In the article we will consider the symptoms and treatment of rheumatism of the joints. We will also tell you which pills to take.
Rheumatism is an inflammatory systemic disease localized predominantly in the cardiac membrane. The risk group includes people with a hereditary predisposition to this disease, as well as in the age category from seven to fifteen years. Rheumatism usually affects young people and teenagers, more rarely debilitated and elderly patients.
Cardiac rheumatic disease is one of the main sources of death (about 50,000 people die from this disease in the US every year). Often this pathology begins in the cold season, especially in northern latitudes. It is not among the epidemic diseases, although streptococcal infection preceding rheumatism may manifest itself as an epidemic in character. That is why the disease can begin in a whole group of people– for example, in orphanages, schools, military camps, hospitals, in cramped living conditions and poor families. Serological and bacteriological studies show that rheumatism is a specific allergic reaction to an infection that has occurred with any of the beta-hemolytic streptococci belonging to group A.
Within a month, 2.5% of patients who have had a streptococcal infection develop acute rheumatism. Often, diseases such as scarlet fever, tonsillitis, erysipelas, acute inflammation in the middle ear, puerperal fever precede the onset of rheumatism. In this case, the body does not develop immunity to this infection, and an autoimmune attack begins as a response to re-infection. The treatment of rheumatism is described below.
What causes rheumatism?
Rheumatism can be caused by three main causes:
- patient streptococcal infections (eg, tonsillitis, etc.);
- hereditary predisposition;
- allergic (immune) reaction.
Rheumatism symptoms
A disease like rheumatism is not an isolated one. Often it is accompanied by other diseases due to the fact that the harmful substances and antibodies of immunity secreted by streptococcus affect and damage various systems and organs, and such symptoms can be considered as rheumatic forms.
The first signs of rheumatism make it impossible to diagnose pathology. They appear about 2-3 weeks after the patient has repeated infections of the upperrespiratory tract (tonsillitis, laryngitis, pharyngitis) with an established lesion of streptococcus. Outwardly, the picture resembles a relapse of a cold-like disease. Symptoms of acute rheumatism are an increase in body temperature up to forty degrees, chills, rapid pulse, loss of strength, excessive sweating, painful and swollen joints. The most actively working and largest joints suffer from the disease in the first place. Treatment for rheumatism of the hands is quite common.
The inflammation then spreads to the rest of the joints, often symmetrically. They are very reddened, swollen, hot to the touch, pain is felt when moving and pressing. Most often, the inflammatory process is not the cause of articular stable changes. The pulse is arrhythmic, frequent, chest pains appear, expansion (dilation) of the heart, in some cases, the sound of pericardial friction is heard, which indicates heart damage.
Rheumatism has the following common features:
- hyperthermia, when the temperature rises to dangerous levels (from 38 to 40 degrees); this is due to the formation of an acute immune response to the pathogen;
- headache felt in the forehead;
- lethargy, according to the description of patients, they want to sleep all the time, the body is like "cotton".
Specific signs of rheumatism:
- articular pain, primarily affecting large joints (elbows, knees), drawing, prolonged and dull pain. Rheumatism is characterized by the rapid development of the inflammatory process, sosigns of inflammation and joint pains quickly disappear, restoring their functions;
- vascular disorders: nosebleeds, vascular fragility, etc.;
- pain behind the sternum: aching or dull heart pain that does not appear immediately, but after one or several days;
- annular rashes, which appear in about 4-10% of cases, are outwardly a pink rash, rounded in shape and with jagged edges; does not disturb the patient in any way;
- rheumatic nodes that appear on inflamed joints; these are formations under the skin with a diameter of 5 mm to 2-3 cm, motionless and dense, but painless; they appear very rarely, remain within two months from the onset of the disease. Treatment of active rheumatism should be timely.
Specific symptoms appear only after 1-3 days. In rare cases, there are symptoms of damage to the peritoneal organs (pain in the right hypochondrium, etc.), which indicates a severe course of the pathology and needs to be hospitalized as soon as possible.
Treatment of rheumatism in children is also carried out. In them, the pathology has either a chronic or milder form of the course, without any special signs. Characterized by a rapid pulse, general malaise, joint pain, pain is not felt when moving (the so-called "growing pains"). In the absence of symptoms of heart disease, the disease is rarely fatal, although patients with carditis have a significantly reduced life expectancy.
