Rheumatism harms the body at any age: why does it arise and what are its symptoms?

Rheumatism, as we generally refer to rheumatic diseases, is generally associated with joints. These are painful, swollen, stiff or deformed.

In the past, it was mistakenly referred to as a disease of the elderly, as a memorable image of rubbing ointment or gel on the joint for pain. However, it is known in professional circles that it also affects children and young adults.

Worldwide, approximately 350 million people suffer from rheumatic diseases.
Women are more likely to have rheumatism.
It is one of the most common causes of work disability.

Rheumatic diseases group together a wide variety of different diseases and syndromes, of which there are more than 200. Rheumatism is therefore not a single disease that uniquely affects only the joints.

The disease affects joints, bones, cartilage, tendons, muscles and other soft structures. In addition, it can affect internal organs, the heart, blood vessels, lungs, eyes, kidneys and skin.

Rheumatism, translated from the Greek, means to flow.
In ancient times, it was described as a lingering pain.
It was said to spread from the head to the whole body.

The exact cause of rheumatic diseases is unknown. And there's no known cure.

Rheumatism = a long-term, progressive disease that worsens over time.

Treatment focuses on slowing the progression (advancement), relieving the discomfort and returning the person to normal life.

Rheumatism negatively affects the life of the person affected. It can lead to temporary or permanent disability. In this case, the person is unable to manage normal life activities without the help of others or special aids.

Do you want to know more about rheumatism?
What are the typical or general symptoms?
How does it affect the whole body?
Read on with us.

Rheumatism has several forms

Rheumatism affects a number of disease states and syndromes.

Rheumatism is a long term and progressive disease = worsens over time.

It is usually characterized by periods of rapid worsening of the problem, when rheumatic pain and associated symptoms are acutely aggravated.

This acute stage is then alternated with periods of improvement.
In some cases, there is a complete disappearance of the symptoms of the disease.
As if cured.
This is an alternation of periods of deterioration and improvement.

The classification of rheumatic diseases is extensive and complex, but necessary from a theoretical and practical point of view. The differences concern the cause, the course of the disease, the prognosis and also the treatment.

Decker in 1983 created a classification of rheumatic diseases, which he divided into:

1. general diffuse connective tissue diseases
2. arthritis associated with spondylitis
3. osteoarthritis
4. rheumatic syndromes associated with infectious agents
5. metabolic arthropathies
6. tumours
7. neurovascular diseases
8. diseases of bone and cartilage
9. extra-articular rheumatism
10. various conditions associated with joint manifestations

There is also a simplified classification according to Pavelka.

The Pavelka classification of rheumatic diseases is given in the table below

The above disease states and syndromes are a modest glimpse into the vastness of rheumatism. However, the average person does not need to be familiar with the complexity of the problem and know all the diagnoses.

It is important to see a doctor when problems arise, who will recommend a rheumatological examination based on the history.

The variety of symptoms can prolong the journey to the right specialist.

Rheumatism even in youth and childhood

Joint pain occurs even at a younger age, but it is not a predominant feature of the elderly.
Therefore, early diagnosis is already important in people of a younger age or in children.

Rheumatism is a long-term and progressive disease.

This means that over a long period of time it significantly and negatively affects the body. When caught and treated early, the future prospects improve.

On the other hand, if the disease makes serious changes to the musculoskeletal system over time, the correction and treatment will be more difficult, the prognosis less favourable and the complications more severe.

In the wide range of rheumatic diseases, there are those that typically start to manifest themselves at an older age. The other side consists of those that are triggered at a relatively young age or in childhood.

Diseases of younger age and children include, for example:

• juvenile idiopathic arthritis JIA
• rheumatoid arthritis
• spondyloarthritis and axial spondylarthritis
• reactive arthritis
• rheumatic fever
• systemic connective tissue diseases
• juvenile systemic lupus erythematosus
• scleroderma
• juvenile dermatomyositis
• Kawasaki disease

Rheumatic diseases in childhood are usually chronic. They are accompanied by pain, swelling and morning stiffness. They can appear as early as 10-12 years of age.

Juvenile idiopathic arthritis is...

