Rheumatoid Arthritis Treatment – What are Rheumatic Diseases?

Rheumatic diseases are known to cause inflammation- inclusive of redness, swelling as well as pain along with significant changes in your joints and pain in the nearby structures. As rheumatic disease becomes worse, it can even make it difficult for you to carry out your everyday activities.

There exist more than 100 distinct rheumatic conditions which include osteoporosis, gout, fibromyalgia, rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, systemic lupus erythematosus and scleroderma.

Some of the rheumatic conditions like osteoarthritis happen to be the result of wear and tear while others like rheumatoid arthritis occur because of the immune system problems.

In general, the symptoms of rheumatic conditions will tend to vary based on the type you are suffering from. However, in most cases, rheumatic conditions usually target your musculoskeletal system which comprises of your bones, muscles, joints, and tendons which help the body function smoothly.

In some people, rheumatic conditions, can even involve the internal organ or experience more than one condition of rheumatic disease.

Owing to this, it may be a little difficult for your primary healthcare provider, or a specialist in rheumatic conditions known as rheumatologist, to arrive at the specific diagnosis and the ideal treatment approach.

In general, the treatment plan for rheumatic conditions involves regular exercise, medications, a healthy diet, proper rest and stress management.

Causes and Risk Factors of Rheumatic Diseases

It is believed that rheumatic conditions are a result of genes combination and environmental factors. If you have certain modified genes, it can increase your susceptibility to rheumatic diseases. Some factors in your environment can also trigger the onslaught of the disease.

There are numerous factors that increase your risk of developing one or more rheumatic conditions. Some of these factors include:

• Older adults are more prone to suffer from Osteoarthritis than younger adults
• Conditions like rheumatoid arthritis, fibromyalgia, scleroderma and lupus are more common in women than men
• Men are more likely to suffer from gout and spondyloarthropathies
• Lupus is most likely observed in African-Americans and Hispanics
• If you smoke or are obese, you will be at a higher risk of suffering from different rheumatic diseases
• Certain dietary factors can also increase or cut down your risk of some rheumatic diseases. For instance, if you take a diet that’s high in purines, you can suffer from gout. Purines are generally found in different meat types.

Rheumatic Disease: Symptoms

Though the main symptom associated with the rheumatic diseases is inflammation, in case of arthritis, inflammation can lead to certain symptoms in your joints, including:

• Pain
• Swelling
• Stiffness, especially in the morning
• Warmth and redness
• Sensitivity
• Trouble in using the joint normally

Rheumatic diseases can cause a range of other symptoms as well, some of which include:

• Fatigue
• Rashes and sores
• Eye inflammation or infections
• Pain in the neck, spine, or back
• Trouble in taking a deep breath
• Muscle pain

Rheumatic Diseases Types

There are various rheumatic diseases and some of the common ones include:

Osteoarthritis: It is one of the most common rheumatic diseases wherein the slippery tissues covering the end of bones in your joint get damaged. Without the slippery tissue, the bones start rubbing together. This rubbing leads to swelling, pain and loss of mobility in the joints. Gradually, the joint even tends to lose its usual shape and bone spurs grow on the joint edges. Furthermore, bone chunks or cartilage break off and start floating in the joint space. This makes the pain to aggravate and even increases the damage. Quite different to the other types of arthritis, osteoarthritis predominantly affects only your joints and not the internal organs.

Rheumatoid arthritis & Symptoms: It is an autoimmune disorder wherein your body’s immune system starts attacking the synovium (it is a soft tissue which lines your joint) mistakenly. This leads to inflammation and your joints get affected. If you suffer from rheumatoid arthritis, you will suffer from swelling, stiffness and pain. If the joints on just one side of your body suffer from rheumatoid arthritis, the joints on the other side will also experience it gradually. Rheumatoid arthritis normally affects more than one of your joints and it can target any joint in your body. Some symptoms associated with rheumatoid arthritis include sickness, fever and tiredness.

