Rheumatoid Arthritis
Arthrosis and rheumatism
The World Health Organisation (WHO) defines the concept of rheumatism as all conditions (about 450 different ones) which are manifested in the musculoskeletal system and which are associated with pain and limited movability. All these conditions are almost always chronic and are usually not curable. They are divided into four main groups:
- Inflammatory rheumatic diseases, i.e. arthritis
- Degenerative changes in the joints, i.e. arthrosis
- Rheumatism of the soft tissue, i.e. fibromyalgia
- Conditions of the metabolism which affect the joints, i.e. gout
Sometimes it is not quite easy to distinguish between all these forms. Their symptoms can be very similar and they may even appear simultaneously. For example, long-term arthritis may lead to arthritic damage to the joints concerned, and some cases of arthrosis can often lead to side inflammations, which appear periodically. Generally, rheumatism refers to rheumatic or rheumatoid arthritis which usually symmetrical affects several joints. It often starts between the age of 35 and 45, but can also develop during childhood. In Germany, the disease affects around 800,000 people, 5% of whom are children and young people under the age of 16. The first signs of the condition usually appear in the elementary and middle knuckles, which can cause a typical pain during shaking hands, the so-called "greeting pain". In its further development, the condition, little by little, begins to affect other joints such as the elbows, shoulders, toes, ankles and knees. So-called.rheumatic nodes, most often created on the forearm near the elbow, are typical for this condition.
Rheumatoid arthritis is not only a joint condition, it affects the entire person
Unlike arthritis, rheumatoid arthritis is a systemic disease, i.e. it affects the entire system. Hence, the condition is not confined merely to the joints, but may also spread to internal organs such as the heart, lungs, eyes, the nervous and circulatory system. Patients then do not only suffer from joint problems, but also from accompanying general symptoms such as anemia, fatigue and lack of energy. The real reasons as to why this happens are not yet known. Most scientists assume that it is a disorder of the immune system. A genetic predisposition certainly plays a role as well, as can be inferred from the frequent occurrence of the condition within the same family. Since women develop the condition much more frequently than men, some believe that hormones also have a certain impact on the condition.
The development of the disease is well-researched
The reason why this condition occurs is not yet known, but how it works, and what exactly happens, is very well-known. The membrane which surrounds the joints from the inside (sinovialis), gets attacked by the body's own immune system. This leads to the formation of various transmitters which trigger inflammatory processes. The joint membrane thickens, begins to grow rapidly and secrete excessive joint fluid, which is then observed as a very painful effusion in the joint. The enzymes that appear in these processes, alongside the joint membrane, also attack the cartilage and bone, until eventually the entire ankle is destroyed. Not only the whole joint, but also the surrounding joint capsule, ligaments and tendons are involved in the inflammatory process. Ever weaker mobility and movement lead to the disappearance of muscle mass, resulting in the joint's instability and therefore in curve positioning. If this vicious cycle is already underway, it is difficult or even impossible to bring back existing changes to their old state.
Since the wearing down of the joints takes place very rapidly, especially in the first two years, it is important to recognize the condition as soon as possible in order to stop it, or slow it down as much as possible. Consequently, by applying treatment, it is possible to achieve function improvement even in later stages. In fact, even today, it takes very long (sometimes even years) until rheumatoid arthritis is diagnosed. According to the data of the German League for Rheumatism (Deutsche Rheuma-Liga) in 80% of cases, consequential damage can be avoided if therapy begins early.
The diagnosis of rheumatoid arthritis is set on the basis of symptoms and the patient's general condition, condition of the joints, laboratory values and X-ray images. However, it is sometimes is not easy to distinguish the results from arthritis.
The stages of rheumatoid arthritis
Stage 1 - Everyday activities at work and during leisure time are not restricted.
Stage 2 - Taking care of oneself (Dressing, undressing, eating, body care) and work activities can be performed without restriction, but free time activities are limited.
Stage 3 - Taking care of oneself is possible without restrictions, but work and leisure activities are substantially limited.
Stage 4 - All activities are limited.
The diagnosis and treatment of rheumatoid arthritis assumes the doctor/therapist to have a lot of experience. A nearly complete overview of therapeutic strategies for arthritis would greatly exceeded the scope of this article. In addition to drug treatment - same as with arthrosis - physical activity isof utmost importance, even when it causes pain. Whether it's arthritis or arthrosis, it does not matter: joints need to be moved, otherwise they '"become rusty." Only when the joints move can the cartilage receive the necessary nutrients.
Source: Excerpt from the book by M. Krieger, "Arthrosis - Causes, Treatment and Diagnosis"
