English text:
Researchers do not know the cause of ankylosing spondylitis. However, studies show that both genes and environment may lead to the development of the disease. Translation of the text: Researchers do not know the cause of ankylosing spondylitis. However, studies show that both genes and the environment may contribute to the development of the disease.

causes of spinal rheumatism

Although genetic factors seem to be involved, ankylosing spondylitis is said to have no known cause. In particular, people who carry a gene called HLA-B27 are at increased risk of developing ankylosing spondylitis. However, only some people with this gene get this disease.

Ways to diagnose spinal rheumatism

Diagnosis of spinal rheumatism is possible through initial examination and then some medical methods. These methods will help to start the treatment as soon as possible. In this section, you can see the types of spinal rheumatism diagnostic methods:

• Physical examination: During the physical examination, the doctor asks the patient to bend in different directions to check the range of motion of his spine. The doctor may also ask the patient to take a deep breath to check the patient's ability to open and close the chest.
• Imaging tests: X-rays allow doctors to check for joint and bone changes, also called radiographic axial spondyloarthritis.
• Magnetic Resonance Imaging (MRI): This method uses radio waves and a strong magnetic field to provide more detailed images of bones and soft tissues.
• Laboratory tests: There are no specific laboratory tests to diagnose ankylosing spondylitis. Only some blood tests can check the diagnostic signs of inflammation.
• Genetic tests to measure the HLA-B27 gene: Many people who have this gene but do not have ankylosing spondylitis. In fact, people without HLA-B27 gene can get this disease.

Definitive treatment of spinal rheumatism

There is no definitive treatment of rheumatism; In fact, the goal of treatment is to relieve pain and stiffness and prevent or delay complications and deformity of the spine. Treating ankylosing spondylitis before the disease causes irreversible damage is very successful. Physical therapy is an important part of treatment and can provide many benefits, from pain relief to improved strength and flexibility. A physiotherapist can suggest specific exercises according to the patient's needs and conditions. Some of these exercises will include the following:

• range of motion and stretching exercises
• strengthening exercises for abdominal and back muscles
• Exercises to improve sleep and walking

1. Medicine for spinal rheumatism

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen sodium (Aleve) and ibuprofen are drugs that doctors prescribe to treat rheumatism of the spine. These medications can relieve inflammation, pain, and stiffness, but they may also cause gastrointestinal bleeding. If nonsteroidal anti-inflammatory drugs (NSAIDs) don't help, your doctor may suggest starting a tumor necrosis factor (TNF) blocker or an interleukin-17 (IL-17) inhibitor. These drugs are injected under the skin or through an intravenous line. Another option is a Janus kinase (JAK) inhibitor. Janus kinase (JAK) inhibitors are taken orally. These types of drugs can reactivate untreated TB and make the patient susceptible to infection. Examples of tumor necrosis factor (TNF) blockers include:

• Adalimumab (Humira)
• Etanercept (Enbrel)
Golimumab
• Infliximab (Remikid)

2. Spinal rheumatism surgery

Many cases of ankylosing spondylitis are treated without surgery. These treatments may include nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, and medications and physical therapy. But if the disease has progressed to the extent that it severely interferes with daily activities, surgery may be the right and timely option. In very rare cases, a procedure called an osteotomy with fusion may be used to straighten the spine and fuse the vertebrae into better alignment. The aim of the surgery is to remove the compression of the nerve roots, and the second aim is to stabilize and fuse the spine with bone grafting. The most common surgical methods for ankylosing spondylitis are:

• Laminectomy: Laminectomy is performed to reduce pressure on the nerve roots. This surgical procedure involves removing a part of the vertebral bone called the lamina in order to reduce the pressure on the nerves. This minimally invasive procedure requires a small incision in the back, where the muscles are pushed to the side rather than cut. This surgery takes approximately 1-2 hours.
• Fusion: Fusion surgery may be performed in cases of trauma where there is a fracture in the spine. This surgery often involves the placement of screws and rods to stabilize the spine.

English text:
Four progressive stages are described: an inflammatory stage (stage 1), the stage of early discal calcification (stage 2), the stage of fibrous ankylosis (stage 3), and the stage of bony ankylosis (stage 4) (stage 2), fibrous ankylosis stage (stage 3) and osseous ankylosis stage (stage 4).

3. Diet for rheumatism of the spine

Following a proper diet for spinal rheumatism is one of the obligations that patients with this disease should keep in mind. In the following, you can see some tips about the proper diet for rheumatism of the spine. By complying with these things, the possibility of recovery and reducing the aggravation of possible complications will be significantly reduced.

• In general, following a mostly plant-based diet is recommended for patients with rheumatism of the spine. These patients should consume a lot of vegetables, fruits and whole grains.
• Patients should avoid highly processed foods, especially those high in saturated fat, sugar, or salt.
They should consume a lot of healthy fats. Add fresh olive oil, nuts and seeds, avocados and oily fish to your diet. Omega 3 is not only important for brain growth and function, but it can improve the joint symptoms of rheumatism of the spine.
• Eating slowly, choosing smaller meals, drinking plenty of water and limiting sweet foods are examples of an ideal lifestyle for patients with this disease.
• Extreme or trendy diets should be avoided, because these diets do more harm than good.
• Each person should talk to their doctor about an appropriate meal plan, dietary needs, supplements, and all over-the-counter and prescription medications.

