Bekhterev’s disease

Bekhterev’s disease (ankylosing spondylitis) is a type of chronic rheumatic inflammation. The inflammation primarily affects the spine and the sacroiliac joints, which connect the spine to the pelvis. The disease features episodes of pain during the night and spinal stiffness in the morning. Over time the intervertebral joints can ossify, causing increasing stiffness in the spine. The main aim of treatment is to reduce the level of pain and maintain spinal mobility.

Bekhterev’s disease owes its name to the Russian neurologist who first described the condition in the early 19th century. This chronic inflammatory disease is a type of rheumatic disease. The inflammatory changes primarily affect the intervertebral joints in the spine and the sacroiliac joints. Typically the joint ligaments and the areas where the tendons attach to the bones also become inflamed. Over time, the intervertebral joints lose their mobility and the ligaments and spinal discs can ossify. This leads to increasing stiffness in the spine. The joints in the arms and legs can also be affected by the disease, however this is rarely the case. On the other hand, around one third of patients with Bekhterev’s disease also suffer from inflammation of the eyes.

The disease usually starts developing in people around the age of 40. Not a lot is known about how or why it occurs. The only thing that is known for sure, is that the inflammation is caused by unnecessary responses from the immune system’s defence mechanisms. As such, it is considered an autoimmune disease. Genetic predisposition has a major influence on the development of Bekhterev’s disease. 95% of all patients with the disease share a specific hereditary trait, known as the HLA-B27 antigen.

The initial symptoms include pain in the lumbar region and the buttocks. The pain typically occurs at night and improves with movement, forcing the affected person to get up during the night. Another classic symptom is stiffness in the spine after waking up in the morning.  These complaints slowly develop over the years and increasingly restrict the movement of the spine.

Bekhterev’s disease is diagnosed on the basis of its distinctive symptoms and the diagnosis is confirmed using various radiological examinations. This usually also includes an MRI examination. As with all rheumatic diseases, signs of the inflammation can be detected in the blood.

Treatment focuses on reducing the symptoms and trying to retain as much spinal mobility as possible. There is currently no cure for Bekhterev’s disease. The pain and inflammation are treated using pain killers and anti-inflammatory medication, as well as special rheumatism medication.

People with Bekhterev’s disease must do exercises and have physiotherapy every day to retain mobility in their spine. Heat treatments and massage are recommended for relieving muscle tension. In general, moderate sporting activities such as cross-country skiing, Nordic walking, cycling, hiking and swimming can help to slow down or reduce the progression of the disease.