Rheumatic Diseases: An overview, What is rheumatism? and more

Rheumatism is considered a widespread disease. But actually, rheumatism is not an independent disease. Many people think of the term “rheumatoid arthritis,” but this equation is wrong because the term rheumatism collects many different diseases.

Due to the many manifestations that rheumatism can have, doctors often speak of the so-called “Rheumatic type.” Here, you can find out which diseases belong to rheumatism, how to recognize rheumatism, and what treatments are available.

Definition: What is Rheumatism?

The term “rheumatism” describes a variety of different diseases that mainly cause problems in the musculoskeletal system. The most well-known complaints are joint pains, which is why some also speak of “Joint tearing. “

However, rheumatism does not only include diseases that affect joints or joint capsules but also bonestendonsmuscles, or connective tissue. Vascular inflammation is also part of the rheumatic spectrum. Rheumatism can occur at any age. Many diseases are chronic. Serious complications threaten significantly when internal organs are affected. An example is kidney failure.

What Rheumatic diseases are there?

Rheumatism comprises hundreds of individual diseases. Some of them can be combined under collective terms. The various vascular inflammations are connected, for example, under the term “vasculitis.” Depending on the cause, the large field of rheumatism can be divided into five groups:

  1. Inflammatory rheumatic diseases
  2. Wear-related rheumatic diseases
  3. Metabolic disorders with rheumatic complaints
  4. Rheumatic diseases of soft tissues
  5. Chronic bone diseases

Inflammatory rheumatic diseases

These include diseases that are based on inflammatory processes. As a rule, the defense system is directed against the body’s cells. Doctors, therefore, speak of autoimmune diseases. This field includes, among other things, the well-known rheumatic disease “rheumatoid arthritis,” but also connective tissue and vascular diseases.

Autoimmune joint inflammation

When the immune cells attack, it is primarily the joints that become inflamed in these diseases. They are very painful, often swollen, warm, and red. Internal organs can also be affected. Autoimmune joint diseases include:

Rheumatoid arthritis
Rheumatoid arthritis is a chronic autoimmune disease that causes inflammation of the joints. It can also affect other organs in the body, including the skin, eyes, and lungs. The cause of rheumatoid arthritis is unknown, but it is thought to be due to a combination of genetic and environmental factors. There is no cure for rheumatoid arthritis, but treatments can help to reduce the symptoms and slow the progression of the disease. Read more about it here!

Collagenosis (connective tissue diseases)

In the case of collagenosis, the defense system is directed against the body’s connective tissue cells. Since there is connective tissue everywhere in the body, such autoimmune diseases can show up in any organ. Women are affected more often than men. Known collagen diseases include:

Lupus erythematosus is an autoimmune disease. The immune system mistakenly sees the body’s cell structures as foreign and attacks them.

Sjögren’s syndrome is a chronic autoimmune disease that affects the salivary and lacrimal glands. The condition can also affect other organs, such as the kidneys, liver, lungs, and nervous system. Symptoms of Sjögren’s syndrome include dryness of the mouth, eyes, and skin; fatigue; and joint pain. The cause of Sjögren’s syndrome is unknown, but the disease is thought to be triggered by a combination of genetic and environmental facets. There is no treatment for Sjögren’s syndrome, but treatments are available to help relieve symptoms.

Vasculitis (angiitis)

Vasculitis is an inflammation of blood vessels. It occurs because immune cells attack the body’s blood vessels. The consequences are sometimes severe damage to the organs supplied by the affected vessels. Vasculitis symptoms are diverse since vessels can become inflamed anywhere in the body. In principle, physicians differentiate between three types of vasculitis:

Behçet’s disease (silk road disease) plays a unique role. It mainly affects small vessels. In contrast to other vasculitides, any vessel can become inflamed, regardless of size.

Vasculitis is a disease that results when the blood vessels become inflamed. This can lead to several serious problems, including organ damage, stroke, and even death. While the exact cause of vasculitis is unknown, several factors are thought to contribute to the development of this condition. Treatment for vasculitis typically involves the use of corticosteroids and other immunosuppressive drugs.

Read more about vasculitis: symptoms, causes, diagnosis, therapy, and prognosis!

Special shapes

A unique form of rheumatism is Rheumatic fever. Here, too, the immune system attacks its body cells – but only if an infection with certain bacteria has preceded it. Joints and skin become inflamed about two to three weeks after a streptococcal infection. It becomes hazardous when the heart muscle, pericardium, and heart valves become inflamed. The nervous system can also be affected.

