How is turmeric linked to rheumatoid arthritis

Rheumatism: early treatment is crucial

Status: 07.12.2015 1:11 p.m. | archive

The term rheumatism comes from the Greek and means "flowing pain". Today rheumatism is a generic term for diseases of the locomotor organs, which are usually associated with pain and restricted mobility. The so-called rheumatic group includes more than 400 different diseases. They can be divided into four main groups:

  • inflammatory rheumatic diseases, for example rheumatoid arthritis
  • degenerative joint diseases, for example osteoarthritis
  • Soft tissue rheumatism, for example fibromyalgia
  • Metabolic diseases with rheumatic complaints, for example gout

Medicine has made great strides in inflammatory rheumatic diseases: around ten years ago, sooner or later, more than half of all those affected had to undergo an operation to stiffen a destroyed joint or to have an artificial joint inserted, thanks to new drugs and Therapy procedures are rarely necessary today. The earlier treatment for rheumatoid arthritis begins, the greater the chance of a complete regression of the symptoms (remission).

Inflammatory rheumatic diseases

In inflammatory rheumatic diseases, not only one or more joints are inflamed, but the whole body is affected. Those affected feel sick and weakened, and there are often high levels of inflammation in the blood.

  • The best known inflammatory rheumatic disease is Polyarthritis (rheumatoid arthritis) with almost half a million people affected in Germany alone. Women are three times as likely to be affected as men and the disease can occur at any age, most commonly between 50 and 70 years of age.
  • Even the so-called Spondyloarthritis (for example Bechterew's disease, psoriatic arthritis) belong to the main group of inflammatory rheumatic diseases. In addition to the joints, they can affect the entire spine and often occur as a result of urinary tract infections or chronic intestinal inflammation such as Crohn's disease or ulcerative colitis.
  • At a reactive arthritis A bacterial infection in the stomach, intestines, urinary tract or genital organs triggers joint inflammation. If further inflammation occurs on the mucous membranes of the urinary tract, eyes or mouth, it is called Reiter's syndrome.
  • Collagenoses and Vasculitis can be life-threatening because internal organs and blood vessels are also involved. Collagenoses include systemic lupus erythematosus, systemic sclerosis (scleroderma) and dermatomyositis (polymyositis). Mixed collagen disorders such as Sharp's syndrome and Sjogren's syndrome occasionally occur together with rheumatoid arthritis. The most common types of vasculitis include the muscle disease polymyalgia rheumatica and giant cell arteritis.

Chat minutes on the subject of rheumatism

In order to treat rheumatoid arthritis, the disease must be detected early. Prof. Dr. Gabriela Riemekasten answered questions. The chat log for reading. more

Causes of Inflammatory Rheumatic Diseases (Polyarthritis)

The cause of polyarthritis has not really been clarified to this day. Researchers suspect that a dysregulation of the immune system leads to certain cells attacking the synovial membrane and the articular cartilage. Above all, a messenger substance of the immune system (TNF-α) is produced in large quantities. It attaches to the synovial membrane and signals an inflammation to the body's own defenses, scavenger cells are attracted and destroy the joints.

Risk factors: heredity and smoking?

What triggers the dysregulation of the immune system is still unclear. It is certain that a hereditary predisposition plays a decisive role, which, together with certain poisons, can presumably lead to the outbreak of the disease. Studies have shown that cigarette smoking is responsible for the majority of cases of illness, often leads to more severe courses of rheumatoid arthritis and can impair the success of the therapy. Research into the tissue hormones (cytokines) involved in inflammation, which can be effectively influenced by new drugs, has made great strides in recent years.

Rheumatoid Arthritis Symptoms

Rheumatoid arthritis usually starts in the little finger and toe joints, which suddenly hurt and swell. The joints are particularly painful in the morning and can only be moved to a limited extent. Morning stiffness can last for several hours. In some cases, however, only a few large joints are initially inflamed, often the shoulder joint in old age. As the disease progresses, other joints can become inflamed and swollen, and tendon sheaths, cervical spine and bursa can also be affected. In addition, there are general symptoms such as exhaustion, weakness, tiredness, fever, night sweats and weight loss, since the entire body suffers from the inflammation. One in five people affected develop so-called rheumatoid nodules, especially on the elbows and fingers.

