Rheumatism: the big three

Rheumatism is a collective name for more than a hundred different rheumatic diseases. More than half of the people with rheumatic complaints are between 40 and 64 years; It is therefore nonsense that only the elderly get rheumatism. In fact, the number of people with rheumatism is increasing, not only because people are getting older, but also because of the increase in obesity and therefore the pressure on the joints.

With rheumatism you always have one of the following complaints:

• The mucous membrane in the joint capsule is inflamed (inflammatory rheumatism)
• The cartilage in a joint is damaged (osteoarthritis)
• or you have pain in the connective tissue around the joint (soft tissue rheumatism)

Three main groups of rheumatism

Rheumatic diseases can therefore be divided into three main groups: inflammatory rheumatism, osteoarthritis and soft tissue rheumatism. Most people with rheumatic complaints have osteoarthritis. That is no less than 1.1 million. Chronic joint inflammation occurs in approximately 420,000 people. About 240,000 people suffer from some form of soft tissue rheumatism.

Category 1: inflammatory rheumatism

If the joint mucosa is inflamed, you make more synovial fluid than necessary. This causes the joint to swell, causing pain and stiffness. This is often accompanied by fatigue and lethargy. Akylosing spondylitis (Bechterew’s disease) and rheumatoid arthritis (RA) are the best-known forms of inflammatory arthritis.

Rheumatoid arthritis

Rheumatoid arthritis is one of the most common forms of inflammatory arthritis. It is an autoimmune disease in which the immune system does not know the difference between good (the body’s own) and bad organisms (viruses and bacteria) and therefore attacks its own tissue. The course of rheumatoid arthritis varies. Patients have periods with serious complaints, but also almost painless periods. RA is more common in women than in men.

Bekhterev’s disease

Axial spondyloarthritis is a collective term for rheumatic diseases in which inflammation is present in the pelvis and spine. It occurs in about 1 in 200 people and usually starts between the ages of 15 and 35. The inflammation causes chronic pain and stiffness, especially around the hips, buttocks and lower back. Other parts of the body may also be involved, such as joints in the arms or legs, the tendons, but also the eyes, intestines and skin. Regular exercise and medication can help to reduce the symptoms.

Ankylosing spondylitis (AS) is the best-known form of axial spondyloarthritis and is also known as Bechterew’s disease. Other names are also used for this disease, such as ankylosing spondylitis, spondyloarthropathy(s) or Marie-Strumpell’s disease. In ankylosing spondylitis, X-rays show abnormalities in the pelvis or spine. Today, the name “axial spondyloarthritis” (often abbreviated to axial SpA) is growing in popularity, as this term also recognizes the people with non-radiographic axial spondyloarthritis.

Category 2: osteoarthritis

Osteoarthritis, internationally known as osteoarthritis, is the most common musculoskeletal rheumatic disease. The cartilage deteriorates in quality; it gets thinner and softer. This leads to deformation of the bone directly beneath the cartilage. Visible and palpable lumps, called osteophytes, form at the edge of the joint. These nodules limit the mobility of the joint. Nerves can also become trapped, resulting in pain, sensory disturbances and loss of strength.
Osteoarthritis has always been thought to be a disease of only the cartilage, but it is a disease of the entire joint. And this can occur in all joints. However, there are joints in which it occurs more often, such as the neck, lower back, knees, hips, thumb, fingers and big toe. Osteoarthritis is a chronic condition and progresses slowly. It is also sometimes called joint wear, but it really does not only occur in the elderly. Younger people can get it too.

Category 3: soft tissue rheumatism

The name already gives it away; with this form of rheumatism you suffer from the so-called soft tissues. Around your joint are the joint capsule, the bursa, ligaments, tendons and muscles. These are the so-called soft tissues. If you have pain in these soft tissues, you may have soft tissue rheumatism. Sometimes pain in this form of rheumatism is caused by an inflammation, for example with tendonitis (tendonitis) or bursitis (bursitis). Sometimes the muscles and tendons hurt for a long time, but they are not inflamed. For example, there could be fibromyalgia. In addition to pain, people with fibromyalgia also suffer from fatigue and sleeping problems.