Rheumatism

Rheumatism or rheumatic disorder is an umbrella term for conditions causing chronic, often intermittent pain affecting the joints and/or connective tissue. The study of, and therapeutic interventions in, such disorders is called rheumatology.^[1] The term "rheumatism", however, does not designate any specific disorder, but covers at least 200 different conditions.

Sources dealing with rheumatism tend to focus on arthritis, but "rheumatism" may also refer to other conditions causing chronic pain, grouped as "non-articular rheumatism", also known as "regional pain syndrome" or "soft tissue rheumatism".^[2] The term "Rheumatic Diseases" is used in MeSH to refer to connective tissue disorders.^[3]

History

The term rheumatism in the current sense has been in use since the late 17th century, as it was believed that chronic joint pain was caused by excessive flow of rheum or bodily fluids into a joint.^[4]

The term rheumatism is somewhat older, adopted in the early 17th century in a different meaning, from Late Latin rheumatismus, ultimately from Greek ῥευματίζομαι "to suffer from a flux", i.e. any discharge of blood or bodily fluid (Mark 5:25 uses ῥύσις, from the same root, for "flow of (menstrual) blood", translated as "flux" in KJV).

Before the 17th century, joint pain thought to be caused by viscous humours seeping into the joints was named gout, a word adopted in Middle English from Old French gote "a drop; the gout, rheumatism".

Types

The major rheumatic disorders currently recognized include

• Ankylosing spondylitis
• Back pain
• Bursitis/Tendinitis, Shoulder pain, wrist, biceps, leg, knee (patellar), ankle, hip, and Achilles
• Capsulitis
• Neck pain
• Osteoarthritis
• Palindromic rheumatism has been theorized to be a form of rheumatoid arthritis.^[5]

Although these disorders probably have little in common in terms of their epidemiology, they do share two characteristics: they cause chronic (though often intermittent) pain, and they are difficult to treat. They are also, collectively, very common.

Other rheumatic diseases which are caused by autoimmunity include:

• Relapsing polychondritis^[6]
• systemic lupus erythematosus
• rheumatoid arthritis (see also gout, inflammatory arthritis, pseudogout)
• juvenile arthritis
• Sjögren syndrome
• scleroderma
• Polymyositis
• Dermatomyositis
• Behçet's disease
• Reactive arthritis
• Psoriatic arthritis^[7]

Treatment

A vast number of traditional herbal remedies were recommended for "rheumatism".^[8] Modern medicine, both conventional and alternative, recognises that the different rheumatic disorders have different causes (and several of them have multiple causes) and require different kinds of treatment.

Nevertheless, initial therapy of the major rheumatological diseases is with analgesics, such as paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs), members of which are ibuprofen and naproxen. Often, stronger analgesics are required.

The ancient Greeks recorded that bee venom had some beneficial effects on some types of rheumatism. Bee and ant stings were known as a folk remedy in the late 19th century, and at least one physician developed a treatment consisting of repeated formic acid injections.^[9] Certain Amazonian tribes, including the Zo'é use fire ant stings as a remedy for aches and pains.^[10]

Cod liver oil has also been used as a remedy.

Weather

There has long been said to be a link between "rheumatic" pain and the weather. There appears to be no firm evidence in favour or against; a 1995 questionnaire given to 557 people by A. Naser and others at the Brigham and Women's Hospital's Pain Management Center concludes that "changes in barometric pressure are the main link between weather and pain. Low pressure is generally associated with cold, wet weather and an increase in pain. Clear, dry conditions signal high pressure and a decrease in pain."

See also

• Corbett's electrostatic machine

References

Further reading

• The Rheumatology Handbook (WSPC 2012) ISBN 978-1-84816-320-1

External links

• American College of Rheumatology
• EULAR - The European League Against Rheumatism
• National Institute of Arthritis and Musculoskeletal and Skin Diseases - US National Institute of Arthritis and Musculoskeletal and Skin Diseases