Rheumatism is not a specific
disease, but the generic term for a group of more than 100 different diseases
that have different causes and courses. What they have in common is that
pain mainly occurs in the musculoskeletal system: in the bones, joints,
muscles, tendons and bursa. Rheumatism (especially rheumatoid arthritis ) can be experienced by people of any
age. However, the risk of illness increases with age. Children and
adolescents rarely develop inflammatory rheumatism.
Rheumatism: types
Experts divide rheumatism
diseases into two groups: non-inflammatory and inflammatory rheumatism . The
most common inflammatory rheumatoid disease is rheumatoid arthritis . In
Germany, 800,000 people have it, which corresponds to one percent of the
population.
Rheumatism: causes
While non-inflammatory
rheumatic diseases mostly develop through wear and tear and joint wear, the
inflammatory rheumatic diseases are based on a misdirected immune
system. It mistakenly considers joint cells to be enemy invaders and
attacks them.
If the defense is directed
against the own body, doctors speak of an autoimmune disease. This causes
inflammation that gradually destroys the affected joint and sometimes also
affects internal organs.
Non-inflammatory rheumatism
Non-inflammatory rheumatic
diseases include osteoarthritis (degenerative
diseases of the joints), crystal arthropathies (such as gout ) and all forms of soft tissue rheumatism and
bone diseases ( e.g. osteoporosis ).
Inflammatory rheumatism
These include all forms of
arthritis (joint inflammation), as well as spondyloarthritis (inflammatory
diseases of the spine and joints, such as ankylosing spondylitis )
as well as vasculitides (inflammatory diseases of the vessels) and collagenoses
(connective tissue diseases such as scleroderma and systemic lupus
erythematosus).
The most common inflammatory
rheumatic disease is rheumatoid arthritis. It occurs because the immune
system attack the joints and, if left untreated, increasingly destroys
them. It is a chronic disease (lasting more than six weeks) that usually
affects the right and left halves of the body. Since it often occurs in
more than two joints at the same time, doctors used to refer to it as
polyarthritis (multiple arthritis, so to speak).
The course of a rheumatic
disease is different and unpredictable. It can develop unnoticed for years
and affect the finger, wrist and toe joints, but it can also occur suddenly and
affect almost all joints (including larger joints such as the shoulder or
elbow) of a patient and also internal organs, especially the heart, within
weeks. Damage kidneys, lungs, intestines, skin and eyes.
The course is typical in
episodes, with some patients only experiencing a single episode, with others
the symptoms recur. In some cases the disease progresses permanently until
the spine and joints are ossified, in other cases the disease rests for years
before a sudden flare-up (worsening) occurs and the disease spreads to
previously unaffected joints.
Rheumatism as a concomitant disease of
psoriasis: Psoriatic arthritis:
Every fifth psoriasis patient develops arthritis after the onset of the inflammatory skin
disease psoriasis, usually ten years between them, but some sufferers have
symptoms at the same time. The excessive immune system mistakenly
classifies the skin cells and the joint cells as hostile pathogens that it has
to fight and eliminate. This so-called psoriatic arthritis usually affects
individual or all finger or toe joints.
Rheumatism: symptoms
The first signs of rheumatoid
arthritis are pain in the wrists , fingers or toes , which
can be felt especially in the morning. As a rule, the base and middle
joints as well as the end joints (where the fingernail or toenail sits) are
spared from the inflammation.
The so-called morning stiffness can
last longer than 30 minutes. It is also typical that the pain occurs in
several (at least two) joints at the same time and usually symmetrically. The
inflammation also causes swelling of the synovium. The affected area feels
soft, it is also sensitive to pressure and warm.
Medium and large joints such as shoulder,
elbow, hip, knee and ankle joints are
more rarely affected by rheumatoid arthritis. The tendon sheaths can
also become inflamed and swollen.
If arthritis occurs in the
knee or shoulder joint, the bursa there often becomes inflamed .
The patient has a general feeling of illness with
symptoms such as fatigue, fever , loss of
appetite, weight loss, and night sweats. A slight fever and muscle pain are also occasional.
In the later stages of the
diseases, small, hard nodules called rheumatoid nodules can form under the
skin. About twenty percent of patients are affected. The rheumatoid
nodules (doctors also call them granulomas) consist of defense cells
(especially macrophages) of the immune system. They are not
painful. Granulomas not only form in rheumatoid arthritis, but also in
other inflammatory diseases, such as the lungs, intestines or blood vessels.
With advanced rheumatism,
severe consequential damage occurs. Joints and bones deform and become
deformed.
In addition to the
disease-specific symptoms, rheumatism can trigger a number of secondary
diseases:
- Inflammation of the blood vessels: it manifest itself as
circulatory disorders, small punctiform wounds (so-called small vessel vasculitis)
on the skin, skin ulcers or tissue death. In addition, the patients
are more likely to constrict blood vessels ( arteriosclerosis ),
which increases the risk of a heart attack .
- Inflammation of the lungs: As a result of rheumatoid
arthritis, the alveoli can become inflamed. Difficulty breathing and
coughing are typical signs.
- Inflammation of the eye : The eye is one of the
organs with the best blood supply and is therefore prone to inflammatory
processes. Rheumatoid arthritis can damage the lacrimal glands or the
internal structures of the eye. Rheumatism patients notice this in
dry, burning and red eyes, a foreign body sensation and sometimes stabbing
pain in the visual organ.
- Inflammation of the
salivary glands: Rheumatism
can also damage the tear and salivary glands. This course, which
doctors also call sicca syndrome ,
affects around a third of all patients. You suffer from dry eyes and
dry mouth.