and Arthritis Education
Introduction to Rheumatism
In this article:
rheumatologists diagnose patients
rheumatologists manage patients
see a rheumatologist
What is Rheumatism:
exact meaning of the word "Rheumatism" is pain in the musculoskeletal
system, that is, the joints, the bones and the muscles. The word
"rheumatism" is used interchangeably with the word "rheumatology" and
both refer to that branch of medicine that deals with diseases and
disorders of the joints, the bones and the muscles. In more simplistic
terms, it is similar to the orthopedic specialty in that it is related
to the musculoskeletal system but differs from it in that rheumatism
doctors, or rheumatologists, do not do surgeries.
word rheumatism the way many patients perceive it in the Middle
East: Many patients in our countries think that "rheumatism" is the
chronic disease that causes pain in the joints of elderly people
especially the knees and the back joints that is caused by or that
increases by cold weather and humid conditions. And even if a young
person complains of persistent pains in any joints, common people
explanation in such cases would be that he/she got the known rheumatism
of the old age but at a younger age. This concept is a completely wrong.
We really don't know how or when it started and how it managed to
diffuse so strongly in the culture of lay people and to persist and
survive despite many attempts by rheumatologists to correct it.
short, rheumatism (or rheumatology) is a word or term that does not
refer to any specific disease. It is the name of a specialty that
encompasses many rheumatic diseases that can affect the joints, the
muscles and the bones at any age from childhood to old age. And the
common question that patients usually ask the rheumatologist "Doctor, do
I have rheumatism" is just like going to the urology doctor and asking
him "Doctor, do I have urology?"
of rheumatic diseases: there are several different causes for the many
different rheumatic diseases. Bad posture habits as when sitting for
long hours in front of a computer or overusing the joints and muscles as
in certain sports and occupations are the causes of most patient
complaints and disorders. Hyperactivity of the immune system that makes
the body's defense cells, in addition to attacking the microbes that
enter the body, attack the joints and muscles with antibodies is the
cause of a group of disorders known as autoimmune disorders as
rheumatoid arthritis and systemic lupus erythematosus. Aging of the
cartilage of joints can lead to osteoarthritis of the joints most famous
in the knees and spine. Disorders of sleep in addition to psychological
factors are thought to result in a condition called fibromyalgia.
Deposition of crystals of urate (salt of uric acid) in joints can cause
a bodily reaction of intense inflammation called gouty arthritis.
Duration of a rheumatic disease: some rheumatic disorders can last for
only a few days as some types of tendinitis while others can last for
many years or for the lifetime of the patient just like diabetes and
hypertension as rheumatoid arthritis while others visit the joints on
and off as gout.
affected by a rheumatic disease: anybody can be affected by a rheumatic
disease. Each of the many different rheumatic diseases that exist tends
to have a predilection to certain age groups or to a certain sex. But in
short, for every age from birth till old age and for each sex, there is
a certain rheumatic disease(s) that tends to occur.
the rheumatologist diagnoses his patient:
listening to the patient's history (history is the patient's description
of his symptoms and how they had started and what aggravates and
alleviates them and whether someone else in the family was suffering of
similar problems and also whether the patient was receiving any
medications for his symptoms). History taking gives the rheumatologist
more than 70% of the information he needs to diagnose diseases.
Examining the patient then ranks second to history taking in its
importance for diagnosis and lastly the labs and the imaging
investigations that the doctor might request if needed.
the rheumatologist treats his patient:
By educating the patient about his disease, that is, by explaining to
the patient the reasons for his symptoms or disease and also about the
medicines prescribed and how they work and after how long in addition to
giving the patient an idea about any possible side effects or
precautions he should take while receiving those medicines.
the patient the necessary instructions that are indicated for the
management of his disease. This includes instructions for posture,
movement and for carrying out daily activities as well as dietary
instructions if needed.
Rehabilitation: rehabilitation means helping the patient
regain a lost function due to his illness or at least helping him regain
as much of that lost function as possible. This is accomplished by more
instructions, assistive devices and by physiotherapy sessions.
Physiotherapy sessions include working with appliances (as ultrasound,
short wave, microwave, LASER) and doing therapeutic exercises which, if
done properly, are extremely effective and even more specific in effect
than medicines in the management of postural disorders.
The prescription of medications which are optional in
some disorders (as in postural syndromes where instructions are more
important) and form an important part of the management plan in other
disorders (as autoimmune disorders).
Examples of disorders and diseases for which you need to see a
back pain and neck pain and any joint or muscle pain, sciatica
Rheumatoid arthritis, systemic lupus erythematosus, dermatomyositis
Fibromyalgia, gout, osteoporosis, osteoarthritis,
rheumatic fever, calcaneal spurs
sports injuries, tendinitis, bursitis