Joint rheumatism is a fairly common pathology. This disease has a number of unpleasant symptoms that can not only significantly reduce the quality of life of the patient, but also limit his physical activity.
General information
Joint rheumatism is a chronic autoimmune disease. More often they suffer from women (approximately 75% of the total number of patients). The disease usually manifests between the ages of 35 and 60.
Most often, this autoimmune process begins to develop after an infectious disease caused by beta-hemolytic streptococcus of group A. During the course of this disease, the body produces antibodies to combat the pathogenic microorganism. Unfortunately, they are able to infect not only infectious agents, but also those tissues that have a similar protein structure. Most often, the joints and heart become the “targets” of these antibodies.
Provocative factors
There are a number of factors that provoke the development of this disease. Joint rheumatism occurs much more often in the following cases:
- The closest relatives of the person suffer from this pathology.
- A history of viral diseases such as rubella, hepatitis B, herpes.
- The presence of collagen type 2, 9, 10 and 11th in the connective tissue.
- Transferring severe psycho-emotional stress.
- Traumatic joint damage.
- The development of menopause in women.
- Frequent occurrence of allergic reactions.
The risk of developing rheumatism of joints is higher, the greater the number of provoking factors affect the human body.
Clinical picture
Symptoms of rheumatism in the joints during the classical course of pathology are somewhat different from the manifestations of other diseases that affect similar anatomical areas. The clinic of this disease consists of:
- joint pain;
- periodic muscle pain;
- systematic increase in body temperature to 37.5 º;
- general weakness;
- morning stiffness.
If you identify the first symptoms of rheumatism in the joints, you should immediately consult a doctor. The sooner treatment measures are started, the less the quality of life of the patient in the future will be reduced.
Nature of pain
Damage to joints with rheumatism is manifested primarily by pain. At the same time, she begins to bother the patient at night or in the morning. Soreness can become quite pronounced. As a result of its presence, the patient has limited movement. In the future, pain and morning stiffness gradually decrease.
Diagnostics
You should immediately consult a specialist doctor after the onset of the first symptoms of this disease. Joint rheumatism can have a fairly rapid course with the development of serious motor restrictions. With timely diagnosis and treatment, the patient has the opportunity to avoid such complications. In order to verify this diagnosis, the doctor conducts the following types of studies:
- radiography of the affected joints;
- general blood analysis;
- blood chemistry;
- joint puncture with further examination of synovial fluid;
- test for the presence of anticytrulline antibodies.
Radiography of the affected joints allows you to clarify the nature of the lesion in this area. In the case of rheumatism, narrowing of the joint spaces, osteophyte overgrowth can be observed. These changes will further contribute to limiting the patient's motor activity.
In a general blood test for rheumatism of the joints, the following changes can be observed:
- excess leukocyte levels: above 9.0 * 109 / l;
- increase in erythrocyte sedimentation rate: more than 10 mm / h in men and more than 15 mm / h in women;
- increase in platelet count: more than 420 * 109 / l;
- erythrocyte reduction: less than 3.5 * 1012 / L.
By themselves, such changes in the general analysis of blood are nonspecific and it is impossible to judge the presence of rheumatism only on their basis.
A fairly informative research method in the case of this pathology is a biochemical blood test. Thanks to him, it is possible to determine the presence of C-reactive protein and rheumatoid factor in the blood. If two of these substances are detected at once, the diagnosis is established in the vast majority of cases. Moreover, on the basis of a negative result of the analysis for rheumatism of the joints, it is impossible to talk about the absence of this disease in the patient.
Joint puncture with suspected rheumatism is relatively rare. This diagnostic procedure is used only when the doctors still have difficulties with establishing a final diagnosis. With rheumatism in the synovial fluid from the affected joint, a large amount of protein, white blood cells and granulocytes is observed. In addition, it is cloudy, and its viscosity is lower than normal.
The test for the presence of anticytrulline antibodies allows a high probability to establish the presence of rheumatism of the joints of the legs and hands. The disadvantage of this research method is its rather high cost.
Therapeutic measures
If this diagnosis is established, the patient should immediately begin treatment measures. There is a specialist who knows exactly how to treat rheumatism. This is a rheumatologist. In ordinary clinics, this specialist is almost impossible to find. To get quality care, you will have to contact a private medical center or a large multidisciplinary public health institution. The referral to the rheumatologist after the necessary examination will be issued by the local GP or general practitioner.
