Rheumatism, what is it exactly?

Symptoms of rheumatism

Rheumatism is a collective term for various conditions that cause discomfort in joints, tendons, and muscles. The symptoms of rheumatism can include pain, but also stiffness. Sometimes rheumatism also causes general symptoms such as fever or extreme fatigue. Rheumatic complaints can be mild and in some cases disappear spontaneously or improve with simple medication. However, it can also be more severe: about 1 in 10 people suffer from a persistent form of musculoskeletal rheumatism, with daily symptoms and a risk of joint deformity.

Different types of rheumatism

In general, a distinction is made between four types of rheumatism:

1. Osteoarthritis, also known as degenerative rheumatism
2. Arthritis, also known as inflammatory rheumatism
3. Soft tissue rheumatism
4. Bone-related rheumatism

Below we discuss the differences between these four types of rheumatism and take a closer look at the most common forms and their specific symptoms.

• Osteoarthritis

Osteoarthritis is a degenerative form of rheumatism. It is one of the most common joint disorders and is related to cartilage loss. At the point where two bones meet and form a joint (such as a shoulder, hip, or knee), the contact surfaces are covered with a layer of smooth white cartilage.

This cartilage acts as a shock absorber and protects the bone. In osteoarthritis, the cartilage loses its smooth surface, becomes thinner, and turns irregular. Osteoarthritis mainly occurs in older people, but it can also develop at a younger age, for example after a sports injury.

• Arthritis

Inflammatory rheumatism or arthritis refers to joint disorders that cause joint inflammation. Arthritis can occur at any age, including in children. In arthritis, the synovial membrane inside the joint becomes inflamed and produces fluid that accumulates in the joint cavity.

This causes the joint to swell, feel stiff, and become painful. There are many forms of arthritis; the best known are gout, rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis (Bechterew’s disease). Below we go into more detail on the most common forms of arthritis: 

Gout

A gout attack usually occurs in the big toe. Several risk factors can trigger gout: obesity, high blood fat levels, a rich diet, and regular alcohol consumption.

Psoriatic arthritis

Psoriasis causes scaly skin lesions on the elbows, knees, scalp, or other areas. In about 1 in 5 people with psoriasis, the skin condition is accompanied by a form of psoriatic arthritis.

Ankylosing spondylitis (Bechterew’s disease)

This inflammatory rheumatic disease usually develops in young adulthood. Characteristic symptoms include night-time back pain and pronounced morning stiffness. Men are more often affected than women, and there is often a genetic component. The disease causes pain and reduced spinal mobility. Standard treatment includes a combination of anti-inflammatory medication and intensive exercise therapy. In severe cases, advanced medications known as biologics may also be used.

Rheumatoid arthritis

Rheumatoid arthritis is a chronic progressive joint disease. Forms of rheumatoid arthritis include the autoimmune disease Lupus, the systemic rheumatic disease scleroderma, juvenile arthritis (occurring in children under 16), and polymyalgia rheumatica, a form of rheumatism affecting people over 55 years old.

The difference between arthritis and osteoarthritis

Arthritis pain differs from osteoarthritis pain: a person with arthritis mainly experiences pain at rest, for example at night. In the morning, there is pronounced stiffness that improves only after several hours. Osteoarthritis pain, on the other hand, increases with activity.

Soft tissue rheumatism

Soft tissue rheumatism occurs outside the joints. This type affects muscles, tendons, ligaments, capsules, bursae, and intervertebral discs. A common form of soft tissue rheumatism is fibromyalgia. 

• Fibromyalgia

This condition is chronic and affects the entire body. Patients with fibromyalgia experience severe pain, often accompanied by significant fatigue. The treatment is mainly supportive and may include pain relief, massage, or exercise therapy.

Bone-related rheumatism

In bone-related rheumatism, there are not always abnormalities in the blood, unlike other forms of rheumatism. These conditions are often treated with medication. The most common form of bone-related rheumatism is osteoporosis.

• Osteoporosis

In osteoporosis, bones become more fragile and brittle. It is especially common in women after menopause. Several factors increase the risk of osteoporosis: genetic predisposition, hormonal disorders, low calcium intake, smoking, alcohol consumption, limited physical activity, or long-term use of cortisone.

Management of osteoporosis starts with prevention. This includes factors you can influence yourself: physical activity, intake of dairy products (the main source of calcium), and avoiding harmful substances.

Medication for rheumatism 

For severe forms of rheumatism, highly advanced medications, so-called biologics, may be prescribed. They are named this way because they consist of biological substances and antibodies. They are designed to act very precisely on their target and can strongly and quickly suppress inflammation.

Want to learn more about rheumatism? 

If you want to learn more about the symptoms of rheumatism and the different forms of this disease, you can read the book ‘Reumapositief, anders omgaan met een chronische aandoening’ by Professor Filip De Keyser and pharmacist Heidi Van de Keere, published by Lannoo.