Systemic lupus erythematosus: More commonly known as lupus, the systemic lupus erythematosus happens to be an autoimmune disorder that can lead to inflammation in various parts of your body, such as your joints, kidneys, skin, blood, heart, lungs and brain. Systemic lupus erythematosus (lupus) occurs when your body’s defense system starts attacking the healthy cells and tissues in your body rather than attacking the bacteria and virus. Systemic lupus erythematosus can damage several parts of your body, including your:

• Joints
• Kidneys
• Heart
• Skin
• Lungs
• Blood vessels
• Brain

Lupus is not transferred from one person to other. When you suffer from this condition, you tend to experience stages of illness (flashes) and wellness.

Gout: It is one of the most common and complex type of arthritis that anyone can suffer from. It is usually characterized by sudden, extensive attacks of pain, redness, swelling and tenderness in your joints, which will mostly occur in the joint at the base of your big toe. You can experience a gout attack suddenly, which could be while you are awake in the middle of the night wherein you will experience a sharp sensation as if the big toe has been put on fire. The joint that gets affected usually remains swollen, hot and so fragile that even the slightest of weight might appear to be unbearable.

The signs and symptoms of gout often keep on fluctuating with their appearance; however, using the right approach, the symptoms can be managed easily. The symptoms of gout often surface suddenly, mostly at night. Some of the commonly associated symptoms with gout are:

• Intense joint pain that can last from four to 12 hours
• Lingering discomfort that can last from few days to few weeks
• Inflammation or redness in the joints
• Restricted motion of joints

Juvenile idiopathic arthritis: The name used for describing arthritis that occurs in small children is juvenile arthritis. Like adults, even children can suffer from arthritis which is caused due to the inflammation of the joints. Juvenile arthritis leads to loss of function owing to an inflamed supporting structure. Some of the rheumatic diseases even tend to involve the internal organs.

Some of the symptoms that a juvenile arthritis can cause include:

• Pain
• Stiffness
• Swelling
• Loss of motion

Juvenile idiopathic arthritis is the most commonly occurring type of arthritis in children, wherein the term idiopathic means ‘from unidentified causes’. Apart from juvenile idiopathic arthritis, there are various forms of arthritis that affect children.

Psoriatic arthritis: It is an arthritis type which usually affects people suffering from psoriasis. In this condition, the skin will have red patches topped with silvery scales. Many people suffering from psoriatic arthritis tend to develop psoriasis first and in the later stage they get diagnosed with psoriatic arthritis. However, in some cases, the joint issue can start prior to the appearance of the skin lesions.

Some of the symptoms associated with psoriatic arthritis include swollen fingers and toes, foot pain, lower back pain, joint pain, stiffness and swelling. Psoriatic arthritis can influence any part of the body, inclusive of the fingertips and spine. The symptoms can range from comparably mild to serious. In case of both psoriasis and psoriatic arthritis, the disease flares are likely to substitute with periods of exemption. As of now there exists no treatment for psoriatic arthritis. Experts usually focus on managing the symptoms while also preventing any damage to the joints. In the absence of treatment, psoriatic arthritis can prove to be immobilizing.

The joints that are most commonly affected by psoriatic arthritis happen to be:

• Outer joints of your fingers or toes
• Wrists
• Ankles
• Lower back
• Knees

Bursitis: It is a distressing condition which mainly affects the small and fluid-filled sacs known as bursae. The bursae cushion your muscles, bones and tendons near the joints. Bursitis occurs when this bursae become inflamed. Bursitis majorly occurs in your shoulder, hip and elbow. However, it can even affect the knee, heel and base of the big toe. Bursitis is known to mostly occur near the joints which carry out persistent repetitive motion.

The treatment for bursitis majorly includes giving proper rest to the affected joint and keeping it safe from any trauma. In most of the cases, the pain arising from bursitis fades away in a time space of few weeks when proper treatment is given. However, the periodic flare-ups of the bursitis stand to be common.

When you suffer from bursitis, your affected joint tends to:

• Feel painful or stiff
• Ache more when moved or pressed
• Appear swollen and red

Ankylosing spondylitis: It is a type of arthritis which majorly affects your spine. Ankylosing spondylitis mostly includes heat, swelling, redness and pain in your spine or in the joint where the base of your spine (sacrum) joins your pelvic bone (ilium).

