Rheumatic diseases, including most forms of arthritis and spondyloarthropathies (inflammatory spinal conditions), are usually painful, chronic, and progressive, which means they get worse over time. Early diagnosis and treatment can slow the progression of many rheumatic diseases. Among the most common rheumatic diseases are:
Ankylosing Spondylitis (AS) AS is a common type of spondyloarthritis, a type of arthritis that attacks the spine and, in some people, the joints of the arms and legs, according to the American College of Rheumatology. (2) Nonradiographic axial spondyloarthritis is a related condition in which the disease causes symptoms including lower back pain, but unlike ankylosing spondyloarthritis, there is no visible damage on X-rays, notes CreakyJoints. (3)Gout Gout is a form of arthritis characterized by the accumulation of urate crystals in a joint — often the large joint of your big toe — causing swelling and pain, according to the Mayo Clinic. (4)Infectious Arthritis A sudden and painful form of arthritis brought on by a viral or bacterial infection, infectious arthritis can sometimes lead to permanent joint damage. (5,6)Lupus Lupus is a systemic autoimmune disease that occurs when your body’s immune system attacks your own tissues and organs, causing damage to joints and organs, per the Mayo Clinic. (7)Osteoarthritis (OA) The most common form of arthritis, OA is an age-related disease that damages cartilage and bone, causing pain and, in some cases, disability, according to the Centers for Disease Control and Prevention (CDC). (8)Psoriatic Arthritis (PsA) An inflammatory type of arthritis affecting some people who have psoriasis, PsA primarily affects the skin and joints, notes the Arthritis Foundation. (9)Rheumatoid Arthritis (RA) RA is an autoimmune and inflammatory disease that occurs when your immune system mistakenly attacks your own body’s tissues, causing painful swelling, according to the CDC. (10)
The following are some of the most common symptoms of arthritis and rheumatic diseases: (2,3,4,5,7,9,10)
Joint painSwelling of a joint or jointsJoint stiffness that lasts for at least one hour in the early morningChronic pain or tenderness in a joint or jointsWarmth or redness in a joint areaLimited movement in an affected joint or jointsFatigue
In addition, some rheumatic diseases are characterized by specific symptoms. For example, the majority of people with lupus will experience some form of skin rash along with joint pain with inflammation and fatigue.
Genes and family historyEnvironmental triggersLifestyle choicesInfectionTraumaMetabolic problemsWear and tear or stress on a joint or joints
Genetics are thought to play a role in the development of ankylosing spondylitis, lupus, and rheumatoid arthritis. (2,7,10) Blood tests can help detect markers of inflammation, antibodies associated with certain diseases, and abnormal organ function, among other things. Imaging tests, such as X-rays, CT scans, MRI scans, or ultrasounds of your joints and bones can help detect inflammation and fluid buildup and reveal bone or joint changes. Some rheumatic diseases, such as lupus, are difficult to diagnose, in part because their symptoms overlap with other conditions. Learn More About Rheumatic Diseases Diagnosis
Prognosis of Rheumatic Diseases
Prognosis varies depending on the type of rheumatic disease. In some cases of ankylosing spondylitis, treatment results in disease remission, notes CreakyJoints. (12) Unlike other types of arthritis, infectious arthritis is usually not a long-term illness, and it’s generally curable. (5) Lupus is chronic, but most people don’t experience symptoms continuously, and according to the Lupus Foundation of America, with close follow-up and treatment, 80 to 90 percent of people with lupus can expect to live a normal life span. (13) RELATED: Why Is It So Hard to Find a Rheumatologist? Recovery from an untreated attack of acute gout, however, can take a few weeks. With proper treatment, patients are less likely to experience painful flare-ups, which otherwise might occur several times a year, notes Johns Hopkins Medicine. (14) Rheumatic arthritis is both progressive and chronic. Damage to the joint bones typically occurs within the first two years. And the earlier you are diagnosed and the sooner treatment starts, the better the long-term outcome. In fact, research published in JAMA shows that when given early on, current treatments can prevent joint damage in up to 90 percent of people with RA. (15) RELATED: Why Is Early Rheumatoid Arthritis Treatment So Important? Medications used to treat rheumatic diseases include:
CorticosteroidsDisease-modifying anti-rheumatic drugs (DMARDs), which can slow the progression of rheumatic diseases by affecting the body’s immune reactions and inflammatory processesBiologics, a subclass of DMARDs that target specific steps in the body’s inflammatory processesJanus kinase inhibitors, a DMARD subclass that targets Janus kinase pathways, which are involved in the body’s immune system response
Medications that help with pain and discomfort include:
Oral analgesics, such as acetaminophen, and prescription narcotics (opioids) like oxycodone and hydrocodoneTopical analgesicsNonsteroidal anti-inflammatory drugs, including ibuprofen and naproxen sodium, and prescription-grade drugs called COX-2 inhibitors
In addition to medications, other treatments may be prescribed for rheumatic diseases, including:
Specific exercisesPhysical therapyOccupational therapyHot and cold therapySplints, braces, and assistive devicesSurgery
