About Arthritis and Other Rheumatic Diseases
Arthritis, itself a group of more than 100 different diseases, is one category of rheumatic diseases. Rheumatic diseases may cause pain, stiffness, and swelling in the joints and other supporting body structures, such as muscles, tendons, ligaments, and bones. However, rheumatic diseases can affect other areas of the body, including internal organs. Some rheumatic diseases involve connective tissues (called connective tissue diseases), while others may be caused by an autoimmune disorder, which means the body's immune system attacks its own healthy cells and tissues.
Arthritis and other rheumatic diseases may be treated by your physician and/or other medical specialists and healthcare providers. Several physicians from different medical specialties may be involved in the treatment at the same time. This multidisciplinary team approach is particularly important in managing the symptoms of a rheumatic disease, especially as many symptoms are chronic and change in severity over time.
Some of the more common medical professionals involved in the treatment of arthritis and other rheumatic diseases may include the following:
- primary care physician
A primary care physician is one who has specialized education and training in general internal medicine, family practice, or another first-level-of-care area. Primary care physicians are those who provide patients with any/all of the following:
- routine healthcare (including annual physical examinations and immunizations)
- treatment for acute medical conditions
- initial care for conditions that may become more serious or chronic in nature
While your primary care physician may treat and/or diagnose your disease, he/she may refer you to a specialist.
Internists specialize in the treatment of adult diseases and internal medicine. Your internist may also refer you to a specialist.
A rheumatologist is a physician who specializes in the treatment of arthritis and other rheumatic diseases that may affect joints, muscles, bones, skin, and other tissues. Most rheumatologists have a background in internal medicine or pediatrics and have received additional training in the field of rheumatology. Rheumatologists are specially trained to identify many types of rheumatic diseases in their earliest stages, including arthritis, many types of autoimmune diseases, musculoskeletal pain, disorders of the musculoskeletal system, and osteoporosis. In addition to four years of medical school and three years of specialized training in internal medicine or pediatrics, a rheumatologist has had an additional two or three years of specialized training in the field of rheumatology. A rheumatologist may also be board-certified by the American Board of Internal Medicine.
- orthopaedic surgeon
The physician who specializes in orthopaedic surgery is called an orthopaedic surgeon, or sometimes, simply, an orthopaedist. Orthopaedists are educated in the workings of the musculoskeletal system, which includes (but is not limited to) diagnosing a condition or disorder, identifying and treating an injury, providing rehabilitation to an affected area or function, and establishing prevention protocol to inhibit further damage to a diseased area or component of the musculoskeletal system.
The orthopaedist may have completed up to 14 years of formal education. After becoming licensed to practice medicine, the orthopaedic surgeon may become board-certified by passing both oral and written examinations given by the American Board of Orthopaedic Surgery.
Many orthopaedic surgeons choose to practice general orthopaedics, while others specialize in certain areas of the body (i.e., foot, hand, shoulder, spine, hip, or knee), or in a specialized area of orthopaedic care (i.e., sports medicine, trauma medicine). Some orthopaedists may specialize in several areas and may collaborate with other specialists, such as neurosurgeons, rheumatologists, or physiatrists in caring for patients.
- physical therapist
Physical therapy is the health profession that focuses on the neuromuscular, musculoskeletal, and cardiopulmonary systems of the human body, as these systems relate to human motion and function.
Physical therapists, or PTs, are very important members of the healthcare team. They evaluate and provide treatment for persons with health problems resulting from injury, disease, or overuse of muscles or tendons.
Physical therapists have an undergraduate degree in physical therapy, and many have a Master's degree. In order to practice, all graduates must be licensed by their state by passing a national certification examination.
Physical therapists may practice in a variety of settings, including:
- rehabilitation centers
- home health agencies
- sports facilities
- community health centers
- private practice
As related to arthritis and other rheumatic diseases, physical therapists provide comprehensive training that includes, but is not limited to, the following:
- functional mobility
- balance and gait retraining
- soft-tissue mobilization
- body mechanics education
- casting and splinting
- wheelchair safety and management
- neuromuscular re-education
- exercise programming
- family education and training
- assistance with pain relief and management
- instruction in safe ambulation
- occupational therapist
Occupational therapy is a healthcare profession that uses "occupation," or purposeful activity, to help persons with physical, developmental, or emotional disabilities lead independent, productive, and satisfying lives.
An occupational therapist often coordinates the following in the care for the individual with a debilitating condition, such as an orthopaedic condition:
- evaluating children and adults with developmental, neuromuscular problems in order to plan treatment activities that will help them grow mentally, socially, and physically
- assisting children and adults in learning how to carry out daily tasks
- conducting group or individual treatment to help children and adults in a mental health center learn to cope with daily activities
- recommending changes in layout and design of the home or school to allow children and adults with injuries or disabilities greater access and mobility
Occupational therapists work in a variety of different settings, including the following:
- rehabilitation centers
- home care agencies
- private practice
- government agencies
A podiatrist specializes in foot care and is licensed to prescribe medication and perform surgery. For example, people who suffer from arthritis in the feet may see a podiatrist for special supportive shoes.
Nurses specialized in the care of rheumatic diseases may assist your physician in providing care. In addition, these nurses may help you learn about your treatment plan and can answer many of your questions.
One in five American adults has arthritis or chronic joint discomfort, according to a 2005 report from the Centers for Disease Control and Prevention (CDC). The CDC found that nearly 47 million people per year have joint problems, which was previously estimated at 43 million people (including children). It also found that 19 million Americans had to limit their activities because of their discomfort. Arthritis is the leading cause of disability in America. CDC experts advise people not to ignore the pain and stiffness in their joints, since these symptoms can be treated.
Arthritis and rheumatic diseases can affect anyone, at any age, or of any race. However, certain diseases are more common in certain populations, including the following:
- Osteoarthritis is more common among the elderly.
- Seventy percent of persons with rheumatoid arthritis are women.
- Fibromyalgia affects 2 percent of the US population.
- Gout is more common in men.
- Scleroderma is more common in women.
- Lupus affects women about eight to 10 times as often as men.
- Ankylosing spondylitis is more common in men.
The cause of most types of rheumatic diseases remains unknown and, in many cases, varies depending on the type of rheumatic disease present. However, researchers believe that some/all of the following may play a role in the development or aggravation of one or more types of rheumatic diseases:
- genetics and family history (i.e., inherited cartilage weakness)
- lifestyle choices (i.e., being overweight)
- neurogenic disturbances
- metabolic disturbances
- excessive wear and tear and stress on a joint(s)
- environmental triggers
- the influence of certain hormones on the body
The following are the most common symptoms of arthritis and other rheumatic diseases. However, each individual may experience symptoms differently, and different types of rheumatic diseases present different symptoms. In general, however, symptoms may include:
- joint pain
- swelling in the joint(s)
- joint stiffness that lasts for at least one hour in the early morning
- chronic pain or tenderness in the joint(s)
- warmth and redness in the joint area
- limited movement in the affected joint(s)
The symptoms of arthritis and other rheumatic diseases may resemble other medical conditions and problems. Always consult your physician for a diagnosis.
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