Rheumatism of the joints is a fairly common pathology. This disease has a number of unpleasant symptoms that can not only significantly reduce the patient's quality of life, but also limit his physical activity.
General information
Rheumatism of the joints 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 group A beta-hemolytic streptococcus. During the course of this disease, the body produces antibodies to fight the pathogen. Unfortunately, they are able to affect not only infectious agents, but also those tissues that have a similar protein structure. The most common targets for these antibodies are the joints and the heart.
Provoking factors
There are a number of factorsleading to the development of this disease. Rheumatism of the joints occurs much more often in the following cases:
- The closest relatives of a person suffer from this pathology.
- History of viral diseases such as rubella, hepatitis B, herpes.
- The presence of collagen types 2, 9, 10 and 11 in the connective tissue.
- Suffering serious psycho-emotional stress.
- Traumatic joint injury.
- Development of menopause in women.
- Frequent occurrence of allergic reactions.
The risk of developing rheumatism of the joints is the higher, the more provocative factors affect the human body.
Clinical picture
Symptoms of joint rheumatism in 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 ºС;
- general weakness;
- morning stiffness.
When identifying the first symptoms of rheumatism of the joints, you should immediately consult a doctor. The sooner therapeutic measures are started, the less the patient's quality of life will be reduced in the future.
Character of pain
The defeat of the joints in rheumatism is manifested primarily by pain. At the same time, she begins to disturb the patient at night ormorning hours. Soreness can become quite pronounced. As a result of its presence, the patient has a restriction of movement. Later on, pain and morning stiffness gradually decrease.
Diagnosis
You should immediately consult a specialist doctor after the first symptoms of this disease appear. Rheumatism of the joints can have a fairly rapid course with the development of severe 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 research:
- radiography of affected joints;
- complete blood count;
- biochemical blood test;
- joint puncture with further examination of the synovial fluid;
- anticitrulline antibody test.
X-ray 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, proliferation of osteophytes can be observed. These changes will further contribute to the limitation of the patient's motor activity.
The following changes may be observed in the general blood test for rheumatism of the joints:
- exceeding the level of leukocytes: above 9.0109/l;
- increase in erythrocyte sedimentation rate: more than 10 mm/h in men and more than 15 mm/h in women;
- increased platelet count: more than 420109/L;
- decrease in red blood cells: less than 3.51012/L.
By themselves, such changes in the general blood test are nonspecific, and it is impossible to judge the presence of rheumatism only on their basis.
A fairly informative method of research 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. When two of these substances are detected at once, the diagnosis is established in the vast majority of cases. At the same time, based on the negative result of the analysis for rheumatism of the joints, one cannot say that the patient does not have this disease.
Puncture of a joint with suspected rheumatism is done relatively rarely. This diagnostic procedure is used only when doctors have difficulty making a definitive diagnosis. With rheumatism, a large amount of protein, leukocytes and granulocytes is observed in the synovial fluid from the affected joint. In addition, it is cloudy, and its viscosity is lower than normal.
The test for the presence of anticitrulline antibodies allows with a high degree of 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.
Treatment measures
If this diagnosis is established, the patient should immediately begin treatment. There is a specialist who knows exactly how to treat rheumatism. This is a rheumatologist. In ordinary clinics of this specialist, findalmost impossible. To receive quality care, you will have to contact a private medical center or a large multidisciplinary public he alth institution. A referral to a rheumatologist after the necessary examination will be issued by a local therapist or general practitioner.
Currently rational treatment for rheumatism of the joints may include:
- non-steroidal anti-inflammatory drugs;
- glucocorticosteroids;
- cytostatics;
- antibiotics;
- gold preparations;
- aminoquinolines;
- mercaptocarboxylic acid derivatives;
- selective immunosuppressants;
- systemic enzyme therapy drugs;
- physiotherapeutic effect;
- physiotherapy exercises.
Naturally, the patient is not simultaneously prescribed the full range of these medicines and medical measures. A specific treatment regimen is developed by a specialist, depending on the severity and speed of the development of the pathological process.
Nonsteroidal anti-inflammatory drugs
Drugs from this pharmacological group are used in the treatment of joint rheumatism in almost every patient. This is due to the fact that they simultaneously have an anti-inflammatory and analgesic effect. The main drugs of this group used for rheumatism are as follows:
- "Nimesulide".
- "Ketoralac".
- "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 a specialist doctor should tell you how to treat rheumatism with the help of such drugs. 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 more commonly used:
- "Prednisolone".
- "Methylprednisolone".
- "Dexamethasone".
All of these drugs have one serious side effect - they increase blood pressure levels. That is why, with extreme caution, they should be prescribed to hypertensive patients. Currently, glucocorticosteroids are more often recommended to patients only during an exacerbation of the pathological process or in 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 those cases of rheumatism of the joints, when there is a serious progressive course and significant severitysymptoms of the disease. Also, cytostatics are used when other drugs are ineffective. The main drugs in this group are:
- "Methotrexate".
- "Cyclophosphamide".
- "Azathioprine".
When taking cytostatics, it is imperative to strictly follow absolutely all the recommendations of a specialist. If you experience any side effects, you should immediately consult him.
Antibiotics
With rheumatism of the joints, they are not used so often. As a rule, only in case of an exacerbation of the disease, accompanied by an increase in body temperature and leukocytosis in the 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. These medicines should only be taken when prescribed by a specialist and after meals.
Physiotherapeutic effect
There are a number of physiotherapy techniques that are used for rheumatism of the joints. The main ones are:
- Magnetotherapy.
- Exposure to ultra-high frequency radiation.
- Electrophoresis with novocaine.
- Exposure to infrared radiation.
- Ozokerite applications.
- Paraffin applications.
Magnetotherapy is better for treating knee rheumatismjoints. Electrophoresis with novocaine should be prescribed only after examining the patient's allergic history, since an anaphylactic type response is often observed to its use. In this case, the patient may need emergency medical care.
Physiotherapeutic treatment cannot act as the main treatment for this disease. The greatest effectiveness of it can be achieved in combination with taking drugs according to a rational scheme prescribed by a specialist doctor.
Therapeutic exercise
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 develops a program of physiotherapy exercises. He will select exactly those exercises that will help in each case.
Therapeutic exercise, like physiotherapy, as an independent technique does not play a decisive role. It works 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 in the course of his life. For this, it is necessary to use those medicines that are prescribed by a specialist doctor and, above all, antibiotics. Hypothermia should also be avoidedjoint injury.
