Rheumatism, rheumatoid arthritis or chronic polyarthritis are terms for a rheumatic disease. Rheumatism can also be divided into inflammatory and degenerative rheumatic diseases.
What is rheumatoid arthritis?
Rheumatism is the generic term for a variety of painful conditions of the musculoskeletal system. It does not always affect only the bones, but also the connective tissue at and in the joints. Rheumatism, which affects the connective tissue, is classified as a collagenosis (connective tissue disease). Collagen is a protein-like component of connective tissue. Collagen connective tissue is present in the skin, bones, tendons, cartilage, muscles and blood vessels. Collagen provides strength and support to other structures in the body. Degenerative joint diseases, such as osteoarthritis, are among the rheumatic diseases. Thanks to modern medical diagnostics, it is now possible to better diagnose the approximately 200 different rheumatic diseases, although they cannot yet be completely cured.
Causes
There are a variety of causes for the disease rheumatism. First and foremost is a misdirected immune system (autoimmune disease). The immune system recognizes some of the body’s own structures as foreign bodies and thus tries to fight them, resulting in inflammatory reactions. Today, autoantibodies can be differentiated very well in the laboratory, so that early detection is possible. The autoimmune disease rheumatism has a familial component, i.e. rheumatic diseases occur more frequently in some families. Infections with streptococci, borrelia, chlamydia or exposure to humidity, cold or toxins can trigger rheumatism. Psoriasis may additionally affect the joints and/or spine. The occurrence of rheumatism is linked to certain processes in the blood. It is assumed that a special form of allergy is present. This causes sensitization of the joint surfaces. The human immune system can then recognize these as foreign tissue and react. Rheumatism translates as “flowing, streaming, tearing”. And this is exactly how sufferers describe the pain of rheumatism.
Symptoms, complaints and signs
The first sign of rheumatism is the so-called morning stiffness, which can be associated with mild pain. After own minutes of movement, the affected joints become more mobile again. This may involve one or more fingers. The ankles can also be affected. As the disease progresses, the duration of morning stiffness increases significantly. The painful joint complaints can also occur even at rest. Swelling forms in the affected joint areas. Restrictions on movement increase. In addition to functional complaints, changes in shape may occur. The pain that occurs can present itself as pulling, tearing or flowing. In addition to the joints, bones, muscles and ligaments may also be affected in an inflammatory rheumatoid disease (arthritis). The number of affected parts of the body increases. Both the left and right sides of the body are affected. The symptoms can also occur in larger joints such as the shoulder joint or knee joint. Over a long period of time, rheumatism can cause bony deformities to form. In a rheumatic disease in the form of arthritis, the inflammatory processes also affect the organs and the nervous system. General feelings of illness may develop, such as night sweats, exhaustion and excessive fatigue, as well as weight loss. Rheumatic symptoms may occur in episodes. In a rheumatic disease in the form of gout, sudden severe pain occurs in a specific joint (gout attack). Signs of soft tissue rheumatism include pain in muscles, tendons, cartilage, as well as fatty tissue.
Disease process
Infographic of pain regions and affected joints in rheumatoid arthritis. Click image to enlarge. Rheumatism as a disease has many faces in its course. It can be acute, episodic or chronic. Rheumatism is noticeable through pressure sensitivity, painfulness and stiffness of the muscles and joints. In the early stages, many sufferers complain of fatigue and morning stiffness of the entire musculoskeletal system. At this stage, only slight changes can be seen in the blood count. If some joints are then swollen, inflamed and very painful in the acute phase, deformities (visible changes) remain.Some rheumatic diseases from the area of collagenoses have exhaustion, fever, loss of appetite and weight loss as accompanying symptoms in your clinical picture. However, rheumatism can also run for several years without signs of disease and thus without affecting everyday life.
Complications
Rheumatism or rheumatoid arthritis can cause various complications. This risk is particularly prevalent if appropriate treatment is not received. The most common sequelae of rheumatoid disease include swelling of the base and middle joints of the fingers. The change in the joints is gradual and can take up to ten years. While some joints hyperextend, others assume a flexion malposition. It is not uncommon for so-called rheumatoid nodules to form on the joint extension side. In the adjacent area, affected individuals often suffer from bone loss (osteoporosis), whereby the bone loses its strength. In the marginal area of the joints, bone defects also develop, which are referred to by medicine as erosions. Even with the help of medical therapy, the symptoms can often only be alleviated. A further complication is the spread of the rheumatic nodules into the viscera. The nodules are often painless, but in some cases they cause discomfort, primarily affecting heavily used areas of the body. If the rheumatism progresses further, this has a negative effect on the gripping functions of the hands. This in turn can result in the need for care for those affected. Around ten percent of all rheumatism patients suffer from severe disabilities. In the worst case, destruction of the diseased joints occurs. The carpal tunnel syndrome also belongs to the rheumatism sequelae. In this case, pressure damage to the nerves occurs due to rheumatoid arthritis, which causes paralysis of the hand muscles in addition to pain.
