Singer Li Yuchun revealed that he was suffering from "ankylosing spondylitis", and rehabilitation treatment took 6 steps!

Recently, according to surging news reports, singer Li Yuchun said when recording a program that he had relapsed due to ankylosing spondylitis, and he could not sleep for a time due to pain, and even needed to travel
in a wheelchair.

Ankylosing spondylitis, because it cannot be cured, has a high frequency of recurrence, and is also known as "immortal cancer"
.
According to data, the prevalence of ankylosing spondylitis in China is about 0.
3%.

The age of onset is generally late adolescence, with an average age of onset of 23 years
.
So, what is ankylosing spondylitis? How to self-heal with ankylosing spondylitis?

Ankylosing spondylitis (AS) is a chronic inflammatory disease that mainly affects the sacroiliac joint, spinal bony process, paraspinal soft tissues and peripheral joints, and can be accompanied by extra-articular manifestations, and spinal deformities and rigidity
can occur in severe cases.
According to experts, in the early stage of the disease, low back pain is a typical manifestation, and patients will feel dull pain
in the lower back or buttocks.
The spine is limited in motion and becomes very stiff, which may lead to deformation
of the spine in an advanced stage.

Ankylosing spondylitis is long-term, recurrent, and easily disabled, and most patients require lifelong treatment
.
At present, there is no ideal root treatment for ankylosing spondylitis, and the main treatment methods include drug treatment and non-drug treatment
.

1.
Drug treatment

At present, the drug treatment of ankylosing spondylitis is mainly non-steroidal anti-inflammatory drugs, tumor necrosis factor-α antagonists, and antirheumatic drugs to alleviate the condition, but there is no standard treatment and maintenance remission plan
.

1.
Nonsteroidal anti-inflammatory drugs (NSAIDs).

NSAIDs can rapidly improve low back pain and morning stiffness, reduce joint swelling and pain, and increase range of motion, and can be used as first-line drugs
for early or late symptom treatment.
There are many types of NSAIDs, and the efficacy of AS is roughly comparable
.
If, after 2 weeks of continuous adequate treatment with NSAIDs, the patient with AS is not satisfied with symptom relief, it is recommended to switch to another NSAIDs
.
However, the combination of ≥ two NSAIDs at the same time not only does not increase the efficacy, but also increases the adverse drug reactions
.

The most common adverse reactions of this class of drugs are gastrointestinal discomfort, and a few can cause ulcers; Other less common cardiovascular diseases such as hypertension can be accompanied by headache, dizziness, liver and kidney damage, cytopenia, edema and allergic reactions
.

2.
Biologics

T biological agents have good anti-inflammatory and disease progression effects, rapid onset, obvious effect of inhibition of bone destruction, significant efficacy on axial and peripheral symptoms, and overall good
tolerability.

Note: Patients who do not respond to standard therapy for 2 NSAIDs after 4 weeks should be treated
with TNF-α antagonists as soon as possible.

The main adverse reactions are infusion reaction or injection point reaction, nausea, headache, itching, dizziness to hypotension, dyspnea, chest pain, etc
.

3.
Antirheumatic drugs (DMARDs) to relieve the condition

Sulfasalazine: can improve joint pain, swelling, and stiffness in AS, and can reduce serum IgA levels and other laboratory activity indicators, especially for improving peripheral arthritis
in AS patients.
SSZ is slower to act, and usually one fast-acting NSAIDs is used
in combination with it.
Adverse effects include gastrointestinal reactions, rash, cytopenias, headache, abdominal pain, and decreased sperm and morphological abnormalities in men (recoverable with discontinuation).

Patients with sulfa allergy are prohibited from SSZ
.

Thalidomide: can inhibit the production of TNF-α by monocytes, and has shown a good therapeutic effect on AS patients in clinical practice
.
The main adverse reactions include drowsiness, thirst, decreased blood cells, increased liver enzymes, microscopic hematuria, and tingling sensation at the end of the fingers
.

Methotrexate: is an antagonist of folic acid metabolism, has immunosuppressive and anti-inflammatory properties, has a relieving effect on peripheral joint pain, can slow down bone erosion, and has no obvious
effect on axial joint lesions.
Common side effects include gastrointestinal discomfort, erosion of the oral mucosa, liver damage, interstitial inflammation and fibrosis of the lungs, bone marrow suppression, hair loss, headache, dizziness, etc
.

4.
Glucocorticoids

Oral or intravenous systemic corticosteroids for AS are generally not advocated because of their adverse effects and inability to prevent the course
of AS.
However, glucocorticoids can be applied topically to treat AS.

5.
Anti-rheumatic phytomedicine

Antirheumatic phytopharmaceuticals are recommended for patients with AS who are not responsive to conventional treatment of peripheral joint involvement, but their efficacy for axial joint lesions is uncertain and may be effective
in relieving joint swelling and pain.