Juvenile idiopathic arthritis is a group of diseases of children and adolescents. Juvenile = young, immature. In this case, it is the most common systemic childhood disease and the first symptoms usually appear before the age of 16.

It is a rare disease, occurring in about one or two children in 1000.

Rheumatic diseases can also occur in young children. They complain of not being able to walk and pain in their feet. Other symptoms may not be present. Over time, their joints may swell.

Subsequently, limping or inability to stand may occur. Even in young children, the disease can be severely limiting and lead to disability.

Therefore, care must be taken to detect the signs of rheumatism early even in this period. This is followed by early and appropriate treatment.

What is behind rheumatism?

There is no clear-cut answer to this question. First of all, it is important to understand that rheumatism has a multifactorial basis. Genetic predisposition is cited as one of the initial causes.

The trigger may be infection with a certain pathogen from the environment. For example, EBV virus, which is the causative agent of mononucleosis, but also retrovirus, parvovirus, borrelia, E. Coli, staphylococcus and streptococcus, hepatitis virus and others.

These infectious agents in genetically predisposed and susceptible people trigger a cascade that leads to subsequent rheumatism.

Rheumatism + autoimmunity + rheumatoid factor = autoantibodies.

Autoimmune origin is also significant. In this case, a person's immunity is directed against their own cells and tissue. This is a pathological process in which the immunity has lost the ability to recognize its own from others.

It is reported that 5-7% of the population suffers from autoimmune diseases.

The first type of autoimmune diseases are organ non-specific, such as systemic connective tissue diseases.

A...

The second type are organ-specific, which extend throughout the body. And they affect the cardiovascular system, the glands of the body, the nervous and respiratory systems, as well as the liver and kidneys and the rest of the digestive and excretory systems. Plus they affect the skin and mucous membranes.

What's behind them?

General risk factors for the development of rheumatism:

• Gender - more common in women
• age - more so between the ages of 30 and 60
• genetic predisposition and heredity - some family history, not direct inheritance
• infections
• increased susceptibility to morbidity
• overweight and obesity
• blood transfusion
• Hormonal changes and short fertility period - shortening of the fertile period
• trauma
• allergies
• stress
• smoking
• coffee drinking
• overall lifestyle

How can rheumatism manifest itself?

Are you asking about the symptoms of rheumatic diseases?
They are different and affect different parts of the human body.

In professional circles they are referred to as:

1. articular manifestations - directly affecting the joints
2. extra-articular - i.e. extra-articular manifestations

The occurrence of these extra-articular manifestations and the presence of general difficulties leads a person to seek various examinations. And it is only at a later stage that rheumatological examinations take place.

Yet prompt diagnosis and early treatment affect future health.

From a practical point of view, it is very important to recognize whether the problem is inflammatory or non-inflammatory. Because the inflammatory component can cause irreversible damage to the organs.

Among the general symptoms, the following may occur:

• Fatigue
• general weakness
• malaise
• lack of appetite
• weight loss
• increase in body temperature
• sleep disturbances
• abdominal pain
• muscle and tendon pain
• inflammation of blood vessels
• inflamed and irritated eyes
• skin rash, skin redness, skin defects to ulcers
• anxiety and depression
• and others

Problems affecting the joints:

• Joint stiffness
  • Typical is morning stiffness on waking and after inactivity
  • stiff fingers or stiff spine
  • may persist for up to an hour after waking
  • feeling of difficulty in clenching the hand into a fist
  • heavier steps in the morning
  • Warm-up and activity brings relief from discomfort
• 3 or more joints may be affected at the same time, most commonly:
  • finger joints
  • wrists
  • knees
  • ankles
  • toes
  • shoulders
  • elbows
  • hip joints
  • spine
  • temporomandibular joints - joints between the temporal bone and the jaw
• joint pain
  • Worsens with stress, in an inappropriate position,
  • subsides at rest
  • pain can be throbbing and dull, but also sharp and burning
• joint swelling, in non-inflammatory and inflammatory rheumatic diseases
• joint inflammation, also manifested by warm skin over the joint, redness (e.g. in DNA and arthritis)
• skin changes, in some cases also nail changes, rheumatic nodules
• limitation of mobility, partially or completely depending on the extent and degree of damage
• joint instability and limitation of function
• joint deformities

Non-inflammatory and inflammatory rheumatism differ.

