Joint pain and swelling are among the most common symptoms of rheumatic diseases. Despite being stigmatized as problems of the elderly, these diseases make up a group of more than 120 diseases, which affect joints, bones, cartilage muscles and tendons, in addition to the skin and the respiratory and gastrointestinal systems. Celebrated on October 30, the National Day for the Fight against Rheumatism warns of the importance of early diagnosis and the impact of adequate treatment on the patient’s quality of life.
“People associate these health problems with older people, but most rheumatic diseases appear around the age of 35 and 40 in both men and women, at the height of patients’ professional lives”, explains the president of SBR (Sociedade Brasileira of Rheumatology), José Roberto Provenza.
Among the most common diseases are: rheumatoid arthritis, osteoarthritis, osteoporosis, gout, tendonitis and bursitis, rheumatic fever and fibromyalgia. However, according to Provenza, the lack of early diagnosis and self-medication are among the biggest challenges in facing rheumatic diseases.
“The patient who presents persistent pain, for example, for 3 to 4 weeks, mainly with bilateral involvement of the hands and wrists, morning stiffness, temperature increase and swelling in the joints, makes us have to call attention”, says Provenza.
“However, easy access to anti-inflammatory drugs and self-medication delay the patient’s visit to the office and can aggravate the disease,” he added.
Currently, the treatment of rheumatic diseases relies on so-called disease-modifying antirheumatic drugs that can slow the progress of illnesses. However, they only work properly when administered when the problem arises.
“A palliative will not completely resolve the course of the disease. In many of them, the cartilage will be corroded and once destroyed, it will no longer recover. The person will become deformed. So, often, the alternative is to lead the patient to the orthopedist put a prosthesis, for example “said Provenza.
“Another problem is the excess of false advertisements about products said to be miraculous, which promise a cure for rheumatic diseases. We have to be very careful, because there are dozens of drugs that have no effect and this can delay the appearance of serious treatment and result. There should be greater rigor with the marketing of these products “, he added.
According to Provenza, another limitation for early diagnosis is the small number of specialists. In Brazil, there are currently about 1,800 rheumatologists. The Southeast Region concentrates the majority of professionals, approximately 700 doctors are in the state of São Paulo.
According to the SBR, rheumatic diseases have a strong impact on the country’s health system. Between September 2019 to August 2020, more than 100 people per day were admitted to hospitals linked to SUS (Unified Health System) with signs and symptoms compatible with some rheumatic disease, as revealed by Datasus. In total, there were 40,014 hospitalizations.
If left untreated, these illnesses can cause a number of limitations and lead to physical disability, causing time off work and early retirement. A study by the Faculty of Medicine of the University of São Paulo (FMU-USP) showed that, in 2014, rheumatic diseases led Social Security benefit concessions, with 19% of sickness benefits and 13.15% of disability pensions.
According to Provenza, fibromyalgia is one of the most common diseases in the office and affects 2.5% of the world population, regardless of gender. It usually affects more women than men and appears between 30 to 50 years of age. To guide the population, the rheumatology society has a booklet with the most prevalent diseases, symptoms and possible treatments.
The disease is characterized by widespread, chronic muscle pain, which can persist for more than three months. However, illness does not show evidence of inflammation at pain sites. It is accompanied by symptoms such as non-restorative sleep and tiredness. There may also be mood disorders such as anxiety and depression, and many patients complain about changes in concentration and memory.
Among the most common and serious is rheumatoid arthritis, a disease that has the potential to deform if not treated early. The cause is unknown and affects women twice as often as men. It usually starts between 30 and 40 years and its incidence increases with age.
The most common symptoms are arthritis (pain, edema, heat and redness) in any joint of the body, especially the hands and wrists. Lumbar and dorsal spine involvement is rare but the cervical spine is often involved.
Gout is an inflammatory disease that mainly affects the joints and occurs when the level of uric acid in the blood is above normal levels.
However, not everyone who has a high uric acid level (hyperukemia) will develop gout. The majority of patients are adult men between 40 and 50 years old and, mainly, overweight or obese individuals, with sedentary lifestyle and alcohol users frequently. Women rarely develop gout before menopause and are usually over 60 when they develop it.
The manifestations of the disease can vary from just a continuous and significant back pain located mainly in the buttocks region, or higher in the lumbar region. It is a more serious and systemic disease, affecting several other joints, the eyes, heart, lungs, spinal cord and kidneys.
Typically, patients develop their first symptoms in late adolescence or early adulthood (17 to 35 years of age).