis can provoke stable pathological conditions:

  • Dyspnea;
  • Difficulties in turning – it will turn out only with the whole body;
  • The vertebrae are stretched into one vertical axis, natural bends disappear, which creates a load on the back and legs;
  • There are complications in the work of internal organs, especially – the kidneys, lungs, bronchus, heart, arteries, intestines and stomach;
  • Not passing stable fatigue;
  • Deterioration in sleep quality.

The development of ankylosing spondylitis in men leads to a partial or complete loss of mobility, a decrease, and even a lack of physical activity. The most unpleasant consequence is disability.

This disease affects mortality only indirectly, and with competent treatment of the disease itself and its complications, patients survive even with disabilities up to 70-75 years.

Forms of manifestation and stage of the disease

It will be easier for patients and people at risk to determine the likelihood of an ailment before visiting an orthopedist, traumatologist or rheumatologist, if you know about the existing stages and forms.

There are 3 stages of the disease:

  • Initial – accompanied by slight discomfort in the joints during movement. Hardware and laboratory methods do not reveal any deviations, sometimes there is a decrease in joint mobility;
  • Moderate – narrowing of the interarticular gap, depletion of synovial fluid, the formation of bone growths, severe soreness;
  • Late – the irreversibility of the signs of spondylitis is activated, the volume of accumulated calcium salts increases, the whole complex of symptoms is fully manifested.
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At the same time, the classification of ankylosing spondylitis in men suggests differences in the location of the symptoms:

  • The central form is characterized by the defeat of the purely articulations of the spinal column, partially or completely of all its departments. With this form, the disease proceeds imperceptibly and slowly;
  • The rhizomelic form manifests itself in the hip and shoulder joints;
  • The Scandinavian form is a rare pathology, in which the articular elements of the phalanx of the fingers mainly suffer, some parts of the back and feet;
  • The peripheral form spreads quickly and its symptoms are noticeable in the ankle, knee, elbow joints, as well as in the spine.

Diagnostic measures

The initial diagnosis is made on the basis of clinical examinations, medical history. To confirm it, laboratory examinations are prescribed – a blood test for the erythrocyte sedimentation rate, the biochemical content of the components in the blood. Blood is also tested for rheumatoid factor. Typically, the presence and presence of the HLA B-27 antigen is detected in a laboratory.

At the same time, methods of hardware and instrumental diagnostics are carried out:

Therapeutic techniques

To achieve a therapeutic effect in the treatment of ankylosing spondylitis in men, a comprehensive course of treatment is used, which includes:

  • Acceptance of pharmacological agents;
  • Physiotherapy
  • Swimming;
  • Hirudotherapy;
  • Reception of healing baths;
  • Massage treatments.

The most significant is drug treatment. It involves such methods:

Removing soreness – for this, Paracetamol, TNF inhibitors are used, Rimicade is injected.

At the same time, antipyretic drugs and medications of the glucocorticosteroid group are prescribed:

  • Leukeran;
  • Kenalog;
  • Methylpred;
  • Depot-medrol;
  • Urabzon;
  • Methyl prednesalon;
  • Ibuklin.

With the appearance of spasms and with severe pain, Skutamil-C is effective.

The progressive course and chronic form of ankylosing spondylitis require the use of potent agents.

Among them, the following are particularly distinguished by their effectiveness:

This course is supplemented with physiotherapeutic procedures – exposure to critically low temperatures, the use of therapeutic leeches, magnetotherapy, electrophoresis using novocaine, and mud therapy.

Resulting are baths containing turpentine, iodide-bromine components, radon, sodium chloride.

Alternative recipes can also help the patient with spondylitis. Tinctures and baths from calamus, elecampane root, St. John’s wort leaves and stems, as well as fruits of chokeberry, pine needles and oregano effectively relieve inflammation and neutralize pain.

Prevention

To prevent the development of ankylosing spondylitis, as well as in the event of its occurrence, doctors recommend a moderate lifestyle, limiting the intensity of physical activity. You should try to avoid inflammatory and infectious diseases as much as possible.

Particular attention should be paid to the loads on the hip, elbow, knee joint and on the phalanges of the fingers. Similarly, you need to monitor the loads on the axis of the spinal column. It is advisable to sleep without tall and elastic pillows, preferably on a hard or orthopedic mattress.

If all the recommendations are followed, even the chronic form will recede, and for many years ankylosis will not remind of itself. And in order not to encounter this pathology at all, parents need to monitor the condition and complaints of the child, and adults should be regularly examined by an orthopedic doctor.

Shishkevich Vladimir
Shishkevich Vladimir
Orthopedic doctor, traumatologist
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