Inflammatory rheumatic diseases

Ankylosing spondylitis and axial spondyloarthritis

Axial spondyloarthritis is a chronic inflammatory disease of the sacroiliac joints and the spine. It includes a radiographic form (ankylosing spondylitis, Bechterew’s disease) and a non-radiographic form. The leading symptom is inflammatory back pain: gradual onset before the age of 45, morning stiffness lasting longer than 30 minutes, improvement with activity and night pain in the second half of the night. The disease often also shows signs in other organs and organ systems, such as the skin, eyes, lungs and bowel.

The diagnosis is made according to the ASAS criteria, on the basis of the clinical picture, HLA-B27, CRP and MRI of the sacroiliac joints. Treatment includes non-steroidal anti-inflammatory drugs and, in active disease, biological drugs (TNF and IL-17 inhibitors) or JAK inhibitors. Rehabilitation is a permanent part of treatment: spinal extension and mobility exercises, and breathing exercises to expand the chest. The disease is described in detail in the section of the website on inflammatory rheumatic diseases.

Psoriatic and enteropathic spondyloarthritis

Inflammatory involvement of the spine and sacroiliac joints in people with psoriasis or inflammatory bowel disease (Crohn’s disease, ulcerative colitis), often asymmetrical. Rehabilitation is carried out in step with rheumatological treatment and the activity of the underlying disease. These diseases are described in detail in the section of the website on inflammatory rheumatic diseases.

Rheumatoid arthritis of the cervical spine

Involvement of the craniovertebral junction, with possible atlantoaxial instability and subaxial subluxation. Before any mobilisation the doctor assesses stability on functional X-rays, and manipulation is contraindicated.

After spondylodiscitis

Rehabilitation after a cured infection of an intervertebral disc and the adjacent vertebrae, whether bacterial or tuberculous. It is carried out only after antimicrobial treatment has been completed and inflammatory markers have returned to normal, under medical supervision.