Recognize early signs

Rheumatoid arthritis

  • soft swelling of at least two joints for more than six weeks
  • Swelling accompanied by pulling pain
  • Joint stiffness in the morning for more than an hour
  • General symptoms such as fatigue and fever

Spondyloarthritis (ankylosing spondylitis)

  • Deep back pain for at least three months that started before the age of 45
  • Relief of back pain through exercise
  • night or early morning awakening from back pain
  • Morning stiffness in the back that lasts for more than 30 minutes
  • Spondyloarthritis in the family

Vasculitis and collagenosis

  • general fatigue and lack of movement
  • Cold hands with discoloration of the fingers when it is cold
  • Pasty swollen hands or fingers that last longer than a month
  • inflamed areas on fingertips with scarring
  • Rash after exposure to the sun, especially around the nose ("butterfly erythema")
  • dry or sandy eyes, dry mouth, blood or protein in the urine

Diagnosis of Rheumatoid Arthritis

In order to be able to treat and stop rheumatoid arthritis, the disease must be recognized as early as possible. That is why numerous rheumatism centers have set up special consultation hours. Those affected who are suspected of having an inflammatory rheumatic disease for the first time can be examined there. The diagnosis takes place in several steps:

  • Scan of the fabric
  • Blood test in the laboratory for rheumatoid factors, inflammation markers and antibodies against certain proteins (CCP antibodies): They help the rheumatologist to better assess the further course of the disease.
  • X-rays provide information about the extent of the bone damage.
  • Soft tissues of the joints are made with Ultrasonic examined. For example, the doctor recognizes a joint effusion or an inflamed, thickened synovial membrane (synovitis).
  • For special questions, a Magnetic resonance imaging to be required.

Therapy of rheumatoid arthritis

With early treatment, the symptoms of rheumatoid arthritis can go away completely. If the disease is already advanced, it can at least be slowed down. Rheumatologists adjust the therapy to the individual course of the disease and check its effectiveness in cooperation with the family doctor.

  • To bring the inflammation under control, is usually done cortisone administered. If the effect is not sufficient, doctors combine the cortisone with a basic therapeutic agent such as methotrexate (MTX), which is in high doses in the chemotherapy is used. In low doses, methotrexate is effective against inflammatory rheumatism. The basic therapy helps many patients so well that after about a year they no longer need any rheumatism medication.
  • If the therapy does not work, rheumatism experts rely on so-called Biologics. These highly effective drugs, which have only been available for a few years, have revolutionized rheumatism therapy. They consist of antibodies (TNF-α blockers), which purposefully render inflammatory messenger substances harmless and thus prevent further joint destruction. Although TNF-α blockers intervene in the immune system, they are well tolerated apart from a slightly increased tendency towards infection.
  • Further measures are physiotherapy to maintain joint function, muscle strength and mobility, physical therapy, such as cold therapy, for pain relief, occupational therapy to relieve the joints, cortisone injections into the affected joints, sclerotherapy of the inflamed synovial membrane, orthopedic measures such as insoles, crutches and splints.
  • Psychological support can help to cope with illness and pain. They are often supplemented by social-medical measures to secure jobs, retraining or rehabilitation.
  • Functional and physical fitness training, yoga, walking, aqua jogging and aqua gymnastics, Pilates training, tai chi and qigong, Feldenkrais and relaxation techniques provide support. A conscious change in diet can also have a positive effect on the course of the disease, for example not eating meat and sweets.

When to have an operation

The drug therapies do not always work in all affected joints. In about two out of ten cases, an operation is still necessary today because the inflammation in the joint does not stop. A complete removal of the inflamed joint lining (synovectomy) can help relieve the pain. Further surgical therapy options are the stiffening of the joint (arthrodesis), which again enables pain-free loading, and the artificial joint replacement, which restores mobility.

Why early treatment is so important

Treatment of inflammatory rheumatic diseases can prevent joint destruction, but cannot undo existing damage. Only if the sick are treated at an early stage do they have the chance to keep their joints pain-free and flexible for a long time. Treatment should begin within three months of the onset of symptoms, also to prevent it from spreading to internal organs.

Degenerative joint diseases (osteoarthritis)

Joint problems are often due to wear and tear. In so-called osteoarthritis, damage to the articular cartilage, for example in the hip or knee joint, increasingly leads to pain and restricted mobility. Previous damage or malformations of the joint are often the cause of the wear and tear, for example a broken bone, a hip socket that is too flat or severe malpositions. A disruption of the bone metabolism or excessive stress on the joint can also be responsible for osteoarthritis.

Inflammatory rheumatismOsteoarthritis (wear and tear)
AgeAt any age, often between 50 and 70 yearsEspecially in old age
complaintsAlternating and in batchesWith every movement, especially under stress
SymptomsLike the flu, for example tiredness and fatigueApart from pain in the affected joints, there were no other symptoms
Risk factorsInflammatory rheumatism in the familyIncorrect or overloading of the joints

Soft tissue rheumatism (fibromyalgia)

The most well-known disease from the group of soft tissue rheumatic diseases is so-called fibromyalgia, which is a chronic pain disease and causes discomfort throughout the body. The group of non-inflammatory rheumatoid diseases also includes, for example, the tennis elbow, the "stiff neck" and tension due to poor posture.

Metabolic diseases (pararheumatic diseases)

If metabolic diseases cause the corresponding symptoms, they too are rheumatic diseases. The most famous examples from this group are

  • osteoporosis: A breakdown of the bone mass leads to vertebral body collapses and severe back pain
  • Gout: A disruption of the uric acid metabolism leads to the deposition of uric acid crystals in the joints and inflammation of the joints (gout attack)

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