Moredetails about the treatment of rheumatism in children will be discussed below.
Diagnosis of rheumatism
None of the diagnostic procedures will not allow one hundred percent accuracy to confirm the presence of rheumatism in a patient. Only with a comprehensive assessment of the information received, an experienced specialist will be able to draw conclusions about the presence of the disease. That is why the diagnosis of rheumatism is complicated.
Diagnostic measures include the following instrumental and laboratory tests:
- blood tests;
- ECG (cardiography);
- Ultrasound diagnostics.
Ultrasound
Thanks to an ultrasound examination of the heart (it is also known as echocardiography), it is possible to determine the condition of the valves and their ability to contract. In the process of development of rheumatism, cardiac activity also changes. Echocardiography allows you to identify defects in the early stages and take the necessary actions in a timely manner.
Is rheumatism treated at home? More on that later.
ECG (cardiography)
This study makes it possible to clarify the level of nutrition of the heart muscle. The ECG determines the minimum defects of cardiac activity and shows them graphically using a special sensor. The most effective will be to conduct cardiographic studies for several days, because rheumatism is a constant violation, and changes in the activity of the heart are best determined in dynamics. Most people with rheumatism (about 90%) have similar pathologiesfunctioning of the heart muscle.
Tests
To diagnose rheumatism, blood is taken from a vein. The doctor may be alerted by indicators such as:
- leukocytosis, that is, an increased concentration of leukocytes;
- presence of antibodies to streptococci;
- protein defects in blood composition;
- detection in the body of antibodies to enzyme substances of streptococci;
- increased ESR;
- decrease in the degree of hemoglobin;
- detection of a specific C-reactive protein.
In addition, during the initial examination, the doctor may notice signs of polyarthritis (redness and swelling of the joints, they are hot to the touch). If diagnostic measures are carried out in a complex manner, it is possible to diagnose rheumatism with high accuracy.
To determine the diagnosis, the manifestation of one of the following complex signs is required:
- impaired cardiac function (carditis), as well as the isolation of antibodies from the patient's blood against streptococcus;
- bright external manifestations (articular swelling, etc.) and deviations of the heart;
- cardiac defects and the existence of two laboratory values that indicate rheumatism;
- 2 history of specific symptoms (cardiac abnormalities, joint inflammation, skin rashes, rheumatic nodes, chorea minor) and one non-specific (hyperthermia, cardiac arrhythmias, changes in laboratory parametersanalyzes);
- three non-specific symptoms and one specific.
The treatment of rheumatism and arthritis is very similar.
Varieties of rheumatism
Rheumatologists have adopted a basic classification that includes two types of rheumatism:
- Chronic rheumatism, which is characterized by a frequent relapsing course even with treatment. Its exacerbations occur at different times of the year, mainly in the cold seasons (winter and autumn). A similar effect is also characteristic of patients who live in cold or damp apartments. There are exacerbations several times a year. Most of the patients (about 85%) are under the age of forty. The heart and joints are affected. The disease is severe and significantly impairs the quality of life. The patient feels constant pain in the heart and joints. After the relapse (acute phase) has passed, the disease can last for several months or even years. Treatment of rheumatism in the active phase is most often carried out in a hospital.
- Acute rheumatism. The disease in this phase is predominantly characteristic of young patients (under twenty years of age). Its causative agent is streptococcus. The disease is associated with a patient's infection of the upper respiratory tract, which consists in the later manifestation of its symptoms (from two to three weeks).
Now we know the symptoms of rheumatism of the joints. What treatment is prescribed in each case, we will consider further.
What medicines to drink, many people are interested. Acute rheumatism is characterized by rapiddevelopment. Initially, signs of general intoxication appear, like a cold, which makes it difficult to determine the disease immediately. Then, after 1-2 days, specific symptoms appear (carditis, polyarthritis, skin rashes, in rare cases, nodules). The duration of the acute phase is on average about three months. It may also last longer - up to six months. The most dangerous in the acute form is carditis, that is, damage to the heart, since in a quarter of all cases it causes heart disease.
Remedies for the treatment of rheumatism will help you choose a doctor.
