1) WHAT IS RHEUMATISM? WHY DOES IT HAPPEN?
When it comes to rheumatism, the first thing that comes to mind is joint pain. However, as explained in medical schools, an extremely wide group of diseases is defined. Pain and swelling of all kinds of joints, disorders of the tissues around the joint, affecting the whole body including the heart-lungs-kidneys-brain-intestinal system, and accompanying skin diseases can be listed. We can sometimes see a few of these and sometimes all of them in the same patient. However, since pain is the most important complaint that brings us to the doctor, muscle and joint problems always come to mind.
Most rheumatism patients have a genetic predisposition that we may not be able to fully define today. Under certain conditions, these genetic features come to the fore and make the person sick. These triggering situations, which we can call environmental conditions, play an effective role, especially in previous infections, increased stress load of the person, and extreme fatigue. Although it is generally summarized in this way, the causes of rheumatic diseases are not yet known for certain.
2) IS IT TRUE THAT IT HAPPENS MORE IN WOMEN AND GIRLS? IF SO, WHY?
We can say this in adulthood, especially during the years that we call the fertile period for women. This is the case in diseases where the immune system is impaired, especially rheumatoid arthritis and Lupus. This rate is higher in women under the age of 15 and over the age of 50 for these diseases, but this excess has decreased from 9 times to 3 times.
It can be stated that hormonal change plays an important role at this point. Although it is not fully determined why and how it happens, there are many theories, especially about the estrogen hormone.
3) WHAT SYMPTOMS DOES IT GIVE? WHICH DISEASE IS IT MOST MIXED WITH, HOW CAN WE DIFFERENTIATE?
The most common complaint that brings rheumatism patients to us is their pain. Joint pain, accompanied by joint swelling and redness, and movement disorders occur. Waist and hip pain, especially seen in young people, may be low back pain, hip and heel pain that starts at midnight and in the morning. Stiffness and difficulty in movement develop in the mornings in the areas where the pain occurs and this situation is extremely important for us if it lasts more than half an hour. Our patients sometimes have important skin findings, and our skin specialist physician friends usually refer these patients to us.
Although there are fewer cases of confusion if the problem starts only with the joint, rheumatism diseases are diseases that can be confused with all diseases.
One of the most important problems is that these diseases are often confused with others. For example, a patient who is thought to have a herniated disc may actually have Ankylosing Spondylitis, an inflammatory disease of the spine. Or the main problem of a patient who has been around with a rash for years may be rheumatism. Of course, adding pain to the process here guides us. The main problem of a patient, which is sometimes mistaken for the urinary tract, is rheumatism affecting the kidneys. Or a recurring fever that is thought to be an infection is actually familial Mediterranean fever.
In general, they can be confused with thyroid diseases, hepatitis, sometimes heart diseases, and all kinds of infectious diseases. In fact, sometimes a cancer patient may initially show symptoms like rheumatism. The situation will become clear within a few months.
4) WHAT ARE THE TYPES OF RHEUMATIC DISEASES?
Rheumatic diseases are popularly called inflammatory and non-inflammatory. This is actually a description by which we try to explain the inflammatory reaction. On the one hand, there are topics such as osteoarthritis, tendinitis and bursitis, which are diseases that develop as a result of mechanical trauma and wear; On the other hand, there are connective tissue diseases such as rheumatoid arthritis, systemic lupus, and many diseases such as ankylosing spondylitis, psoriatic arthritis, Behçet's disease, and familial Mediterranean fever. These classifications are made by looking at the number of affected joints, joint areas, accompanying extra-articular internal organ and skin findings, age, gender and many factors.
5) WHAT ARE THE NEWEST TREATMENT METHODS? HOW IS IT TREATED? IS THERE ANY EARLY TREATMENT OR PRECAUTIONS THAT CAN BE TAKEN IN CHILDREN?
Here, the meaning of early treatment is always perceived as diagnosis from childhood, which is extremely wrong. Rheumatic diseases can start at any age, and early diagnosis means diagnosing the patient at the first stage when the symptoms begin and before it is too late. For example, for rheumatoid arthritis, this period lasts for the first 2 years. While these are pronounced, today our goal is to make a diagnosis within the first 1.5-3 months. While an adult's disease may primarily cause disability, this situation manifests itself as both damage and growth and development disorders in children. In other words, if you delay the diagnosis of a child, you will cause that child to lag significantly behind normal growth. Because children are stronger than adults, especially in terms of joints, they have difficulty explaining, for example, a hip or knee swelling. There are more reasons to delay diagnosis in the pediatric age group.