Currently, the rational treatment of rheumatism in the joints may include:
- non-steroidal anti-inflammatory drugs;
- glucocorticosteroids;
- cytostatics;
- antibiotics
- gold preparations ;
- aminoquinolines;
- derivatives of mercaptocarboxylic acids;
- selective immunosuppressants;
- systemic enzyme therapy drugs;
- physiotherapeutic effect;
- physiotherapy.
Naturally, the patient is not simultaneously prescribed the whole range of these drugs and medical measures. A specific treatment regimen is developed by a specialist, depending on the severity and rate of development of the pathological process.
Nonsteroidal anti-inflammatory drugs
Drugs from this pharmacological group are used in the treatment of rheumatism of joints in almost every patient. This is due to the fact that they simultaneously have anti-inflammatory and analgesic effects. The main drugs of this group, used for rheumatism, are as follows:
- Nimesulide.
- Ketoralak.
- Diclofenac.
- Ibuprofen
- "Meloxicam."
As for Meloxicam, it also has a muscle relaxant effect. All non-steroidal anti-inflammatory drugs have a serious side effect - damage to the gastric mucosa. That is why, how to treat rheumatism with the help of such drugs, a specialist doctor should tell you. In the vast majority of cases, regardless of the specific drug, they are prescribed 1 tab. 2-3 times a day after meals.
Glucocorticosteroids
These drugs are used much less frequently than non-steroidal anti-inflammatory drugs. The following representatives of this pharmacological group are most often used:
- Prednisone.
- "Methylprednisolone".
- "Dexamethasone".
All of these drugs have one serious side effect - they help increase your blood pressure. That is why, with extreme caution, they should be prescribed to hypertensive patients. Currently, glucocorticosteroids are often recommended for patients only during an exacerbation of the pathological process or in case of a severe progressive course.
Cytostatics
These drugs can also cause significant harm to the body. That is why they are not used in most patients. They are used only in cases of rheumatism of the joints, when there is a serious progressive course and a significant severity of the symptoms of the disease. Cytostatics are also used for the ineffectiveness of other drugs. The main drugs from this group are the following:
- "Methotrexate".
- "Cyclophosphamide".
- "Azathioprine."
When taking cytostatics, it is imperative that you strictly follow all the recommendations of a specialist. If any side effects occur, you should immediately consult with him.
Antibiotics
With rheumatism of the joints they are used not so often. As a rule, only in the case of an exacerbation of the disease, accompanied by an increase in body temperature and leukocytosis in a general blood test. In this case, antibacterial agents from the group of cephalosporins (Ceftriaxone, Cefazolin), macrolides (Azithromycin, Erythromycin) or protected penicillins (Amoxiclav) are usually used. Such medicines should be taken only as directed by a specialist and after eating.
Physiotherapeutic Impact
There are a number of physiotherapeutic methods that are used for rheumatism of the joints. The main ones are:
- Magnetotherapy.
- Exposure to microwave radiation.
- Electrophoresis with novocaine.
- Exposure to infrared radiation.
- Ozokerite applications.
- Paraffin baths.
Magnetotherapy is better suited for exposure to rheumatism of the knee joints. Electrophoresis with novocaine must be prescribed only after studying the patient’s allergic history, since anaphylactic type response is often observed on its use. In this case, the patient may need emergency medical care.
Physiotherapeutic treatment cannot act as the main one in this disease. The greatest efficiency from it can be achieved in combination with taking drugs according to the rational scheme prescribed by a specialist doctor.
Physiotherapy
A set of special exercises can significantly improve the functional activity of the patient. Thanks to them, he will be able to overcome morning stiffness and increase mobility in the affected joint. At the same time, it is very important that a specialist physical therapy program be developed. He will select exactly those exercises that will help in each case.
Physical therapy, like physiotherapy, as an independent technique does not play a decisive role. It acts only against the background of rational pharmacotherapy.
Prevention
The main preventive measure to reduce the likelihood of developing rheumatism of the joints is the rational treatment of all infectious diseases from which a person suffers during his life. For this, it is necessary to use those medicines that are prescribed by a specialist doctor and, first of all, antibiotics. Hypothermia and trauma to the joints should also be avoided.