Disease classification
Rheumatism is divided into the following forms, distinguished depending on the affected organ or system:
- Cardiac form, or rheumatic heart disease. In this case, damage to the muscular heart structures occurs. The patient may either be disturbed by severe pain, or their barely noticeable manifestation. However, the processes of destruction will still occur. Treatment of heart rheumatism should be comprehensive. The course of the disease is almost imperceptible in the early stages and is determined only by means of an ECG. During the late stage, severe cardiac lesions appear, as well as acute heart failure due to a decrease in the nutrition of its muscles, and as a result, the ability to contract is reduced. The patient has heart rhythm disturbances (tachycardia), which is determined by echocardiography (ultrasound). Treatment of rheumatism of the heart is described below.
- Articular form. It can exist as an independent manifestation of the disease or in combination with a heart lesion. With this formdisease affects large joints. Small joints are involved in the process at a later stage. Under the influence of antibodies of streptococcal enzymes and lymphocytes, cartilage and the articular bag are destroyed in rheumatism. That is why there are no problems in diagnosis: the joint is red and very swollen. The patient cannot make movements with inflamed limbs, as he feels severe pain. The acute phase of this form of rheumatism is characterized by an increase in temperature to 38-39 ° C.
- Neurological form. Damage to the nervous system is slightly less common. This form of the disease is characterized by damage to neurons in the cerebral cortex, which are responsible for motor activity. Their involuntary stimulation by active substances causes the patient to have uncontrolled spontaneous muscle movements. This is manifested by twitching limbs and grimaces. This form of the disease is very unpleasant, as it complicates a person's life in society and interferes with his household self-service. Symptoms last two to four weeks. Manifestations are absent in the dream.
- Pulmonary form. It manifests itself along with damage to the heart and joints, but is very rarely present (from 1 to 3% of the total number of clinical cases). The disease develops in the form of bronchitis or pleurisy.
- Dermal form. It manifests itself in the form of skin rashes or rheumatic nodules. May occur in no more than five percent of cases of all diseases.
- Ophthalmic form. It can be diagnosed only in a complex way, along with the "classic" signs of rheumatism. Manifested indamage to the retina (retinitis) or other structures of the organs of vision (iridocyclitis, iritis, etc.). This form can cause partial or complete loss of vision.
If the treatment of rheumatism is not started in a timely manner, complications may occur.
Possible complications of the disease
Complications of rheumatism experienced by the patient include:
- recurrent chronic course - the disease can become chronic;
- development of heart defects - their formation occurs in about a quarter of all cases of pathology in acute form; the defect affects the main muscle structures of the heart, which leads to a deterioration in the quality of the organ;
- ischemic and thromboembolic disorders, resulting in the occurrence of blockage of blood vessels (strokes) or ruptures, including renal arteries, retinas of the organs of vision, etc.;
- inflammation of the membranes of the heart, which is infectious in nature and can pose a serious danger to the life of the patient.
Features of the treatment of rheumatism
The following drugs are most often prescribed in therapy.
Bicillin
A disease such as rheumatism is characterized by a mixed immune-bacteriological origin. That is why the treatment is difficult, and the pathology is almost never cured completely. Since the disease is caused by a streptococcal bacterium (the reaction of the immune system is secondary and is a response topenetration of a foreign organism), then the main therapeutic task is to eliminate bacteria and remove the products of their decay and vital activity as soon as possible.
Bicillin, an antibiotic from the penicillin group, which has a longer lasting effect compared to simple penicillin, has become the main drug in the fight against the causative agent of the disease.
The active (first) phase of antibacterial treatment lasts from ten days to two weeks. Studies show that a shorter period is inappropriate, since the infection persists. At the same time, a long period is ineffective, because streptococcus produces substances that destroy the active ingredients of drugs for the treatment of rheumatism, and the antibiotic becomes dangerous for the patient.
After that, the passive (second) phase begins. Three weeks after the end of the medication, the same drug is administered orally to the patient intramuscularly. Such treatment is carried out for 5-6 years (every three weeks, one injection) to reduce the likelihood of recurrence of the disease and prevent possible heart complications. Rheumatism is also treated with other drugs.
"Aspirin"
Excellent in medical practice, such a drug as acetylsalicylic acid. The use of aspirin has a number of contraindications (the time of bearing a child and breastfeeding, vascular fragility, problems with the digestive organs), but such treatment of rheumatism allows you to get a significant effect.with neurological and articular forms of the disease. "Aspirin" eliminates pain and reduces joint inflammation. In the first two weeks, it is used in the maximum permissible dosage. After the main period of treatment, Aspirin should be taken for another 30 days, two grams per day.
