Spondylarthritis is a group of chronic inflammatory diseases, which have in common a set of clinical and genetic characteristics. These diseases are divided, according to the predominance of clinical manifestations, into axial spondylarthritis (when it mainly affects the spine and sacroiliac joints), peripheral spondylarthritis (when the involvement of other joints predominates, especially the lower limbs) or the enteopathic form (when the ligament insertions are the predominant manifestation). This group of diseases includes ankylosing spondylitis, psoriatic arthritis, arthritis associated with inflammatory bowel disease (Crohn's disease or ulcerative colitis), reactive arthritis, among other forms.
The cause of these diseases remains unknown. They are diseases that result from a deregulation of the body's immune system, with genetic factors playing a major role, although multiple environmental factors can contribute to the onset of the disease. Chronic inflammation is a predominant characteristic in this group of diseases, and analyses that detect inflammation, such as C-reactive protein (CRP), may be altered.
Axial spondylarthritis usually appears in young people between the ages of 20 and 30. While ankylosing spondylitis is more common in males.
The cardinal symptom of axial spondylarthritis is pain in the lumbar spine, known as inflammatory rhythm. This pain typically appears during rest, conditioning awakening in the second half of the night. When waking up (or after rest periods), the patient feels stiffness, "prison in movements", usually lasting more than thirty minutes, referring to difficulty, for example, in bending over to put on shoes.
In both axial and peripheral spondylarthritis, other joints may be affected: shoulders, hips, knees and tibiotarsis (ankles) are the most frequently affected when there is peripheral joint disease.
Jointitis, i.e., inflammation of the entheses, which are the sites where the ligaments are inserted into the bones, is quite characteristic of spondylarthritis. The most common cases are Achilles tendon and plantar fascia (membrane surrounding the muscles of the feet on the plantar face).
Spondylarthritis can have other types of involvement besides the musculoskeletal system. Mucocutaneous involvement, translated as psoriasis, is an important and frequent facet of the constellation of disease associated manifestations. Another frequently affected organ is the eye, in the form of anterior uveitis, which manifests as a red and painful eye, usually unilateral, with blurred vision. In addition to the eye and skin, there may also be inflammation at the intestinal level. Fatigue is a very common complaint.
Objectives of a rehabilitation program:
Improving mobility and joint movement
Relief from pain and inflammation
Stabilization of spine static and dynamics
General physical reconditioning
Improvement of gait, balance and coordination
Teaching and counselling of support products (orthotics, splints, etc.)
Return to work activities , daily life and sports activities
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