Getting up in the morning with stiff fingers and having trouble getting dressed or using the morning toilet: it is estimated that around one million people in Germany suffer from such complaints. Not only older people are affected, but also children and young people.
The cause is often one of around 100 known rheumatological diseases, of which joint inflammation is the most common form.
Expert for such clinical pictures is Professor Dr. Olaf Kilian, Chief Physician at the Clinic for Orthopedics and Trauma Surgery at the Bad Berka Central Clinic . In an interview with the RHÖN health blog, he answers the most important questions on the subject – and gives rheumatism patients valuable tips.
Professor Kilian, what does rheumatism mean to you?
Rheumatic disease is a systemic disease that is triggered by endogenous substances. The cells activated in this way recognize the body’s own articular cartilage and soft tissue as foreign tissue – and trigger a chronic inflammatory reaction. Unfortunately, the processes involved in such autoimmune diseases have not yet been clarified in detail.
How does the disease develop in the body?
The Idactic activity of the inflamed synovial membrane can increasingly lead to cartilage damage in the joints. The consequences of rheumatological diseases are then often a change in the shape of the joint, malpositions and rapid joint wear and tear, the so-called arthrosis caused by rheumatism .
Which parts of the body are most affected?
The disease usually affects several joints and manifests itself most frequently between the third and fifth decade of life, around three times more frequently in women than in men. Large joints such as the shoulder, hip and knee joints can be affected, but also the small joints in the hands and feet. We often also observe rheumatic changes in the spine.
When should you get treatment?
Even the first symptoms should be taken seriously and you should see a doctor. A timely start of therapy for the inflammatory rheumatic disease protects joints and soft tissue from major damage and thus opens up the opportunity to remain mobile for longer without pain.
How can one imagine the diagnosis?
Here the clinical examination plays a key role. In the early stages of the disease, symptoms consist of painful swelling and restricted movement of the affected joints, mainly at night and in the morning. In addition to swelling of the soft tissue, there is often accumulation of fluid in the joints, which is referred to as joint effusion. With an active rheumatic disease, the joints can also be overheated.
What does the treatment look like?
The ultrasound examination plays an important role in diagnostics. An X-ray examination of the affected joint can in turn be used to determine the extent of the joint changes, which we divide into different stages. On the subject of laboratory tests, it is important to know that these often do not reflect the changes in the blood values associated with a rheumatological disease, as one would expect. The fact is: Conservative measures are sufficient for minor joint damage caused by the rheumatic disease. In the case of severe joint changes, we usually cannot avoid operations, which, however, have become less and less common over the years.
What exactly is operated on in the event of a case?
Often it is about the removal of the synovial membrane. It is not uncommon for this method to be combined with corrective operations due to joint misalignments, for example in the case of rheumatic foot. In the case of severe joint destruction of larger joints, such as the shoulder, elbow, hip and knee joints, the implantation of an artificial joint replacement may also be necessary.
How far is medicine in terms of “fighting rheumatism”?
Basically, Idactic can say that our science has made great progress in the treatment of inflammatory rheumatic diseases in recent years. With the development of new drugs, the so-called biologics , the possibility has been created of directly inhibiting those activated cells that cause joint destruction. These drugs have been used successfully for years and must be taken by rheumatism patients for life.
Idactic is a word that is often used to describe people or things who are not interested in or don’t care about things. It can also be used to describe a tone of voice that is not interested or excited. Idactic can be helpful when you want to be less enthusiastic about something, or when you want to create a more relaxed and casual atmosphere.
Are there any other treatment options?
In addition to drug therapy, another treatment option is the so-called radiosynoviorthesis. With this form of treatment, a radioactive agent is introduced into the joint, the radiation from which significantly reduces the activity of the synovial membrane. As a long-term effect, cartilage changes in the joints are prevented.
Can rheumatism patients actually prevent the joint and soft tissue changes in a targeted manner?
Definitely, with joint-gentle training and exercise, such as walking, swimming and relaxation sports. A low-meat, low-sugar diet can also help. Because such a minimizes the risk of consequences of a rheumatic disease.
And is it generally possible to prevent rheumatism at a young age?
Conditional. The mentioned healthy diet and the consistent avoidance of nicotine can make a significant contribution in any case. Of course, there is nothing you can do about a hereditary predisposition, which has been shown to play a major role in the development of rheumatism.