In certain people, Ankylosing spondylitis can even affect your shoulders, hips, ribs, knees, and feet. The condition can even influence the areas where the ligaments and the tendons attach to the bones. In some cases, Ankylosing spondylitis can even affect your eyes, bowel, and seldom it has a possibility of affecting your heart and lungs.

Many people suffering from Ankylosing spondylitis experience mild back pain that keeps coming and going. Certain people can experience acute pain which will not subside and in some cases, the spine can also become very stiff. In the worst of cases, the swelling can lead to blending of two or more bones of your spine. This can cause the rib cage to stiffen, thus making it hard for you to take a deep breath.

Reactive arthritis: This condition is characterized by the pain or swelling in your joint which is often caused by an infection in the body. When you suffer from this condition, you can possibly have swollen and red eyes, and swollen urinary tract. These conditions can either occur alone, together or can be completely absent.

Most of the people who suffer from reactive arthritis tend to get better completely from the initial flare of symptoms and even get back to usual activities in next two to six months. In some cases, it could be a long-term yet mild condition while in few people, the arthritis will be very severe and difficult to manage with treatment. And in some cases it can even lead to joint damage.

Scleroderma: Also known as systemic sclerosis, the scleroderma happens to be an autoimmune rheumatic condition which causes the thickening and tightening of your skin along with inflammation and scarring in many other parts of the body, inclusive of the blood vessels, certain organs and joints.

Polymyalgia rheumatica: This condition leads to pain and stiffness of your tendons, ligaments, muscles, and the tissues around your joints. Polymyalgia rheumatica leads to muscle pain and rigidity in your hip, neck and shoulder. The pain and rigidity normally happen in the morning time or when your body has been at rest for a while. The pain will last for more than 30 minutes. In most of the cases, Polymyalgia rheumatica develops over time. However, in some people, the condition can start very quickly – even suddenly. Other than stiffness, you can even experience weakness, fever and weight loss.

Though Polymyalgia rheumatica normally fades away in a year’s time, in certain cases, the condition can last for longer.

People suffering from polymyalgia rheumatica have giant cell arteritis, which is a disorder linked with the inflammation of arteries placed on each side of your head.

Fibromyalgia: It is a disorder which is characterized by the extensive musculoskeletal pain followed by sleep, fatigue, memory and mood issues. Fibromyalgia intensifies distressing sensations by affecting your brain’s way of processing the pain signals. The symptoms at times start post a physical trauma, infection, surgery or important psychological stress. However, in some other cases, the symptoms slowly accumulate without any single triggering incidence.

As compared to men, women are more prone to developing fibromyalgia. People who suffer from fibromyalgia, also experience tension headaches, irritable bowel syndrome, temporomandibular joint (TMJ) disorders, anxiety and depression.
There is no precise cure for fibromyalgia, but the symptoms can be managed with the help of certain medications. Exercise, stress-reduction and relaxation can also help in controlling the symptoms.

Polymyositis: It is a rare type of inflammatory disease that leads to muscle weakness on both the sides of the body. When suffering from polymyositis, you can find it difficult to rise from your seated position, climb stairs, reach overhead or lift the objects.

It mostly affects people who are in 30s, 40s or 50s and is more likely seen in women as compared to men.

Giant cell arteritis: The giant cell arteritis makes the arteries of your scalp and neck to turn hot, red, swollen, or painful. The arteries that mostly get affected because of this condition are the ones situated in your temples on both side of the head. Giant cell arteritis causes the arteries to become narrow, because of which sufficient amount of blood doesn’t pass through them. If the treatment for giant cell arteritis is delayed, it can cause permanent damage to the arteries and can even increase the risk of stroke or blindness. If you are suffering from the giant cell arteritis, your healthcare provider will look for other symptoms also to see if they are occurring because of any other disorder like polymyalgia rheumatica.

Sjogren’s syndrome: The Sjogren’s syndrome happens to be a disorder of the immune system characterized by the two prominent symptoms, dry eyes and dry mouth. The Sjogren’s syndrome is always accompanied by other disorders of the immune system like lupus and rheumatoid arthritis. In Sjogren’s syndrome, your mucous membranes and the moisture-producing glands of the eyes and mouth get affected first which results in lesser tears and saliva.

