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

A summary of rheumatic diseases, pathologies associated with joint pain.

We all know someone with rheumatism, osteoarthritis, osteoporosis and similar pathologies, as some of them are skeletal disorders associated with the tissue degeneration that comes with age. However, the reality beyond the anecdote goes far beyond the annoying picture: as indicated by the World Health Organization (WHO), approximately 1.71 billion people have some kind of musculoskeletal disorder, which makes these conditions one of the main causes of disability worldwide.

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 classic back pain, there are some 150 conditions that damage or prevent the correct functioning of nerves, muscles, tendons, joints and cartilage associated with the locomotor system. Among them, rheumatism stands out.

In any case, it is interesting to note that the term "rheumatism" provides very little relevant information at the clinical level, since we should really be referring to this disease when we speak of it. 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 group of clinical pictures, continue reading.

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 often have a number of commonalities, most notably chronic intermittent joint and connective tissue pain..

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

• Diffuse connective tissue diseases: includes some of the most famous forms of rheumatism, such as rheumatoid arthritis, juvenile arthritis or systemic lupus erythematosus.
• Arthritis associated with spondylitis: this group includes ankylosing spondylitis, reactive arthritis and psoriatic arthritis.
• Osteoarthritis (OA): the most common joint disorder. It is due to cartilage breakage or wear and tear and the consequent rubbing of adjacent bones.
• Rheumatic syndromes related to infectious agents: acute septic arthritis due to streptococcus or staphylococcus (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). (palindromic rheumatism).

By social convention and ease of information transmission, we will now focus on osteoarthritis, the most common variant of rheumatologic 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 and osteoarthritis

As mentioned above, osteoarthritis (OA) is the most common type of rheumatism worldwide. The overall prevalence is estimated to be 3.3 to 3.6% of the population, although 80% of people aged 65 years or older show some 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 million people worldwide, making osteoarthritis the eleventh most debilitating disease in the world.

This pathology develops as a result of tissue aging of the articular cartilage, although there may be certain triggering factors.Although there may be certain triggering factors and anatomical irregularities that promote it. The first evident change in OA is fibrillation, irregularity and focal erosion of the articular cartilage. Over time, these erosions expand in length (bone) and width (increased joint surface area), thus generating a series of characteristic symptoms.

Symptoms of osteoarthritis

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

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

However, it should be noted that not all people with joint pain necessarily have osteoarthritis.. For example, studies have shown that only 25% of patients claiming to have rheumatoid arthritis (another type of rheumatism) meet the diagnostic criteria necessary for this to be true. In the case of osteoarthritis, the differential criteria are as follows:

• Joint pain worsens with activity and improves with rest on a physical level.
• The patient is over 45 years of age.
• Morning stiffness lasts less than 30 minutes and does not explain the picture.
• 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, tendonitis, radiculopathies and many others.. As you can see, all these clinical entities are rheumatoid disorders (rheumatism), but osteoarthritis is differentiated as its own clinical entity by a series of characteristics.

Treatment

The treatment of osteoarthritis (and most types of rheumatism) is based on minimizing pain and pain relief. is based on minimizing pain and loss of function in the affected structures.. To this end, patients are advised to avoid pain-producing activities (excessive joint load), do exercises that promote joint strength, weight loss (if necessary) and occupational therapy.

Above all, weight loss (if necessary) and occupational therapy.. One "extra" kilo in the trunk region is multiplied 3 to 7 times in the knee area, which is why obese people have so many mobility problems. In addition, aerobic exercises used to tone the body (along with resistance development) will help the patient feel less pain, whether general or localized.

On the other hand, pharmacotherapy can also be used to pharmacotherapy can also be used to address osteoarthritic rheumatism.. Paracetamol (or acetaminophen) is the over-the-counter nonsteroidal Anti-Inflammatory drug (NSAID) 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 note that the term "rheumatism" refers to more than 200 different diseases. Osteoarthritis (and to some extent rheumatoid arthritis) are the most socially known types of rheumatism, but there are many others, such as ankylosing spondylitis, psoriatic arthritis and systemic lupus erythematosus.

In general, in those clinical pictures where the autoimmune reaction is more evident, corticosteroids are usually used. corticosteroids (such as prednisone) and immunosuppressants together with the above-mentioned over-the-counter anti-inflammatory drugs. anti-inflammatory drugs mentioned above. Unfortunately, patients undergoing these treatments are more prone to secondary infections because their immune system is slightly disrupted.

Summary

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

Therefore, if your joints ache repeatedly over time, do not hesitate to see a medical professional. He or she will diagnose the condition for your specific case and, surely, with less 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.