With rheumatism of the joints, people met in ancient times, but its true nature and clinic became clear to physicians not so long ago. For quite a long time, official medicine considered rheumatism a joint disease, giving heart complications.
After studies conducted in 1836, there was incontrovertible evidence that rheumatism, in addition to joints, mercilessly affects the heart and the pericardium (heart bag). In honor of two researchers who independently established the pattern of heart disease, rheumatism of the joints became known as Sokolsky-Buyo disease.
Causes of rheumatism
Why rheumatism occurs, and what is it? In most cases, rheumatism occurs in people who have suffered an acute inflammatory disease of the upper respiratory tract. Additional accompanying factors are hypothermia and high humidity. Most often people have rheumatism of the joints, in medicine called rheumatic polyarthritis.
After 10-20 days after suffering acute or chronic streptococcal infection (tonsillitis, pharyngitis, scarlet fever, tonsillitis), acute articular rheumatism develops. This is a consequence of the production of specific antibodies in response to the appearance of pathogen toxins in the blood. Such antibodies are designed to fight streptococcus, but they mistakenly infect their own connective tissue cells.
Studies have shown that such reactions do not occur in all patients with angina, but only in carriers of a special protein of group B. About 2.5% of patients experience joints with rheumatism within a month after an infectious disease.
Symptoms of rheumatism
A feature of this disease is the fact that there is a clear connection with the transferred streptococcal infection. Symptoms of rheumatism of the joints appear 2-4 weeks after the infection (sore throats, tonsillitis or others). The pain in the joint is very strong and the movement in it is very difficult. Sometimes even a light touch of it causes severe pain.
The disease mainly affects large joints:
In addition to the appearance of acute pain, redness appears at the site of the joint, and the temperature of the affected area increases. With the development of the disease, the symptoms intensify, so the pains become stronger and more frequent, which is why the patient practically does not move, and touching the joint causes more suffering. Also, the temperature rises not only in the affected anatomical area, but throughout the body, up to 39-40 degrees.
Quite often, signs of rheumatism develop in several joints simultaneously, which greatly complicates the course of the disease and treatment. If rheumatism is noticed at the time, its development can be stopped, which means that only two or three joints will have time to suffer.
The course of the rheumatic process
The duration of the active rheumatic process is 3-6 months, sometimes much longer. Depending on the severity of clinical symptoms, the nature of the course of the disease, there are three degrees of activity of the rheumatic process:
- Maximum active (acute), continuously recurrent;
- Moderately active, or subacute;
- Rheumatism with minimal activity, sluggishly flowing, or latent. In those cases where there are no clinical or laboratory signs of inflammatory activity, they speak of an inactive phase of rheumatism.
Rheumatism is characterized by relapses of the disease (repeated attacks), which occur under the influence of infections, hypothermia, and physical overstrain. Clinical manifestations of recurrence resemble a primary attack, but the signs of vascular lesions, serous membranes with them are less pronounced; symptoms of heart failure prevail.
Diagnosis of rheumatism
In the event that the symptoms of rheumatism of the joints are expressed slightly, a complex of instrumental studies should be conducted:
- A clinical and biochemical blood test indicates an inflammatory response.
- Immunological analysis helps to identify disease-specific substances that appear in the blood a week after the onset of the pathological process and reach a maximum of 3-6 weeks.
- Ultrasound, ECG and EchoCG of the heart evaluates the condition of the heart, helps to exclude or confirm his defeat.
- X-rays of the joints, arthroscopy, puncture and biopsy of the intra-articular fluid are carried out to analyze their condition.
Remember, the symptoms of rheumatism are the first things to look out for. The patient may note that a few weeks ago he had been ill with angina or some other infectious diseases. In addition, with this disease, he will complain of fever, fatigue, and pain in the joints. The last complaint, most often, is the reason for the patient to go to the doctor.
Treatment of rheumatism of the joints
Patients are treated in the hospital where they carry out complex therapy, including:
- bed rest for the first few weeks;
- etiotropic therapy - the appointment of antibiotics penicillin intramuscularly for 2 weeks;
- anti-inflammatory treatment - use prednisone, nonsteroidal anti-inflammatory drugs.