2.
Non-drug treatment

Non-drug treatment will be intervened
from 5 aspects, including health education, functional exercise, posture training, physical therapy, and psychological intervention.

Health education

1.
Disease knowledge: It is necessary to introduce the disease knowledge of ankylosing spondylitis to the patient, including the normal physiological structure of the spine, the pathogenesis factors, pathogenic mechanism and specific treatment measures of
the disease.
Only after patients have a clear and correct understanding of the disease can they better cooperate with treatment and do a good job in self-management
.

2.
Dietary guidance: Patients with ankylosing spondylitis need to give nutritional support in their daily diet to ensure the intake of fiber and protein, increase the proportion of high-calcium foods, and reduce the consumption of greasy, spicy, raw and cold foods
.
Encourage smoking
cessation.

3.
Medication guidance: Patients with ankylosing spondylitis should take medication regularly, quantitatively and regularly, and patients should be informed of the common adverse reactions and precautions
for taking relevant drugs.

Functional exercises

At present, there are many studies on functional exercise in patients with ankylosing spondylitis, and each research has its own results based on different theories, but the core purpose of all exercise methods is to maintain the patient's range of
motion of the spine and joints.

A balanced exercise program should include 4 aspects: stretching, strength, aerobics, and balance function.

1.
Stretching exercise: mainly by maintaining the range of motion of muscles and joints to improve joint flexibility, in order to improve patients' stiffness, pain and other symptoms, and reduce the risk of
joint fusion.
Recommended stretching exercises for patients with ankylosing spondylitis include cat stretching, superhuman stretching, etc
.

2.
Strength exercise: Mainly through weight-bearing exercises or resistance training of related muscle groups to enhance muscle strength
.
In patients with ankylosing spondylitis, increased strength in the core muscles of the abdomen and back can better support the stability and mobility
of the spine.
Recommended movements include shoulder bridges, planks, etc
.

3
.
Aerobic exercise: can improve the patient's cardiopulmonary function and overall health.
Recommended sports include swimming, tai chi, etc
.

4.
Balance exercise: mainly to increase the stability
of the body at rest and during exercise.
Recommended exercises include yoga, Pilates, etc
.

The frequency, intensity, duration, and manner of exercise should be individualized
based on the patient's disease assessment, goals, and lifestyle.

Postural training

Patients with ankylosing spondylitis need to maintain proper posture in both work and life to improve symptoms and delay the progression of
the disease.

1.
Sitting position: Avoid low and soft sofas, it is recommended to have a hard bench, the chest is upright, the back is straight, and the empty back is sitting
.

2.
Standing posture: keep the head in the middle position, the chin slightly tucked, the shoulders are naturally relaxed, the center of gravity is centered, do not deviate.

3.
Sleeping position: hard bed, back implantation, full extension of the back and hip joints, low or no pillow
.

4.
Walking: Take a big step so that the hip joint is fully extended
.

5.
Breathing: Perform chest breathing exercises
with significant chest fluctuations every day.

physiotherapy

1.
Traction and passive movement: spinal manual traction or instrument traction can make ligaments and joints moderately stretched and fully extended, relieve joint pressure, restore the stability and range of motion of the spine, and make early spinal deformities
corrected.

2.
Acupuncture and massage: Studies have found that electroacupuncture stimulation of the back of patients with ankyrosis or moxibustion treatment of related acupuncture points can improve the patient's symptoms and range
of motion of the spine.
In addition, TCM Tuina can relieve soft tissue morning stiffness and improve symptoms
such as nerve entrapment caused by muscle antagonism.

Psychological interventions

Because ankylosing spondylitis cannot be cured, some patients gradually lose the ability to live independently with the development of the disease, resulting in great psychological disorders, which leads to low treatment compliance and even abandonment of treatment
.
Therefore, psychological intervention of the patient throughout the course of the disease is very important
to control the condition.

1.
First of all, it is necessary to conduct a preliminary psychological assessment of the newly ill patients and formulate a targeted intervention plan
according to the patient's situation.

2.
Explain to family members the importance of mental and psychological factors to the patient's condition, and instruct them to accompany, encourage and take care of the patient
.

3.
Encourage patients to actively participate in patient organizations and exchange experience in disease recovery, so as to improve patients' confidence in fighting diseases and actively cooperate with treatment
.

4.
Be good at using the Health Status Questionnaire (SF-36), Social Support Scale (SSRS), Eysenck Personality Questionnaire (EPQ), Depression Self-rating Scale (SDS), Tools such as the Anxiety Self-Rating Scale (SAS) regularly conduct psychosocial assessments for early intervention
when problems are detected.

Ankylosing spondylitis places a huge burden on patients and their families, and most patients do not receive the right treatment, especially in non-pharmacological treatment
.
In the process of clinical diagnosis and treatment, the effective combination of non-drug treatment and drug treatment can better treat patients and improve prognosis

Comprehensively compiled from The Paper, Biotech Biotech and Fosun Health