Text of Mary Lucy Marques, reumatologista. AThis Saturday, May 2nd, marks World Ankylosing Spondylitis Day, an opportunity to talk about a disease that remains little recognized, despite the significant impact it can have on the lives of those who suffer.
Back pain almost everyone has it. It is one of the most frequent causes of medical consultation around the world and it is estimated that around eight in ten people experience it at some point in their lives. In most cases, the pain is benign and improves over days or weeks.
But sand the pain doesn’t go away, if it gets worse with rest, if it makes you feel “stuck” when you wake up and interferes with sleep, then the story could be different.
This type of pain can be the The first sign of an inflammatory disease of the spine: ankylosing spondylitis, or, as we prefer to call it more correctly and comprehensively today, axial spondyloarthritis.
It is a chronic rheumatic inflammatory disease that mainly affects the spine and the joints between the spine and pelvis. The term “ankylosing” refers to the possibility of progressive fusion of the vertebrae, with loss of mobility and hunched posture, giving rise to the classic “hunchback” image historically associated with the disease.
The name changed because it also changed the way we understand the disease. We now know that “ankylosing spondylitis” represents only the most advanced phase of a broader spectrum of disease.. And, fortunately, we also know that the Progression to severe forms can be avoided when there is timely diagnosis and treatment.
It is estimated that Ankylosing spondylitis affects around 5 in every 1000 people in Portugal.
In clinical practice, I see patients who They have already changed mattresses several times looking for relief. Who blame the posture, excessive work, stress. Who stopped sleeping in the same bed as their partner because they spend the night changing positions due to pain. Who haven’t slept a night in a row for years. For many, sitting and working on the computer or driving is a real ordeal.
Because this is not just “a backache”.
The disease usually appears in second or third decade of lifebeing Its onset after the age of 45 is rare. It affects young people, in an active phase of life. And although for a long time it was considered a predominantly male disease, today we know that It also affects women, who are often still underdiagnosed.
In addition to the spine, inflammation can affect other joints.such as knees, ankles, or hands. It can also cause enthesitis (inflammation at the insertion of tendons, often in the heels) and join demonstrations in other parts of the body, such as psoriasis, inflammatory bowel disease, or uveitis, a painful and potentially serious eye inflammation. There is also an important genetic component, with disease frequently associated with the HLA-B27 marker.
Many patients live with symptoms for years before getting a diagnosis. On average, the diagnostic delay is around seven years.
Seven years in which pain is trivialized.
Seven years in which the inflammation remains active without adequate treatment.
The good news is that today we have highly effective treatments that allow control inflammation, preserve mobility and prevent, in many cases, the progression of the disease. Monitoring by a rheumatologist, associated with regular physical exercise and physiotherapy, radically changed the prognosis of these patients.
But for that, It is essential to diagnose early and correctly. In suspected cases, timely referral to Rheumatology can make all the difference.
Why in axial spondyloarthritis, early recognition is early treatment.
And treating it early means changing the future of those living with this disease.
Article written by Mary Lucy Marques, ccoordinator of the Specialized Spondylarthritis Consultation at ULS in Coimbra, meffective member of the international society ASAS (Assessment of SpondyloArthritis International Society)
