How rheumatism to recognize and treat can

John F. Kennedy and the painter August Renoir should have suffered. Artists such as Rubens, Dürer and Botticelli kept in your images, what is the pain makes the body. And even the pharaohs, you might have already known, believe some experts. Although recent studies suggest that these are probably incorrect diagnoses and, at least, a certain Form of rheumatism is more a disease of the modern era.

For many rheumatism is synonymous with stiff fingers, painful joints and problems to move. Behind the everyday-language term that can be used as “floating pain” translated, hides, however, a variety of complaints. Answers to the important questions:

What rheumatism is?

Doctors know more than a hundred diseases of the so-called rheumatic form circle. Roughly these can be divided into four major groups:

  • In inflammatory diseases such as rheumatoid Arthritis,
  • degenerative, i.e., by wear and tear caused by complaints such as osteoarthritis,
  • Diseases such as gout, when the joints become inflamed due to metabolic disorders,
  • and soft tissue rheumatism.

All of them have in common is the grueling, longer-lasting pain. “Although there are some patients in whom it occurs,” says Hanns-Martin Lorenz, head of the section of rheumatology at the University hospital of Heidelberg and President of the German society for rheumatology (DGRh). “But that’s very rare. Pain is regarded as a warning signal.”

Otherwise, as is often assumed, not pain rheumatism only the bones and joints. Also muscles, Tendons, nerves, vessels and even organs such as the kidney or the intestine can be affected.

What disease is most often behind it, if someone of rheumatism speaks?

Where, in General, of rheumatism of the speech, it’s often the rheumatoid Arthritis. It is the most common inflammatory rheumatic disease. In Germany, approximately 500,000 people under this rheumatic Form of suffering of the DGRh, according to. The disease, which is also referred to as chronic Polyarthritis, can occur at any age. Usually, however, between the age of 40. and 60. Years of age. Women are twice to three times as often as men.

The causes are not yet settled finally. It is assumed that it is a failure of the immune system that is caused to a large extent hereditary. The immune system actually, the protective police of the body, attacking the body’s own tissues, inflammation caused. Also environmental factors such as Smoking play a role in and worsen the prognosis.

Osteoarthritis and rheumatoid Arthritis – what is the difference?

Osteoarthritis and rheumatoid Arthritis are often confused. However, osteoarthritis is one disease to the degenerative joint. It is a phenomenon of Wear that occurs predominantly in old age. Mostly knee, hips or spine are affected, less frequently the foot-, Hand – or arm-Joints.

In osteoarthritis, the cartilage is strained, thereby damaged and rubbed off. The joints are different than in rheumatoid Arthritis – is usually not inflamed. Occasionally, in the course of the disease, inflammation may occur, these symptoms are also back.

Good both rheumatism shapes in mind, when the symptoms show. “In osteoarthritis, the joints in the course of the day pain, such as after a long Walk, or stairs to descend,” says Lorenz. “In your sleep, you are relieved about it.” Anyone who suffers from inflammatory Arthritis, in contrast, usually after getting Up problems that are relieved by movement slowly.

What are the symptoms of rheumatoid Arthritis?

Among the first symptoms are stiffness of fingers or toes, as well as warm, swollen joints. Typically occur Sitting the pain after long periods or to Lie about in the second half of the night. Also after getting the mobility is often restricted (“morning stiffness”), improved in the course of the day.

After the first complaints, the symptoms from a wide range of often according to a certain pattern:

  • First, the small joints (toes, fingers) affected mainly the middle and base joints are common.
  • With time more joints, they stiffen or deform ill. Also the Tendons become inflamed, the muscle force drops.
  • The pain usually occur in symmetrical joints, with around both knees to swell.
  • Up to every fifth patient as the disease Rheumatoid nodules form under the skin, especially on the fingers and elbows.
  • Since the entire body is fighting the inflammation, may show fever, fatigue, loss of power and weakness, night sweats, and weight loss.