Hormonal drugs for the treatment of rheumatism. In the treatment of a severe disease, Prednisolone is used (the dosage is the maximum allowable).
Inpatient treatment of rheumatism includes:
- Hospital regime combined with bed rest for the entire period of acute and subacute symptoms of the disease.
- Diet.
- exercise.
- Medicines and physiotherapy.
- Surgery for severe cases.
Below, consider the treatment of symptoms of rheumatism folk remedies.
Folk methods
Therapy should begin with water procedures, which relieve inflammation, improve blood circulation and have a general strengthening effect.
For the treatment of rheumatism, folk remedies are varied.
Baths with sea mud or s alt or hay husks are very effective. To prepare a hay bath, pour 1 kg of husk with water in an amount of 2 liters and boil for 30 minutes. The resulting broth is poured into a filled bath. Take it for at least 10 minutes.
The treatment of rheumatism with folk remedies is based on the preparation of solutions for rubbing. A good effect can be obtained by using the following recipes:
- 10 tablets of "Analgin" are ground, added to 10 mliodine and mixed with 40 ml of camphor alcohol. 300 ml of alcohol is added to the mixture and shaken. The solution should be left in a dark place for 3 weeks. After that, rubbing is carried out twice a day.
- Good relieves pain in rheumatism mustard tincture. It will take 100 ml of vodka, 1 tsp. mustard powder. Mix everything and insist for five days in the refrigerator. Use as needed.
- Mixture made from indoor ficus green leaves gives good results. 100 ml of alcohol, 20 gr. crushed ficus leaves. Mix the ingredients and insist in the refrigerator for a week. The strained mixture is rubbed on the affected areas in the morning and evening for 7 days.
Therapy in children
Treatment in children is carried out in three stages.
The first stage is inpatient treatment (within 2-2.5 months). In the active phase of rheumatism, bed rest is required with a gradual expansion of motor activity. Drug therapy includes: antibiotics, NSAIDs, antihistamines, immunosuppressive drugs, if necessary, heart drugs, diuretics and other drugs.
The second stage is a spa treatment. Rehabilitation of children is carried out for 2-3 months in a sanatorium. Medicines are used in half the dose. They use therapeutic exercises, aeration, good nutrition, vitamin therapy.
The third stage is dispensary observation. It is carried out to identify manifestations of activation of the process, the implementation of year-round prevention of relapse. Long-acting antibiotics are used. Spendalso sanitation of foci of chronic infection and determine the possibility of attending school.
Disease prevention
There is only one preventive measure to avoid rheumatism and that is to prevent the development of streptococcal infection from the very beginning. With timely antibiotic treatment, the possibility of pathology becomes minimal.
The following preventive measures will help reduce the likelihood of this disease:
- Strengthening the immune system. The main reason for the appearance of rheumatism is the ingress of streptococcal infection with an influx of blood to the systems and organs. Most often, unimpeded infection is possible due to weakened immunity, which cannot suppress the activity of the pathogen in a timely manner. To strengthen the immune system, you need to choose the right diet, rich in vitamins, and properly rest.
- Avoiding contact with streptococcus. It is necessary to adhere to the norms of personal hygiene, to try as little as possible to endure infectious pathologies. In addition, it is necessary to exclude human contact with patients infected with streptococcus infection.
- Timely treatment of colds. Rheumatism can form not only due to repeated interaction with the pathogenic bacterium, but also in the absence of treatment for a long time. If the patient has the first signs of a cold, then you should immediately contact a specialist. This recommendation applies in particular to persons who have hadconfirmed streptococcal infection, or they have previously had the disease.
- Prophylactic sanitation after interaction with the pathogen. It is advisable to take Bicillin in an adequate dosage (intramuscularly and one and a half million units once).
Rheumatism is thus complex, not only in terms of etiology, but also in its symptoms. The disease has not been studied enough, so there are certain difficulties in determining the correct diagnosis. In addition, it is impossible to completely get rid of it. However, thanks to modern methods of therapy, it is possible to eliminate the negative manifestations of the disease, minimize the danger to the patient's life and harmful consequences, and provide patients with a high quality of life.
