12/19/2021 at 4.30 p.m. CET
the spondylitis This is a group of rheumatic diseases that primarily affect the spine, although they can affect other organs as well.
Rheumatologists from the Spanish Society of Rheumatology (SER) include ankylosing spondylitis, psoriatic arthritis, spondyloarthropathies associated with inflammatory bowel disease or reactive arthritis in this type of pathology.
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It is estimated that its prevalence could exceed 1.2% of the population, which is equivalent to around half a million people affected in Spain.
And “although the diagnosis has improved there is still a significant diagnostic delay,” explains the president of the Spanish Society of Rheumatology (SER), Dr. José Mª Álvaro-Gracia.
Types de spondylarthropathies
The most common pathology in spondyloarthropathies is ankylosing spondylitis, as SER experts explain.
In addition to this, rheumatologists also include reactive arthritis in this group “which normally appears one month after the patient has undergone an infectious process (urinary or digestive)”.
And finally, the psoriatic arthritis, the most common manifestation of which is dandruff or eczema on the skin.
Symptoms of spondylitis
Usually, these types of diseases progress as epidemics. Periods without symptoms are followed by “periods of exacerbation”.
The first symptoms usually start with a pain localized in one of the buttocks, pain that, contrary to what you might think, gets worse with rest and improves with exercise.
This means that the pain is more common at night.
Gradually, the pain will spread to the other buttock and, over time, to the spine and neck.
Another symptom is stiffness and inflammation also in the joints such as the hips, shoulders, knees or ankles.
Diagnosis and treatment
The doctor Joaquin Belzunegui, head of the rheumatology department at Donostia University Hospital, explains that “early identification of these patients is not always easy. Some studies have indicated a delay which could be between 7 and 8 years, although this may vary according to the health structure of the countries and in particular in Spain the delay of diagnosis is a little less.
“The fundamental aspect of the success of the treatment and which will determine a good long-term prognosis is to be able to make an early diagnosis in order to be able to administer the most appropriate treatment as soon as possible”, according to Dr Belzunegui.
In addition to study the medical history and explore the patient, the specialist will also perform other diagnostic tests such as scans and imaging tests to determine the existence of the disease.
Depending on the diagnosis and condition of the disease, the rheumatologist may treat it with nonsteroidal anti-inflammatory drugs (NSAIDs), oral glucocorticoids, or injections.
The best medicine: physical activity
People with spondyloarthritis generally get less physical activity than the general population, with the negative effects that follow.
On the contrary, patients “who exercise improve fitness, spine flexibility and pain, reduce inflammation, may improve depression and increase quality of life,” says Dr Álvaro-Gracia. .
And it is that physical activity and physical exercise favorably influence three of the main factors involved in the onset of spondylitis: the immune system, persistent inflammation and the intestinal flora.
In particular, they prevent many of its consequences in the medium and long term and can limit the negative influence on its course of associated diseases, aging and drug side effects, as detailed by experts.
What type of exercise is the best?
But not every type of physical activity is worth it. The doctor Cristina Macia, rheumatologist at Severo Ochoa University Hospital (Madrid), recalls that “it is very important that people with spondylitis perform exercises supervised by sports professionals, according to the limitations and needs of each”.
When choosing the type of exercise, it is essential that the person is comfortable doing it, as this will make it easier for them to develop a habit of exercising regularly. say at least three times a week.
In spondylitis, there are three clinical stages:
Initial (normal or slightly limited spinal mobility, minimal functional impact) Intermediate (partial limitation of mobility, moderate impact) Advanced (areas of the spine with complete loss of mobility, significant impact on daily activities)
Aerobic and strengthening exercises are recommended at all stages. In the middle stage, flexibility exercises are added in areas with reduced mobility and, in some cases, breathing.
But when the patient is at an advanced stage of the disease, it is better avoid flexibility exercises in areas of the spine with established mobility limitation and breathing exercises are also recommended to improve chest expansion.
In addition, there are several practical details to be aware of that vary with each type of exercise. Flexibility exercises are not indicated in some places and situations.
The strengthening exercises They are recommended for all people, but they are especially important from the age of 50.
In general, the most common and recommended aerobic exercises for patients with spondylitis are walking, cycling and swimming.
In people who do not participate in any type of physical activity or exercise, the first goal may be to reduce the sedentary lifestyle and when you are going to start an exercise program that has not been done before, it is advisable to consult a healthcare professional.
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