Self-tests to show whether someone has rheumatism is in danger. A first such Test can be found on the pages of the German rheumatic League.

What is the disease and is it curable?

The rheumatoid Arthritis varies for each Affected differently, and may occur, for example, in batch mode. Like most rheumatic diseases, it is usually not curable. However, it is usually possible to get good in the handle, so that the joint destruction can be stopped, and complaints in the best case, completely disappear.

The disease is not treated, gets worse in about nine cases out of ten. The articular cartilage and bone are usually slowly and over a number of years, the joints are destroyed. In the case of far-advanced disease messengers and immune cells may also attack the blood vessels or organs such as the heart and lungs. But this is rare.

How does the doctor make the diagnosis?

First, the doctor asks the symptoms. A physical examination follows, because swelling can often be felt. It is only when multiple joints are at least inflamed for six weeks, this is according to the Definition of a rheumatoid Arthritis.

Rheumatoid factors and inflammation markers in the blood can also indicate rheumatoid Arthritis. This type of diagnosis, however, is inaccurate. “In some patients the values are not increased at all,” says Lorenz. And the other way around applies: Elevated levels can also occur in other diseases or even Healthy.”

Whether a Joint effusion – an accumulation of fluid in the Interior of a joint is present, by means of ultrasound check. X-rays are sometimes useful in order to detect whether and how strong the bones are already damaged. Rheumatoid Arthritis is detected and treated early, the joint damage in the best case, prevent.

However, “Until a doctor in rheumatoid Arthritis, the correct diagnosis can take up to a year,” says Lorenz. “Patients often have an Odyssey, from the house physician of the orthopedic surgeons to rheumatologists.”

How can rheumatoid Arthritis treat?

The therapy matches the rheumatologist on the individual patient, the nature of the disease, its Severity and prognosis. Ergo therapy and physiotherapy can help mobility to get the muscles to strengthen and learn how joints can relieve can. Also deposits or crutches are sometimes helpful, a cold, or electrotherapy can relieve pain. “It is important, however, to stop the inflammation,” says Lorenz.

The drug therapy has improved in recent years. There are a variety of products with different modes of action, but can also bring side effects such as Nausea and diarrhea with it. In very rare cases, the companion ticket can also be difficult and about the liver damage.

As a basic therapy use Doctors most often methotrexate. Other substances serve to the inflammatory process and to stop the joint destruction, in the best case, in the long term. This so-called biologics, a new group of medicines, which are aimed, among other things, targeted against inflammatory substances, called cytokines, messengers of the count.

They were “in case of insufficient effect of conventional therapies is an Alternative,” writes the DGRh. Over the long-term safety is not yet so much known as the common basis of therapeutics. Because they suppress the immune system, infections in the case of biologics, a common side effect. “In rare cases, skin tumors can occur, especially of the white skin cancer. Regular checks and sun protection are important,” says Lorenz.

Against pain and stiff joints to help so-called non-steroidal anti-inflammatory Drugs (NSAIDs). Caution is in the case of cortisone on offer. Low doses it can be used for support. It acts against inflammation, but should not be applied for too long, because the side effects are numerous and range from anxiety about cravings to osteoporosis.

In patients in whom the inflammation can be fast and easy to control, can be discontinued, the medication may even. “However, this is only in a minority of cases,” says Lorenz.

Be prevented?

“The disease can not be prevented,” said the doctor. Only risk factors such as Smoking, can be avoided. Moderate alcohol consumption appears to have a protective effect. Unlike often assumed, does not help a change in Diet.

“In the case of gout, it makes sense to eat as fleischarm. Because meat and sausage contain a lot of Purines and increase uric acid levels,” says Lorenz. “In the case of rheumatoid Arthritis that does not affect the pain.” This is simply my opinion, a healthy diet.

Occurs rheumatism in children?

Rheumatism is not a disease of the elderly. About 15,000 children in Germany suffer from rheumatoid Arthritis. “Unlike adults, the probability that young patients can be cured, but quite good,” says Lorenz.