“Immortal Cancer”? Repeated back pain of unknown cause, the 32-year-old boy wakes up every night…

“Doctor, I often My chest and back are sore, but it’s fine during the day, but when I go to sleep at night, it’s very painful, and I have to wake up several times a day!” Recently, Xiao Chen (pseudonym) came to the expert clinic of Hangzhou Red Cross Orthopaedic Director Zheng Qi with dark circles under his eyes. . The 32-year-old Xiao Chen is a company employee. He has been working at a desk for a long time and staying up late to work overtime, which has caused him to suffer from many occupational diseases at a young age, and shoulder, neck and low back pain have become commonplace.

But recently, this low back pain is really unusual. After waking up at night, the pain can’t be relieved for a long time. It takes about 20 minutes to get out of bed and walk to get back to sleep. In desperation, he went to the community to get some medicine to take orally, but nothing improved. “It’s fortunate that you found out early, this is not a simple back pain!” Director Zheng Qi carefully inquired about the medical history, physical examination, and combined with the relevant examination results to tell Xiao Chen that he was suffering from ankylosing spondylitis, and he was treated by many The common people call it “immortal cancer”.

What is ankylosing spondylitis?

Ankylosing spondylitis is a disease of the immune system, which mainly affects the axial joints of the human body. It starts from the sacroiliac joints and progresses upward to the lumbar, thoracic and cervical vertebrae, causing pain and later causing pain. Bone stiffness disease with “bamboo-like” changes in the spine. Pain accompanied by the inability of the spine and even limbs to move seriously affects daily life. Some of them can cause diseases of the heart, lungs, intestines, eyes and other organs.

Typical symptoms

Hip or groin, sacroiliac joint pain, even back pain and soreness, feeling joint or spine stiffness, advanced hunched back.

Atypical symptoms

Morning stiffness of limbs and joints, back pain, dull pain at night, difficulty turning over or waking up with pain at night, and can only go back to sleep after getting out of bed. Dry and itchy eyes, red eyes, watery eyes, wheezing with chest tightness, swelling and pain in the heels, abdominal pain due to amyloid enteritis, etc. The incidence of ankylosing spondylitis is actually not low, which is slightly similar to rheumatoid arthritis. There are about 5 million people suffering from this disease in our country, and it is increasing every year at the rate of 100,000 people. However, due to its atypical early symptoms, it is easy to be misdiagnosed as “rheumatoid arthritis”, “lumbar muscle strain”, “lumbar disc herniation”, “lumbar osteoarthritis” and other diseases, thus affecting the diagnosis and treatment of the disease.

What are the characteristics of ankylosing spondylitis?

“sonophobia”: males are more common than females, with a male-to-female ratio of about 9:1.

“Love small fresh meat”: The age of onset is mostly young people, and the age of onset is mostly 17 to 37 years old, and most of them are 20 to 30 years old. The younger the age, the more severe the symptoms. It is self-limiting to a certain extent, and when a certain age is reached, the development of the disease is relatively slow or even stopped.

“familial hereditary tendency”: the elders in the family suffer from the disease, and the children are at greater risk of suffering from the disease, and there is a certain familial genetic predisposition.

How to check for ankylosing spondylitis?

It is difficult to make an early diagnosis when the symptoms are not obvious in the early stage. HLA-B27 can be tested by blood test. If it is positive, most of them can be diagnosed with the disease (if it is not positive, it must be, and some normal people are also positive).

Imaging examinations such as pelvic X-ray/CT showed blurred or even serrated changes in the sacroiliac joint space. In the late stage, the sacroiliac joint disappeared and the intervertebral bone connection of the spine. For HLA-B27 negative in the early stage, MRI can also be used to observe whether there is hyperplasia of the sacroiliac joint synovium to assist in the diagnosis.

Director Zheng reminded that the following situations should be highly vigilant! Persistent or intermittent sacroiliac joint and spinal pain with stiffness that cannot be relieved by rest, but relieved after activity.

Unilateral or bilateral inner thigh pain, recurrent heel pain cannot be relieved by general treatment.

Recurrent knee and ankle swelling without trauma and infection.

Unexplained ophthalmia with lumbosacral pain.

Chest pain, bandage, or even abnormal thoracic movement without cough and sputum respiratory tract infection.

Is “immortal cancer” curable?

Ankylosing spondylitis used to be called the “immortal cancer”, but with the development of medicine, there are more and more treatments to deal with it. Pain is the main symptom in the early stage, which can be controlled by physical therapy, such as infrared radiation, hot compress, moxibustion, non-steroidal anti-inflammatory drugs such as loxoprofena, etoricoxib, etc., and immune preparations such as methotrexate and triptolide glycosides, etc.

Middle and late stages can be treated with biological agents such as etanercept and adalimumab. Some patients have joint or spinal deformity and movement disorders, which can be treated by surgery. Some patients can be treated by traditional Chinese medicine, and the combined diagnosis and treatment of traditional Chinese and western medicine can often have unexpected results.

What should patients with ankylosing spondylitis pay attention to in their daily life?

To maintain adequate sleep, eat more fresh fruits and vegetables, lean meat and milk to enhance nutrition.

Sleep on a hard bed or a hard mattress, avoid soft pads, and maintain the proper physiological curvature of the spine. A soft bed does not support the body and can lead to curvature of the spine in the long run.

Step-by-step functional exercise for the painful and stiff parts, avoid staying in the same position for a long time, change the position frequently, and regularly perform moderate flexion, extension, and rotation movements of the neck, chest, waist, and joints.

Take medicines on time and correctly, and review regularly. Do not easily stop the drug without permission to avoid recurrence.

Regular physical examination and height measurement. Keeping height records to prevent undetected early spinal curvature.

Keep an optimistic, positive and sunny mood and avoid negative, anxious and depressed psychology.

Director Zheng reminded that in summer, don’t be greedy for the cold. After taking a shower, just lie down in an air-conditioned room. Humidity is an important part of this disease. Incentives.