4. Treatment of spinal rheumatism at home

Spinal rheumatism is a chronic disease that natural remedies may be used alone or in combination with other treatments to improve patients suffering from it. Below we have explained 10 rheumatism home treatment for the spine:

Type of treatment	Description
Stretching	Stretching movements help build flexibility and reduce pain.
Heat therapy	To reduce stiffness and pain, place a hot water bottle or heating pad on the injured area. A warm bath, especially before exercise, may help relieve pain.
Cold Therapy	Applying an ice pack, cold gel pack, or frozen vegetable bag to painful joints can help reduce swelling.
Acupuncture	Acupuncture is a complementary therapy. This method is thought to activate the body's relaxation hormones.
Massage therapy	Massage helps to relax the body. It may also help the patient feel more flexible or loose enough to exercise or stretch their body. So get up, move, and stretch regularly.
Exercise	Gentle exercise programs like yoga and pilates are great for AS; Because these exercises include stretching movements. Swimming may also be helpful. Strength training with weights also helps build muscle.
The Alexander Technique	Practicing good posture is very important in AS because it can affect the back. The Alexander technique teaches you to be aware of your body position throughout the day. It also teaches you how to correct bad posture.
TENS Therapy	In transcutaneous electrical nerve stimulation (TENS) therapy, electrical current is used to manage pain. A physical therapist can teach you the TENS technique so you can use it at home.
Smoking Quit	Smokers, especially men, are more likely than non-smokers to develop spinal damage from AS.

5. Herbal treatment of spinal rheumatism

With the help of herbal treatment methods, rheumatism of the spine can be treated and help to reduce complications and of course control the severity of the disease. In the following, we have mentioned the types of herbal treatment for spinal rheumatism:

• nettle
• Consumption of ginger or ginger tea
• Aloe vera tea
• Eucalyptus tea
• Turmeric
• Lavender
• Condor
• Consumption of honey
• Black seed
• Cinnamon Chamomile
• devil's claw plant
• Basil
• Nastern flower
• Enguze
• thyme
• Salt therapy
• Cow tongue flower seed oil

complications of spinal rheumatism disease

Ankylosing spondylitis (AS) is a complex disease that can affect many parts of the body. This disease can cause problems in the patient's daily life and lead to some other diseases. In the following, you will read some of the most common complications of rheumatism of the spine:

• Decreased flexibility: Although most people with AS will continue their normal lives in the long term completely independently or with minimal disability, some people with this condition will eventually have severely limited movement in the spine.
• Joint damage: If the joint is damaged, you may need surgery to replace it with an artificial joint.
• Iritis: Iritis is swelling and inflammation in the colored ring around the pupil of the eye, i.e. the iris. Iritis can usually be treated with corticosteroid drops.
• Osteoporosis and spinal fracture: Osteoporosis in patients with spinal rheumatism can increase the risk of spinal bone fractures. The longer you have the disease, the greater the risk. There are different drugs for the treatment of osteoporosis that can be taken orally or by injection.
• Cardiovascular disease: Rheumatoid arthritis may increase the risk of cardiovascular disease (CVD).
Tail syndrome: Tail syndrome is a very rare complication of rheumatism of the spine. This disease occurs when the nerves at the bottom of the spine are compressed.
• Psoriasis: People with spinal rheumatism also suffer from psoriasis. Psoriasis is a skin disease that causes scaly spots. There is no cure for psoriasis, but your doctor can recommend treatments that improve the symptoms and appearance of the patches.
• Inflammatory bowel disease (IBD): Some people with AS develop inflammatory bowel disease (IBD).

Prevention of spinal rheumatism

Rheumatism of the spine cannot be prevented. However, with proper and prompt diagnosis and treatment, it can certainly be managed. Managing symptoms well reduces the likelihood of long-term complications.

Which doctor should we see for rheumatism of the spine?

For more information about spinal rheumatism, you can make an appointment with the best rheumatology doctor in Iran and the best orthopedic doctor in Iran.
In the following, you can see a list of the most prominent rheumatology and orthopedic doctors in different cities of Iran.

• rheumatologist Tehran
• Karaj Rheumatology Doctor
• Tehran orthopedic doctor
• Karaj orthopedic doctor

Conclusion

Rheumatism of the spine is an autoimmune disease that causes inflammation of the joints. Although this disease usually first affects smaller joints such as hands and feet, it can also extend to the cervical spine.

A combination of drugs, physiotherapy and home remedies can help manage this disease and relieve the patient's condition. If other treatment options don't work, or if cervical RA affects the spinal cord, people may need surgery. In case of persistent joint pain in the hands, feet, neck or any other part of the body that does not respond to treatment, people should immediately consult a rheumatologist or an orthopedic doctor. If you are in such a situation or you need a comprehensive resource for consulting a specialist doctor, get help from your doctor's website. Doctorto is a comprehensive online platform through which you can get a face-to-face appointment or online consultation with a rheumatology doctor and online consultation with an orthopedic doctor from the best specialists all over Iran.

Your doctor takes care of your health!