When should you see a doctor?
The first sign of rheumatoid disease is morning stiffness. The fingers, joints or feet can be moved only with difficulty or hardly at all. Full mobility is achieved only after several minutes. The affected areas often swell. In addition, there is a sensation of heat and discoloration of the skin. A doctor should be consulted at the first signs, since rheumatism is a chronic disease. The sooner medical care begins, the better treatment options are available and the speed of the disease’s progress can be influenced. General restrictions of movement possibilities or mobility indicate an impairment. Malpositions occur and are a cause for concern. If habitual physical performance declines or persistent pain occurs, a physician is needed. Consultation with a doctor is not necessary if the organism has been overexerted. In these cases, spontaneous healing occurs after a sufficient period of rest and a restful night’s sleep. An investigation of the cause is indicated if the complaints gradually increase, a feeling of illness appears or the affected person wakes up with night sweats. Fatigue or deformities of the skeletal system should be presented to a physician. If joint pain occurs in a resting position, this is an alarm signal from the body that should be followed up.
Treatment and therapy
Thanks to research, the treatment options for rheumatism have become very diverse and more applicable specifically to individual rheumatic diseases. Despite everything, in acute cases, cortisone (cortisone) is the drug of choice. Cortisone allows the inflammation to subside. The chronic course of rheumatism also responds very well to cortisone. In the meantime, there are new types of cortisone preparations that start working at night, so that the morning stiffness is less. If cortisone does not bring the desired relief, immunosuppressants are used. These are drugs that inhibit the body’s natural defense reaction against its own tissues. The use of immunosuppressants can reduce the amount of cortisone administered. Every rheumatoid patient should additionally change his or her diet to suit the disease. Since cortisone decalcifies the bones, an adequate calcium intake should not be lacking. Ommega-3 fatty acids and vitamin E have a positive effect on rheumatism. Walks, swimming and physiotherapy alleviate pain in rheumatism.
Aftercare
To alleviate the symptoms of rheumatism, the affected person must adjust his or her lifestyle accordingly. Nutrition plays an important role in this. Rheumatism research now knows that certain dietary patterns can negatively influence the disease and aggravate symptoms that have already occurred. The patient should initially aim for a normal body weight. Rheumatic diseases require a predominantly plant-based diet, supplemented by low-fat dairy products and fish. Animal fats promote inflammatory processes in the body and should therefore be avoided as far as possible. Omega-3 fatty acids, on the other hand, are believed to have anti-inflammatory properties and should be supplied to the body in sufficient quantities. Rheumatics should therefore regularly, about twice a week, integrate fatty sea fish such as herring, mackerel and salmon into their diet. Omega-3 fatty acids are also found in vegetable oils such as rapeseed, walnut or linseed oil, which are good for cooking and refining salads. To supply the body with sufficient fluids, water and unsweetened teas are suitable. Alcohol consumption should be minimized. Regular exercise helps to maintain the mobility and thus the independence of the patient. Moderate sports such as swimming and cycling stabilize the general feeling of the body. Extended walks are easy on the joints and also contribute to the patient’s well-being. Many patients find it helpful to exchange ideas with other sufferers in self-help groups, thereby relieving the psychological pressure of suffering.
What you can do yourself
The symptoms of rheumatism can be alleviated by the patient himself through lifestyle-dependent factors. Diet plays a very central role in this. Rheumatism researchers assume that certain dietary patterns can promote the development of symptoms or aggravate symptoms that have already occurred. It is desirable to strive for a normal body weight. When selecting foods, food intolerances and possible concomitant diseases, such as cardiovascular diseases, should be taken into account. In rheumatoid diseases, a mainly plant-based diet in combination with the consumption of low-fat dairy products and fish is recommended. Animal fats from eggs, meat, sausages, liver or butter contain high amounts of arachidonic acid. This fatty acid promotes inflammation in the organism and should therefore be avoided as far as possible, especially in rheumatism. Anti-inflammatory properties are attributed above all to omega-3 fatty acids. These are found primarily in fatty sea fish such as herring, salmon and mackerel. People with rheumatism should therefore include fish in their diet regularly, about twice a week. Other important suppliers of omega-3 fatty acids are vegetable oils from linseed, rapeseed and walnut oil. These are suitable for refining salads or for cooking. Rheumatism patients should make sure they drink enough fluids in the form of water or unsweetened tea and at the same time keep their alcohol consumption as low as possible. To maintain independence and mobility in everyday life, rheumatism patients should exercise regularly. Depending on the course of the disease and the symptoms, sports that are easy on the joints, such as cycling or swimming, are recommended. Regular and generous walks are suitable alternatives. Furthermore, rheumatism patients can participate in self-help groups to exchange experiences with other sufferers. Regular attendance of self-help groups helps patients deal with everyday problems, provides further individual tips and can significantly reduce psychological suffering.
