Ankylosing Spondylitis (Bechterew's disease or Marie Struempell disease as it is also known) is a form of chronic, degenerative arthritis that affects the spine and sacroiliac joints and often other joints of the body.

Symptoms of Ankylosing Spondylitis

Ankylosing spondylitis comes to light most frequently between the ages of 15 and 30. It can, however, occur before or after this time. The condition is more prevalent in men than in women, with around 1 in 200 men and 1 in 500 women being diagnosed with the condition in the UK. It is thought however, that fewer women are correctly diagnosed due to the differing patterns of symptoms when compared to men.

Symptoms of ankylosing spondylitis may initially be limited to lower back or joint aching, which is often just put down to 'aches and pains' and 'growing pains' in young people. Symptoms come and go and will usually progress to include the following:

  • Stiffness and pain in the morning affecting the sacroiliac joint area and spine.  
  • Aching in the lower back which can disrupt sleep.  
  • Pain radiating down the legs and into the groin.
  • Pain is worse during and after rest e.g. in the mornings.
  • Exercise eases the pain and stiffness.
  • Aches and pains in the buttocks, neck, shoulders, hips and upper back.  
  • Symptoms may flare up and then disappear.  
  • Severe cases may cause feelings of illness, weight loss and fatigue.  

Other complications may include recurrent eye inflammations, heart, lung, nervous system, bowel problems and over time, an increased kyphosis or curvature of the upper spine.

What is Ankylosing Spondylitis?

Ankylosing Spondylitis (Bechterew's disease or Marie Struempell disease as it is also known) is a form of chronic, degenerative arthritis that affects the spine and sacroiliac joints and often other joints of the body. The cause is currently unknown although there is a hereditary factor.

The word ankylosing means fusion and the word spondylitis means inflammation of the joints of the spine. Inflammation within the spine and sacroiliac joints develops which also triggers the development of bony growths which often fuse the vertebrae causing pain and stiffness. Ankylosing Spondylitis is one of a group of arthritis conditions known as spondoarthritides, including psoriatic, colitic and reactive arthritis. AS can occur in isolation or in conjunction with any of these conditions, as well as crohns disease, psoriasis and osteoporosis.

No two cases of AS are exactly the same. Variations occur in the distribution of pain, stiffness, inflammation and in the length of flare-ups and course of the disease. In some cases the disease becomes less active and pain may cease altogether.

Treatment of Ankylosing Spondylitis

What can the athlete do?

  • Keep themselves fit and healthy
  • Maintain an optimum weight to place as little strain on the spine as possible
  • Have a good diet
  • Maintain a good posture and mobility
  • Avoid sudden twisting and turning movements
  • Use a heat pack or warm bath to reduce pain and stiffness
  • Exercise such as swimming can be great for ankylosing spondylitis as it places very little strain on the spine and joints.
  • Other exercises for mobility and back strength can also be beneficial.

What can a doctor do?

  • Do a blood test and x-rays to confirm diagnosis.  
  • Prescribe exercises and physiotherapy to maintain good mobility and posture and counteract the stiffening of the spine.
  • Prescribe anti-inflammatory medication such as ibuprofen.  
  • Prescribe other disease modifying drugs or injections.  
  • Surgery is rare although may sometimes be used to restore movement or straighten the spine in extreme cases.

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