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Rheumatism: what it is, causes, treatment and associated symptoms

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We all know someone with rheumatism, osteoarthritis, osteoporosis and some similar pathology, since some of them are skeletal disorders associated with age-related tissue degeneration. In any case, the reality outside the anecdote goes far beyond the annoying picture: as indicated by the World Health Organization (WHO), approximately 1710 millions of people have some type of musculoskeletal disorder, which makes these conditions one of the main causes of disability throughout the world. world.

Without going any further, lumbago or low back pain occurs in almost 570 million people at any given time and place and is the leading cause of disability in 160 countries. Beyond the classic back pain, there are about 150 conditions that damage or prevent the correct functioning of nerves, muscles, tendons, joints and cartilage associated with the system locomotor. Among them, rheumatism stands out.

In any case, it is of interest to highlight that the term “rheumatism” provides very little relevant information at the clinical level, since it really

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When talking about this topic, we must refer to rheumatic diseases or disorders, a very heterogeneous group of up to 200 interrelated diseases. If you want to know more about this set of clinical pictures, keep reading.

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What is rheumatism?

As we have said, the correct term to refer to this set of symptoms is “rheumatic diseases” or “rheumatisms”. Both concepts include more than 200 clinical entities that usually have a series of points in common, among which intermittent chronic pain in the joints and connective tissue stands out.

Major rheumatic disorders can be divided into 10 categories, as indicated by the American College of Rheumatology (ACR). Among all the entities, we highlight the following groups:

  • Diffuse connective tissue diseases: includes some of the most famous forms of rheuma, such as rheumatoid arthritis, juvenile arthritis or systemic lupus erythematosus.
  • Arthritis associated with spondylitis: within this group are ankylosing spondylitis, reactive arthritis and psoriatic arthritis.
  • Osteoarthritis (OA): the most common joint disorder. It is due to the breakage or wear of cartilage and the consequent friction of adjacent bones.
  • Rheumatic syndromes related to infectious agents: Acute septic arthritis due to streptococci or staphylococci (bacteria) are the most common in this group.
  • Extra-articular disorders: bursitis and tendonitis are in this group.

In the remaining five categories we highlight possible neoplasms, neuromuscular disorders, bone and cartilage diseases, endocrine diseases (gout) and miscellaneous entities (palindromic rheumatism).

By social convention and ease of transmission of information, from now on we are going to focus on osteoarthritis, the most common variant of rheumatological diseases. However, it should be noted that there are many more forms of degeneration within this general picture, such as rheumatoid arthritis or lupus.

Rheumatism

Rheumatism and osteoarthritis

As we have said, osteoarthritis (OA) is the most common type of rheumatism in the world. An overall prevalence of 3.3 to 3.6% of the population is estimated, although 80% of people aged 65 and over show some obvious radiological sign of osteoarthritis (60% of them with symptoms).

Despite these relatively optimistic data, it should be noted that this condition causes moderate or severe disability in 43 millions of people worldwide, making osteoarthritis the 11th most debilitating disease in the world.

This pathology develops as a product of tissue aging of the articular cartilage, although there may be certain triggers and anatomical irregularities that promote it. The first obvious change in OA is fibrillation, irregularity, and focal erosion of the articular cartilage. Over time, these erosions expand lengthwise (bone) and width (greater surface of the joint), thus generating a series of characteristic symptoms.

Symptoms of Osteoarthritis

The clinical presentation of osteoarthritis varies dramatically between patients. In any case, a symptomatic triad appears in all cases, to a greater or lesser extent: joint pain, stiffness, and locomotor restriction in the affected areas. Patients may also have balance problems and muscle weakness, although this is not the most common.

OA usually affects the proximal and distal interphalangeal joints, the first carpometacarpal joints (CMC), hips, knees, the first metatarsophalangeal joints, and the joint areas of the cervical and lumbar spine lower. The most common image when we think of rheumatism is undoubtedly that of an elderly person with atrophied hands and crooked hooked fingers.

Anyway, it should be noted that not all people with joint pain necessarily have osteoarthritis. For example, studies have shown that only 25% of patients who claim to have rheumatoid arthritis (another type of rhema) complete the necessary diagnostic criteria for this to be certain. In the case of osteoarthritis, the differential criterion is as follows:

  • Joint pain worsens with activity and improves with physical rest.
  • The patient is over 45 years of age.
  • Morning stiffness lasts less than 30 minutes and does not explain the condition.
  • A lengthening of the bony joints.
  • Limitation of the motor range of the affected areas.

In the differential diagnosis, This clinical entity must be distinguished from rheumatoid arthritis, psoriatic arthritis, hemochromatosis, bursitis, tendinitis, radiculopathies and many other things.. As you can see, all these clinical entities are rheumatoid disorders (rheumatism), but osteoarthritis differs as its own clinical entity by a series of characteristics.

  • You may be interested in: "Chronic pain: what it is and how it is treated from Psychology"

Treatment

Treating osteoarthritis (and most types of rheumatism) is based on minimizing pain and loss of functionality in the affected structures. For this, patients are recommended to avoid activities that cause pain (excessive joint load), doing exercises that promote joint strength, weight loss (if needed), and therapy occupational.

Above all, you need to emphasize weight loss. An “extra” kilo in the trunk region multiplies 3 to 7 times in the knee area, which is why obese people have so many mobility problems. Additionally, aerobic exercises used to tone the body (along with endurance development) will help the patient feel less pain, either general or local.

On the other hand also drug therapy can be used to address osteoarthritic rheumatism. Paracetamol (or acetaminophen) is the over-the-counter non-steroidal anti-inflammatory drug (NSAID) that is commonly used in people with long-term rheumatic symptoms. Intra-articular glucocorticoid injections can help manage pain, especially in more severe cases that do not respond well to other conservative approaches.

Again, we highlight that the term "rheumatism" refers to more than 200 different diseases. Osteoarthritis (and in a way rheumatoid arthritis) are the most well-known types of rheumatism at the social level, but there are many others, such as ankylosing spondylitis, psoriatic arthritis, and lupus erythematosus systemic.

In general, in those clinical pictures where the autoimmune reaction is more evident, it is usually resorting to corticosteroids (such as prednisone) and immunosuppressants along with over-the-counter anti-inflammatories above named. Unfortunately, patients who undergo these treatments are more prone to secondary infections, because their immune systems are slightly disrupted.

Resume

Thus, we can conclude that rheumatism is not just a disease, but a series of differentiated conditions that have in common chronic and intermittent pain in the joints and connective tissue. Although these diseases are included under a general concept, the causal etiological agents and the prognosis differ in each case.

Therefore, if your joints hurt repeatedly over time, do not hesitate to go to a medical professional. He will diagnose the condition for your specific case and, surely, with mildly aggressive drugs and occupational therapy you will be able to recover normality. Remember that getting used to pain is never a good idea, as there are almost always ways out.

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