Lyme disease occupies a unique position. Infection is also caused by bacteria (Borrelia) transmitted by ticks. This can lead to joint inflammation, the so-called Lyme arthritis. Unlike rheumatic fever, this is not an autoimmune reaction but a direct inflammation caused by the pathogen.

Rheumatic fever is a severe medical condition that can lead to long-term health problems. It most commonly affects children between the ages of five and 15, although it can also occur in adults. The disease is caused by a bacterial infection, typically streptococcal bacteria, and can occur after a strep throat or scarlet fever infection. Rheumatic fever can cause several serious health problems, including damage to the heart, joints, and nervous system. The condition can also lead to chronic rheumatic heart disease, which can be fatal. Early diagnosis and treatment of rheumatic fever are essential to prevent long-term health problems. Read more here!

Lyme disease (Borreliosis) is a severe condition that can have a devastating effect on your health. It is driven by a bacteria called Borrelia burgdorferi, transmitted to humans through the bite of an infected tick. Lyme disease can cause many signs and symptoms, including fever, fatigue, joint pain, and neurological problems. Left untreated, it can lead to severe difficulties like Lyme carditis and Lyme arthritis. Early diagnosis and therapy are important to preventing these complications.

Wear-related rheumatic diseases

The most well-known wear and tear disease is joint wear, medically called arthrosis. It occurs more frequently with increasing age. Osteoarthritis can affect any joint. Knee and hip joints are particularly common. In the beginning, supportive measures such as weight loss, muscle building, and painkillers usually help against the symptoms. In the end, often, only a joint replacement can help.

Some experts also include tendonitis among wear-related (degenerative) rheumatic diseases. Typically, a specific overuse, such as intense practice on an instrument, provokes Tenosynovitis (tendovaginitis). However, it can also arise from inflammatory processes, such as rheumatoid arthritis.

Arthritis is a disorder that impacts the joints. There are numerous types of arthritis, but osteoarthritis is the most common. Arthrosis is a degenerative joint disease resulting in the cartilage’s deterioration. It can affect any joint in the body but is most common in the knees, hips, and hands. The symptoms of arthrosis include pain, stiffness, and decreased range of motion. The condition progresses slowly and can eventually lead to joint deformity. There is no cure for arthrosis, but treatments are available to help manage the symptoms. Read more about osteoarthritis here. Learn more here!

If you’ve ever experienced pain in your tendons, you know how debilitating it can be. Tendonitis is a common condition caused by repetitive motion, overuse, or injury. The good news is that tendonitis is often treatable with rest, ice, and anti-inflammatory medication. This blog post will discuss tendonitis in more detail, including its causes, symptoms, and treatment options.

Metabolic disorders with rheumatic complaints

Rheumatism also includes metabolic disorders that are associated with rheumatic symptoms. They mainly cause pain in the joints.

Those affected by gout have an increased concentration of uric acid in their blood. The uric acid can form crystals (“precipitations”) in the joints and cause severe pain. The big toe’s metatarsophalangeal joint (MTP) is particularly frequently affected. The proper diet and certain medications help against high uric acid levels.

Hemochromatosis is a hereditary disease. Due to a genetic defect, too much iron is deposited in specific organs. The consequences are liver cirrhosis, diabetes, bronzed skin, and joint pain. The treatment of choice is bloodletting.

In addition, some experts also include hormonal disorders in rheumatism, for example, when those affected have related symptoms such as joint, bone, or muscle pain. Rheumatic symptoms occur, for instance, with an overactive parathyroid gland (hyperparathyroidism) or the thyroid gland (hyperthyroidism). According to studies, there also seems to be a connection between diabetes and rheumatism.

Gouty arthritis also called gout. Gouty arthritis is a form of inflammatory arthritis caused by the buildup of uric acid in the joints. It generally affects the big toe but can also affect the knees, ankles, and hands. Symptoms include sudden, severe attacks of pain, swelling, redness, and warmth in the affected joint. Treatment typically involves medications to reduce the pain and inflammation. Read here which diet and lifestyle you can use to get gout attacks under control.

Hemochromatosis is when too much iron creates in the body. If left untreated, it can lead to serious health problems. Early diagnosis and cure are essential to prevent serious complications. If you have hemochromatosis, you may need to be treated with a procedure to remove iron from your body.

Rheumatic diseases of soft tissues

Rheumatism can also affect the “soft” body tissue. These primarily include the muscles and tendons. But ligamentsbursae, or fatty tissue can also be affected. Typical diseases are:

The term muscular rheumatism has also become famous for muscle pain. In addition, many refer to polymyalgia rheumatica (polymyalgia) and others to fibromyalgia as muscular rheumatism since both are associated with severe muscle pain. However, muscular rheumatism is not an official clinical picture.