When the acute stage has passed, you may be prescribed physiotherapy:
- paraffin applications.
Self-treatment of this disease in the home is fraught with serious consequences.
The success of treatment will largely depend on the correct choice of drug therapy. As mentioned above, several types of drugs with different effects are used to treat rheumatism of the joints:
- Antibiotics. The main task in the treatment of rheumatism is the inhibition of streptococcal infection, which is a provocateur of this disease and subsequent complications. For this purpose, antibacterial agents of the penicillin group and their analogues or broad-spectrum antibiotics (erythromycin, ampicillin, etc.) are used. This therapy lasts up to 15 days. Further, for the prevention of recurrence and complications of the heart for 5 years, 1 time in 20 days, the patient is injected with this drug.
- NSAIDs. Of the drugs most widely used non-steroidal anti-inflammatory drugs - NSAIDs. They are prescribed in the acute phase intramuscularly, and after 3-7 days they are transferred to tablets. Use any NSAIDs with good anti-inflammatory activity and a pronounced analgesic effect: nimesulide, ibuprofen, diclofenac, meloxicam, oxicam, ketoprofen, etc. They can relieve pain and signs of inflammation well (the appearance of pain in the stomach, gastrointestinal bleeding, etc.). Therefore, the therapy is carried out strictly according to the purpose and under the supervision of a physician.
- Glucocorticosteroids. The doctor prescribes hormonal compositions for pronounced symptoms, severe joint pain, extensive damage to the heart muscle. Potent drugs reduce the volume of fluid in the cardiac bag, prevent dangerous complications of carditis. During therapy, a cardiogram is necessarily taken to monitor the state of the heart muscle.
- Immunosuppressants. Immunosuppressants weaken the body's response to infection, slightly suppress the immune response.
All agents used for treatment are effective, but have certain contraindications. Therefore, to minimize their harmful effects from long-term use and increase the effectiveness of therapy, treatment is prescribed as complex. It is carried out under the strict supervision of a doctor.
After stopping the symptoms of inflammation, the main task of treatment is to prevent complications from the joints (chronic inflammation, stiffness, adhesions of the joints (ankylosis), etc.). To achieve this goal, the patient begins to do exercise therapy: already in bed he moves his limbs, developing the affected joint and returning him the full range of movements. As the state improves, the volume of the exercises and their intensity increase.
Also, in the subacute phase, doctors prescribe a massage, various methods of physiotherapy (electrophoresis, UHF, a laser - to speed up the recovery of the body after inflammation, early removal of edema).
Doctors recommend that you stick to diet number 15, increase the protein component of the diet and reduce the amount of carbohydrate and salt intake. Do not forget about fruits and vegetables, drink warm drinks: tea with raspberries, decoction of limes.
It is recommended to exclude from nutrition:
- beans and peas;
- meat broths.
Products containing vitamins B, vitamin C, P and PP are required. Fish and meat can be boiled and stewed.
If untreated, rheumatic heart disease occurs.
Disturbances of heartbeat and pulse rate, pain in the heart and heartbeat disruptions suggest that inflammation of the heart tissue develops, accompanied by shortness of breath, sweating and weakness.
Other consequences of untreated chronic rheumatism of the joints include:
- rheumatic skin lesions (subcutaneous rheumatic nodules or ring erythema appear);
- rheumatic disease (characterized by chest pain, cough, shortness of breath and fever)
- if nerve tissue is involved in the inflammatory process, then the patient has uncontrolled muscle contractions (grimaces, sudden movements, speech becomes slurred, handwriting is disturbed).
Rheumatism is a disease, the development of which is easier to prevent than to struggle for many years with its manifestations.
For this you need to take preventive measures:
- Timely destroy streptococcal infections in the body.
- Do not allow hypothermia of the body.
- Eat right, provide the body with the necessary substances.
- Monitor the state of the immune system.
- Pay attention to physical activity.
Rheumatic disease is a serious pathological process, which is accompanied by the formation of inflammation. It can affect various organs. The characteristic manifestations of the disease are pain and general malaise. Treatment of the disease should be comprehensive and be prescribed only by an experienced specialist after a thorough diagnosis. Only by following all the recommendations can the disease be defeated.