First of all, an approach in the form of the newest treatment leads to incorrect results. If you use the treatment you have correctly and on time, older people can also meet their needs. However, unfortunately, the drugs we have available, which we can describe as old, have many side effects. Therefore, they need to be followed very well. These include drugs such as cortisone, methotrexate, azathioprine, and sulfasalazine. The drugs you call new are what we currently call biological treatments. These treatment methods have been used together with other medications for approximately 12 years. These are expensive treatments used as serum and injection. Today, every new drug used all over the world is rapidly coming into use in our country.
6) DOES RHEUMATISM HAVE ANY RELATIONSHIP WITH MENOPAUSE?
There is always talk about this issue. speculations have been made. However, one clear fact is the decrease in the frequency and severity of rheumatological diseases after menopause. On the other hand, starting from this age group, diseases such as osteoarthritis, which develops due to mechanical reasons and is popularly called calcification, begin to be seen more frequently.
7) HOW CAN I PREVENT RHEUMATIC DISEASES?
You can be protected from mechanically originated diseases. You can achieve this by paying attention to your weight and adding regular exercise into your life. Here, housewives can protect themselves by rationalizing the housework they do with love and enthusiasm. However, it is not possible to be protected from real rheumatological diseases, known as inflammatory diseases. How is it possible to prevent a disease whose cause you do not know for sure?
8) PAIN CAN BE REDUCED WITH EXERCISES WHICH SPORTS ARE MOST RECOMMENDED?
One of the most important parts of the treatment for inflammatory diseases of the lower back, especially ankylosing spondylitis, is exercise. Aerobics including stretching exercises, gymnastics of all kinds, pilates and especially swimming are recommended. Of course, there are also unnecessary exercises. It is undesirable for these patients to do sports such as bodybuilding or lifting weights. Special rehabilitation programs can be applied to people whose joint deformities have become permanent. We do not recommend using the stairs or the classical toilet system for a knee osteoarthritis patient.
9) IS RHEUMATISM A DISEASE CONSIDERED SIMPLE AMONG THE PUBLIC, OR IS IT SAID THAT EVERY PAIN AND BONE PAIN IS RHEUMATISM? HOW IMPORTANT ARE NEGLIGENCES FOR THE DISEASE?
Rheumatism was perceived only as a disease of the elderly, and only knee problems were considered rheumatism. This perception is rapidly improving. A patient whose disease is already widespread and severe wanders around searching for the cause of his pain, unable to find a solution, and somehow reaches a rheumatologist. Of course, sometimes rapid internal organ damage occurs, and even a short delay can lead to irreversible consequences. Another problem is in the slow-progressing and moderate-mild patient group. Neglect in these causes delay in diagnosis.
10) IS IT TRUE THAT PAIN INCREASES IN WINTER MONTHS? WHY DOES THE PAIN INCREASE ESPECIALLY DURING THE WINTER MONTHS?
There is actually no specific reason other than the cold. Sometimes our patients ask us questions such as seasonal changes and humidity effects, but these are not proven reasons. Here, only patients with circulatory disorders should be kept separate. These can be listed as Raynaud, scleroderma, all connective tissue diseases accompanied by Raynaud, and sometimes vasculitis patients.
11) IS A DEFINITIVE TREATMENT OF RHEUMATISM POSSIBLE OR IS THERE ANY POSSIBLE TYPE?
I think this question is very important. This is a question that is a source of great misconception and despair. Yes, definitive treatment is possible with a rapid diagnosis and treatment, individual determination of the right medications and very good patient follow-up. Today, we have many treatment options and our alternatives are increasing. However, in most rheumatological diseases, suppression The disease is kept under control. In a patient whose medication you reduce or even stop, you may experience flare-ups over time. Nowadays, our treatment success in these diseases has increased greatly, but there are rare patients in whom we cannot achieve the results we want. I believe that this situation will be overcome in time.
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