Many also vaguely use “soft-tissue rheumatism” or “soft-tissue rheumatism.” It is often equated with fibromyalgia syndrome. Affected people – usually women – complain about chronic pain in different body parts. Instead, soft tissue rheumatism is an umbrella term for all those diseases that affect soft body structures, i.e., not bones, cartilage, and joints.

Fibromyalgia is a medical disease that causes widespread muscle pain and fatigue. The cause of fibromyalgia is unknown, but it is thought to be related to abnormal levels of certain chemicals in the brain. Fibromyalgia is more common in women than males and usually develops between the ages of 30 and 50. There is no cure for fibromyalgia, but therapies can help to relieve the signs and symptoms. Read here how to recognize pain syndrome and how to treat it.

Bursitis is a disease that affects the tiny, fluid-filled sacs that cushion your joints’ bones and tendons. The inflammation of these sacs causes the disease. Bursitis can happen in any joint in the body, but it is most common in the shoulders, elbows, hips, and knees. Bursitis symptoms include pain, swelling, and stiffness in the affected joint. The condition can be treated with anti-inflammatory medications, physical therapy, and rest. Read more about bursitis.

Chronic bone diseases

Chronic bone diseases also belong to the broad area of ​​rheumatism. The leading complaints here are skeletal pain. Sometimes bone deformities or fractures also occur.

Primary osteoporosis is prevalent among older women. Due to the changed hormone balance, the bone mass thins out, and there is a risk of fractures. However, osteoporosis can also result from medication cortisone (secondary osteoporosis).

The disease Osteomalacia, in turn, arises from the fact that the incorporation of calcium and phosphate in the bones is disturbed. In children, the disease is called rickets. It is based on a vitamin D deficiency. In children, this causes, among other things, bone deformities or joint misalignments.

Osteoporosis is a disorder that affects millions of peoples, especially women. It is a condition that causes the bones to become weak and brittle and can lead to fractures. Osteoporosis is often called the “silent disorder” because there are usually no symptoms until a fracture occurs. There are many risk factors for osteoporosis, gender, including age, race, and lifestyle choices. However, some things can be done to prevent or slow the progression of osteoporosis. This blog post will provide information on osteoporosis, the risk factors, and what can be done to avoid or delay the disease. Read everything you need to know here!

Rheumatic diseases from A to Z

Symptoms: how to recognize rheumatism?

The most well-known rheumatism symptom is joint pain. But bones, muscles, and other connective tissue can also hurt. Inflammation, for example, in the common, can be recognized by typical signs:

  • Pains
  • redness
  • swelling
  • overheat
  • Functional limitation of the affected body region (e.g., a poorly movable joint)

In the case of inflammatory rheumatic diseases, the attack on one’s defense system often causes  General symptoms such as:

Rheumatism is also often manifested by typical skin changes.

What are the causes of rheumatism?

The causes of rheumatism are only known for individual diseases. The non-inflammatory symptoms such as arthrosis or tendonitis are usually based on age-related wear and tear or overuse. Risk factors for this are:

  • overweight
  • joint deformities
  • Past bone fractures near the joint
  • Inflammatory joint diseases
  • Lack of exercise over a long period (immobilization)

Hormonal differences after menopause and cells that weaken with age, which build bones, promote osteoporosis. About ten percent of cases are caused by medication (especially cortisone).

The cause of some other rheumatic diseases is also known:

  • Osteomalacia and ricketsvitamin D deficiency; primarily due to lack of sun exposure or malnutrition
  • Classic hemochromatosisgenetic defect; the intestine thus absorbs iron, which is then deposited in the organs
  • Gouttoo much uric acid in the blood (hyperuricemia); too much uric acid is formed, or the kidneys excrete too little uric acid.

In other rheumatic diseases, immune cells attack the body’s tissue, and inflammation occurs. In many cases, rheumatism is an autoimmune disease. Little is known about why the immune system is misdirected. But the genetic material plays a decisive role. This means that most affected people have a genetic predisposition to the disease (genetic predisposition).

In some cases, additional factors can promote the development of the disease, such as environmental influences. Sunlight, for example, is one of the triggers of lupus erythematosus. Infections or tumor diseases can also cause rheumatism. Smoking also promotes the development of inflammatory rheumatic diseases.

