Ankylosing spondylitis

Ankylosing spondylitis is an inflammatory rheumatic disease that, as the name suggests, involves inflammation of the spine (spondylitis) and the formation of syndesmophytes (ankylosis) as its pathophysiological mechanism.

It belongs to a broader group of rheumatic diseases called spondyloarthropathies, which share common clinical and genetic characteristics. Symptoms typically begin between the ages of 20 and 40, but diagnosis is often delayed by several years—on average 7 years.

The hallmark symptom of the disease is chronic back pain (lasting more than 3 months), with an inflammatory pattern that worsens with rest, is more intense in the second half of the night and upon waking, improves with exercise, and is associated with prolonged morning stiffness (≥ 30 minutes).

Pharmacological treatment is based on non-steroidal anti-inflammatory drugs (NSAIDs), which often need to be taken daily. Unlike some other diseases, these drugs have not only a symptomatic effect but also modify the disease: they are proven to reduce inflammatory activity and delay the progression of ankylosis. In refractory cases, immunosuppressive therapy may be indicated. Regular physical activity, focusing on posture and flexibility training, and in selected cases, physiotherapy, are crucial to maintaining mobility and functionality.

It is important for patients to be aware of the symptoms of this disease and seek the help of a rheumatologist, as delayed diagnosis is the biggest obstacle to successful treatment.
 

Useful links:​

https://www.spreumatologia.pt/espondilite-anquilosante/

https://www.anea.org.pt/