In the inflammatory form, it is common to have morning stiffness of the joints. The stiffness lasts for more than an hour and is associated with the general symptoms mentioned above. Examples are rheumatoid arthritis or ankylosing spondyloarthritis.

The non-inflammatory form, on the other hand, is characterised by worsening after a full day of activity. Therefore, the pain usually occurs in the evening, when it is also most pronounced. Morning joint stiffness is not as long-lasting and subsides after a short period of time and after moving around for a few minutes, as in osteoarthritis.

In joint disorders it is said that the trouble may affect only one joint, but also several at the same time.

When assessing the number of affected joints, it is subsequently used:

1. monoarticular form - 1 joint - examples are septic arthritis, DNA, Lyme disease
2. oligoarticular form 2 to 4 joints - as in the monoarticular form
3. polyarticular form 5 or more joints - rheumatoid arthritis, systemic lupus

The rheumatic disease can take different courses. It is also possible that general discomfort is the first symptom. The disease behaves atypically. And the first typical symptoms of rheumatism appear only in a subsequent phase.

Children may complain of leg pain or be unable to walk. Later, swollen joints are associated. Plus rheumatism is accompanied by general and systemic symptoms.

Therefore, the first symptoms of rheumatism may not be typical of a rheumatic disease, which often delays diagnosis and early treatment.

Watch out for rheumatism, it also attacks outside the joints

Rheumatic diseases are also dangerous because they attack structures and tissues outside the joint. They therefore have extra-articular manifestations. These are concurrent disorders that are caused by autoimmune processes.

In many cases, the skin is affected, in the sense of psoriasis, but also various ulcerations - skin ulcers. And in rheumatism, rheumatoid nodules are often mentioned. Similarly, mucous membranes may be affected.

However, in addition to skin and mucous membranes, eye damage is also a possibility. Inflammation of the eye is one of the most common extra-ocular symptoms. Examples include iritis (inflammation of the iris) or conjunctivitis (inflammation of the conjunctiva), among others.

Plus many other problems...

The table lists some extra-articular complaints of rheumatism

Briefly about the treatment

It has been said several times that it is early diagnosis that is important. Of course it gives the basis for early treatment.

The sooner treatment is started, the better. The challenge is mainly to slow down the progression and thus mitigate the damage that rheumatism can do. And as we already know, it does not only affect the joints.

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Rheumatism can't be cured, but it can be treated. The symptoms of acute deterioration - pain and other symptoms - are alleviated. The early participation of the affected person in normal life is also an important goal.

Several methods are used in the treatment.

What is important in rheumatism:

• dietary modification - plenty of vegetables and fruit, elimination of allergens
  • fish and lean meat, poultry
  • diet, smaller portions and 5-6 times a day
• adhere to a drinking regime
• nutritional supplements where appropriate
• • vitamins and minerals such as vitamin C, D, selenium, zinc
  • joint supplements, chondroitin and glucosamine sulphate, etc.
  • turmeric, ginger, chilli
  • essential fatty acids
• a generally healthy lifestyle
• plenty of appropriate and adequate physical activity
• relaxation and rest
• rehabilitation and spa treatment
• in the acute stage, application of cold, but also gels, creams or plasters
• attention to immunostimulant drugs, which promote immunity and thus the autoimmune process
• weight adjustment for overweight
• no smoking and limit alcohol

Medication treatment is also chosen according to the exact form. The basic medications include mainly those that suppress the inflammatory process - these are non-steroidal anti-inflammatory drugs (NSAIDs), non-steroidal antirheumatic drugs (NSAIDs), pain-reducing drugs, corticosteroids.

However, these drugs have only a symptomatic effect.

There are drugs that have been proven to have a positive effect and suppress the inflammatory process and thus the progression of the disease. These are referred to as DMARDs - which is an abbreviation of Disease Modifying Antirheumatic Drugs.

Plus biological treatments are also available.

Read more in this article:
Biologics bring innovative treatments even where conventional treatments have failed