Vitamin D is a necessary vitamin that helps the body absorb calcium and phosphorus. It is also thought to play a role in immune function, brain development, and bone health. A vitamin D insufficiency can lead to health issues like weak bones, rickets, and osteoporosis. While vitamin D can be located in some foods, such as fatty fish and fortified milk, the best method to obtain sufficient vitamin D is by spending time in the sun. However, many people do not get enough sun exposure, which can lead to a vitamin D deficiency.

Almost every second person suffers from vitamin D deficiency during the winter. Find out how he expresses himself and what you can do about it here.

Smokers not only suffer from rheumatism more often than other people. The destruction of the joints also progresses more rapidly in them.

How is rheumatism diagnosed?

The doctor diagnoses rheumatic diseases through several examinations. In the beginning, he collects the previous medical history (anamnesis). Typical questions are:

  • Since when are you having those complaints?
  • Does the pain change over the day?
  • Are the limbs hardly mobile in the morning?
  • Do your parents or siblings have similar conditions, maybe even a known autoimmune disease?

During the physical examination, the doctor looks for typical symptoms of a rheumatic disease. In many cases, these include characteristic skin changes, such as rheumatoid nodules in rheumatoid arthritis, rashes in collagenosis, and signs of bleeding in vascular inflammation. The doctor moves the joints to check for possible movement restrictions.

Typical signs of rheumatism can also be found in the blood. The general inflammation values ​​are often increased, such as the C-reactive protein (CRP), the blood sedimentation rate (ESR), ferritin, or the white blood cells (leukocytes). But there are also some specific parameters, such as the auto-antibodies. The most well-known are:

  • Rheumatoid factor
  • Anti-nuclear antibody (ANA)
  • Antineutrophil cytoplasmic antibodies (ANCA)

In addition, doctors can detect unique surface markers in certain diseases, such as HLA-B27 in Bechterew’s disease and reactive arthritis. They are signs of the patient’s genetic predisposition to rheumatic disease.

However, some rheumatic diseases cause no blood changes or only rarely, especially the non-inflammatory forms such as fibromyalgia syndrome or arthrosis.

In many cases, the doctor will also arrange for imaging tests, such as an ultrasound or X-raysMagnetic resonance imaging (MRI) or computed tomography (CT) is sometimes necessary. This allows physicians to identify inflamed vessels.

Doctors use bone density measurements to diagnose osteoporosis. Sometimes the doctor also has to take a tissue sample (biopsy) to be able to identify the rheumatic disease. If a joint is swollen, doctors puncture the joint effusion. There can also be evidence of the disease in the joint puncture, for example, urate crystals in a gout attack.

How is rheumatism treated?

Rheumatism therapy depends on the respective underlying disease. There are different types of treatment:

Doctors often combine pain treatment, rheumatism medication, and exercise therapy. In the case of inflammatory rheumatism, for example, unique active ingredients help against the misguided immune system. They influence the immune system and thus suppress the inflammatory processes (immunosuppression or immune modulation). Rheumatism treatment aims to avoid permanent damage.

Who is the right doctor for rheumatism?

The first point of contact for rheumatic complaints is the general practitioner. He can classify the symptoms, prescribe the first medication, and, if necessary, refer you to a specialist.

This specialist is in internal medicine and rheumatology or rheumatologist for most rheumatic diseases. Under certain circumstances, however, other specialists are also involved in rheumatism treatment. The dermatologist, for example, supports the therapy of psoriatic arthritis. Specialists treat advanced bone wear or fractures in trauma surgery and orthopedics.

Drugs and active ingredients

In the acute attack of rheumatic disease, doctors use cortisone and simple painkillers and anti-inflammatory drugs (non-steroidal anti-inflammatory drugs, NSAIDs). Sometimes more potent painkillers (analgesics such as opiates) are also necessary.

However, they are not suitable for long-term treatment. The doctors change the rheumatism therapy as soon as the acute symptoms are under control. So-called disease-modulating anti-rheumatic drugs (DMARDs), also known as essential therapeutics or medication, can help. These are divided into three groups:

  • Classic essential drugs (e.g., methotrexate)
  • Biologics (e.g., Adalimumab, Etanercept)
  • Targeted base drugs (e.g., apremilast)

For the other diseases of the rheumatic type, doctors mainly prescribe painkillers. Depending on the condition, there are also other medications, for example:

  • Allopurinol to lower uric acid
  • Iron binders such as deferoxamine for hemochromatosis
  • Psychotropic drugs in fibromyalgia
  • Bisphosphonates in osteoporosis

Rheumatism medication can relieve pain and slow down inflammation. Read more about medicines for rheumatism and herbal rheumatism remedies!

