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Ankylosing spondylitis (AS), also known as Bechterew's disease, is a chronic and progressive form of inflammatory arthritis that primarily affects the spine, particularly the lower back. It is characterized by pain and stiffness in the back and joints, which can gradually worsen over time.

The exact cause of ankylosing spondylitis is unknown, but it is believed to involve a combination of genetic and environmental factors. The condition is more commonly observed in individuals who have a specific genetic marker called HLA-B27, although not everyone with this marker develops AS.

One of the hallmark symptoms of ankylosing spondylitis is back pain, which typically starts in the lower back and can gradually extend up the spine. The pain is often worse in the morning or after prolonged periods of inactivity and may improve with movement and exercise. Stiffness in the back is also a prominent symptom, which can make it difficult to bend, twist, or perform daily activities.

In addition to the lower back, ankylosing spondylitis can affect other joints, such as the hips, shoulders, knees, and ankles. Joint pain, swelling, and tenderness may occur, leading to reduced mobility and flexibility.

Over time, chronic inflammation in the spine can cause the vertebrae to fuse together, leading to a condition known as ankylosis. As the bones fuse, the spine becomes less flexible, which can result in a stooped posture and limited range of motion. In severe cases, fusion of the ribs can restrict lung expansion and lead to breathing difficulties.

Ankylosing spondylitis is a systemic condition, meaning it can affect other parts of the body beyond the spine. Some individuals may experience symptoms such as fatigue, eye inflammation (uveitis), inflammatory bowel disease (such as Crohn's disease or ulcerative colitis), and heart problems.

Diagnosing ankylosing spondylitis involves a combination of clinical evaluation, medical history, imaging tests (such as X-rays or MRI), and blood tests. Early detection is important to start appropriate treatment and prevent complications.

Although there is no cure for ankylosing spondylitis, various treatments can help manage symptoms and slow down the progression of the disease. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed to reduce pain and inflammation. Disease-modifying antirheumatic drugs (DMARDs), such as sulfasalazine or methotrexate, may be used to modify the course of the disease. Biologic medications, such as tumor necrosis factor (TNF) inhibitors, are sometimes recommended for individuals with more severe symptoms.

Physical therapy and regular exercise play a crucial role in managing ankylosing spondylitis. These interventions can help improve flexibility, strengthen muscles, maintain proper posture, and reduce pain. In some cases, surgery may be necessary to correct severe deformities or joint damage caused by the condition.

Living with ankylosing spondylitis requires a multidisciplinary approach involving rheumatologists, physiotherapists, and other healthcare professionals to provide comprehensive care and support. It is important for individuals with AS to maintain a healthy lifestyle, manage stress, and engage in regular physical activity to optimize their overall well-being.

In summary, ankylosing spondylitis is a chronic form of inflammatory arthritis that primarily affects the lower back. Back pain, joint involvement, and stiffness are the main symptoms, and over time, the condition can lead to fusion of the spinal bones. Early diagnosis, appropriate medical management, and a comprehensive approach to care can help individuals with ankylosing spondylitis effectively manage their symptoms and maintain a good quality of life.