Anyone can develop the Sjogren’s syndrome at any age but it is more prominent and in people who are 40 years old or more. Moreover, this syndrome is found more in women than men and the treatment approach is focused at offering relief from the symptoms.

Apart from being characterized as an immune system disorder, the Sjögren’s syndrome also happens to be a rheumatic disease, which usually affects your:

• Joints
• Ligaments
• Bones
• Tendons
• Muscles

The commonly associated signs and symptoms of this condition as a rheumatic disease possibly include:

• Redness or heat
• Pain
• Swelling
• Loss of function

Categories of the Sjögren’s Syndrome: Doctors have categorized the Sjögren’s Syndrome in two categories, namely: Primary and Secondary Sjögren’s Syndrome

The primary form happens when you don’t have any other rheumatic diseases while the secondary form occurs when you are already suffering from any type of rheumatic disease like rheumatoid arthritis, scleroderma, systemic lupus erythematosus or polymyositis.

Diagnosis and Treatment of Rheumatic Diseases

A rheumatic disease is often diagnosed with various blood tests and imaging tests. Depending upon your symptoms and signs, your doctor will advise the diagnosis method.

As stated above, there exist more than 100 rheumatic diseases types which are characterized by the inflammation of different connective or supporting structures of your body. Rheumatic diseases in general are very distressing, chronic and gradual which means the condition becomes worse with time.
Moreover, when the treatment is delayed, it can make way for grave complications. When a condition like rheumatoid arthritis, wherein the immune system starts attacking joints lining, becomes worse, it increases your risk of suffering from certain type of cancers which can further lead to nerve dysfunction.

If diagnosed early, the progression of rheumatic disease can be slowed. Once you approach a rheumatologist for the diagnosis, he or she will first ask details about your current as well as part health inclusive of any illness, exercise routine, travel nature and medical history of your family.

Then a thorough physical examination will be conducted that will check for apparent signs of stiffness, swelling or redness in the joints. During the physical exam, your range of movement and reflex will also be checked along with the examination to look for any swollen gland and inflammation of eyes.

In case any kind of rheumatic disease is suspected, your doctor will recommend some laboratory tests so as to rule out any other possible cause.

You will be recommended blood tests for detecting the markers of inflammation, antibodies linked with particular diseases, unusual blood counts, and unusual organ function. In some cases, testing your urine and joint fluid will also be necessary.

Imaging tests of the joints and bones will help in detecting inflammation, build-up of fluid, loss of cartilage, bone or joint damage or soft tissue tears. For this, you will be suggested to undergo imaging tests such as MRI, X-rays, Ultrasounds or CT scans.

Rheumatic Disease Medication

For treating rheumatic diseases, distinct medication types will be prescribed by your healthcare provider. Certain drugs will only help in treating the symptoms such as pain and inflammation, while other medication type will help in altering the course of rheumatic disease.

Other Rheumatic Disease Treatments

Apart from medication, the doctor can even recommend distinct types of treatments, which will include:

Particular exercise regimes for increasing the muscle strength as well as joint flexibility like,

• Physical therapy
• Hot and cold therapy
• Occupational therapy
• Splints, braces, and assistive devices to support weak joints
• Relaxation therapy

And in some cases of arthritis, a surgery might be recommended.

Conclusion

Rheumatic diseases have a negative impact on the different joints and muscles that form the structural support of your body. It can not only affect the quality of your life by restricting your movement, but the disease can even subject you to various complications that can be very damaging.

Timely diagnosis can ensure that the progression of the disease is controlled with the right treatment, which can be precisely designed, once the diagnosis has been done thoroughly.

At Shalby Hospitals, we are well-equipped with a Rheumatology OPD wherein highly experienced Rheumatologists evaluate the patients suffering from different rheumatic diseases. Our diagnosis is backed by advanced facilities in the form of various imaging and laboratory tests. Our well-trained and experienced Rheumatologists treat all patients with precision and excellence.