Rheumatoid surgery

In some cases, only an operation can help, for example, in the case of advanced arthrosis. Carpal tunnel syndrome or the “snapping finger” are also treated surgically. Treating the lining of the joint (synovium) can help against the symptoms of rheumatoid arthritis. The surgeon removes them (synovectomy) or injects radioactive particles into the affected joint (Radiosynoviorthesis (RSO)).

An endoprosthesis is a medical device implanted into the body to replace a missing or damaged body part. Endoprostheses are commonly used to replace joints, such as the hip or knee, or repair bone or muscle damage. Endoprostheses are made from various materials, including metals, plastics, and ceramics. The type of endoprosthesis best for a particular patient depends on many factors, including age, health, and activity level. A surgeon usually implants endoprostheses. The surgery is typically done under anesthesia, meaning the patient is asleep during the process. The surgeon makes an incision in the skin and then inserts the endoprosthesis into the body.

An endoprosthesis is an artificial joint replacement. Read what types of endoprosthesis are and when and how they are implanted!

A synovectomy is a method to remove the synovial membrane, which is the thin layer of tissue that covers the joints. This procedure is typically performed to relieve pain and inflammation in the joints. Synovectomy can be performed using various surgical techniques, including arthroscopic, open, and minimally invasive. Read everything you need to know about synovectomy!

What else helps with rheumatism?

If you are affected by the rheumatic disease, you can positively influence the course of the disease in many cases. Sports therapies or talks with psychotherapists, for example, are established. Many sufferers alleviate their rheumatic symptoms with a  change in diet or relaxation training. Particularly important: Stop smoking and no excessive alcohol consumption! Alcohol and nicotine favored rheumatism.

What else is important in rheumatism?

There are a few things that people with rheumatism – especially those with inflammatory rheumatic diseases – should take to heart:

Vaccinations for rheumatism

Rheumatic diseases themselves, but the immune-suppressing therapy, make those affected more susceptible to infectious diseases. It is therefore crucial that rheumatism patients pay attention to their vaccination status. They belong to the risk group and should, for example, be vaccinated against influenza every five to six years, pneumococci, and also against shingles.

The doctor treating you will check your vaccination status as soon as the diagnosis is made. He will then discuss with you the best time for the upcoming vaccinations. For example, if the immune system is suppressed (by medication), live vaccines are out of the question. By the way: Vaccinations do not increase the risk of a flare-up. You can find out more about vaccinations on our special page.

Rheumatism - danger to the heart

The heart health of rheumatism patients is just as important as vaccinations. Rheumatoid arthritis, for example, is considered an independent risk factor for cardiovascular diseases. The risk increases, especially when 

  • the condition has existed for several years
  • autoantibodies are detectable,
  • organs other than joints are also affected.

To reduce your risk through regular exercise and a balanced diet. Also, quit smoking. If necessary, your doctor will prescribe medication to counteract further cardiovascular damage. He will regularly determine your risk profile with you and provide appropriate advice.

Prevention for rheumatism

Also, take advantage of all preventive care appointments that are offered. They are essential for detecting and treating cancer early on. Rheumatism patients have an additional risk: The risk of developing skin cancer increases, especially with the typical drugs of rheumatoid arthritis, i.e., Disease-modifying antirheumatic drugs (DMARDs) and biological drugs. Regular skin cancer screening and consistent sun protection are therefore essential.

You can find out which examination you are entitled to when in the Prevention special.

Rheumatism does not only affect the joints: the inflammation that often accompanies it can also damage the heart and blood vessels. What to do?

Diet in rheumatism

You can effectively alleviate rheumatism symptoms with the proper diet. However, a rheumatic diet is not a substitute for drug or surgical treatments. Instead, you can support the course of the disease and the therapy with an adapted diet.

In principle, experts recommend nutrition in rheumatism, especially in rheumatoid arthritis:

  • Lots of vegetables and fruit
  • Reduced-fat milk and dairy products daily
  • Fish twice a week
  • Eat less meat and sausage products, only about once a week
  • Eat balanced and not too one-sided
  • Only eat what suits you

Water and unsweetened tea are best for drinking. Coffee is also possible in moderation. Alcohol, on the other hand, is not advisable: in the case of gout, for example, alcohol can trigger a painful attack.

The little animal, much plant: This is what the proper diet for rheumatism looks like. Find out more here!

More about rheumatism

Scientific standards:

This text corresponds to the requirements of specialist medical literature, medical guidelines, and current studies and has been checked by medical professionals.