Some rheumatic conditions are best treated with a combination of approaches. Some rheumatic diseases are treated with specific medications or treatments. Gout is treated with allopurinol, a uric acid–lowering medicine, as well as corticosteroids such as prednisone. Lupus is typically managed with NSAIDs, antimalarial drugs such as hydroxychloroquine, corticosteroids, immunosuppressants such as azathioprine, and biologics such as belimumab, notes the Mayo Clinic. (16) In addition to long-established treatments, researchers are finding new options for people with rheumatic disease. Until recently, the U.S. Food and Drug Administration (FDA) had approved just one biologic medication for nonradiographic axial spondyloarthritis, the TNF inhibitor Cimzia (certolizumab pegol). In June 2020, the FDA approved two additional biologic medications, Taltz (ixekizumab) and Cosentyx (secukinumab), notes the Spondylitis Association of America. (17)
Alternative and Complementary Therapies
Exercise can help people with RA reduce symptoms like pain while also improving functioning and mood. (18) Some find it beneficial to add massage to their treatment regimen. The gentle kneading can relax muscles and help increase mobility. In addition, some have found relief from RA symptoms through acupuncture, tai chi, and yoga. (19,20) Some patients with rheumatic diseases have found that cognitive behavioral therapy (CBT), particularly the form of CBT called acceptance and commitment therapy, to be helpful in relieving symptoms such as pain, fatigue, and brain fog. However, in some cases, avoiding or reducing certain triggers can help prevent flares. For lupus, this means avoiding common triggers, such as stress, infections, certain medications, or sunlight, per the Lupus Foundation of America. (21) For gout, it may help to avoid diuretics (used in treating high blood pressure), drinking alcohol, or consuming foods or drinks high in fructose (like soda) or too many purine-rich foods (such as red meat, mussels, scallops, or tuna), notes the CDC. (22)
DiabetesDepressionHeart diseaseHigh blood pressureHigh cholesterolKidney diseaseMemory problemsOsteopeniaOsteoporosis (low bone mass)
According to the CDC, 1 in 4 adults have arthritis. In fact, it is the leading cause of work disability, with 8 million working-age adults reporting that their ability to work is limited because of their arthritis. And 24 million adults are limited in their activities by arthritis, with more than 1 in 4 adults reporting severe joint pain, according to the CDC. (25) Data from the U.S. National Health and Nutrition Examination Survey estimates that up to 1 percent of adults in the United States may have spondyloarthritis, including ankylosing spondylitis. (26) Gout is more common in men. It is estimated to affect about 9.2 million adults in the United States. (4,27) About 6 percent of men in the United States and about 2 percent of women have gout. Gout is rare in children and young adults, and most women who have it don’t develop it until after menopause. The Lupus Foundation of America estimates that 1.5 million Americans have a form of lupus. According to data from the CDC’s National Lupus Registry network, just over 204,000 Americans experience the most common form of lupus, which is systemic lupus erythematosus. (28) And 9 out of 10 people with lupus are women. Most people with lupus develop the disease between ages 15 and 44. (29) According to the CDC, osteoarthritis affects over 32.5 million U.S. adults. The risk increases with age, and women are more likely to develop OA than men, especially after age 50. (8) Psoriatic arthritis affects about 1.5 million people in the United States. The condition usually affects those between ages 30 and 50, but it can start at any age. About 30 percent of those with psoriasis will go on to develop psoriatic arthritis. (30,31) An estimated 1.5 million adults in the United States are affected by rheumatoid arthritis, and the disease is 2 to 3 times more common in women than in men. (32,33) The U.S. Department of Health and Human Services’ Office on Women’s Health says that Black and Hispanic women usually get lupus at a younger age and have more severe symptoms, including kidney problems, than other groups. (34) Lupus typically occurs alone. However, according to the Lupus Foundation of America, some people with lupus experience symptoms typical of one or more other connective tissue diseases, such as celiac disease, rheumatoid arthritis, and autoimmune thyroid disease. (36) Rheumatic diseases may elevate your risk of fibromyalgia, a chronic disorder that is characterized by pain, fatigue, and mood issues. (37,38,39) According to the Arthritis Foundation, 20 to 30 percent of people with rheumatoid arthritis will eventually develop an RA-related lung disease, such as interstitial lung disease, chronic obstructive pulmonary disease, or asthma. (40) In addition, osteoporosis, anxiety, and depression are common in people with RA, notes the Mayo Clinic. (41) On this organization’s website, you can learn about common rheumatic diseases and conditions and treatments. The group’s Simple Tasks campaign and site offer a forum for patients to share their experiences dealing with rheumatic disease. Arthritis Foundation This organization works to empower people with arthritis by supporting research and advocacy. On its site, you can find valuable information about new treatments, drugs, and healthy living. CreakyJoints This digital community offers people with arthritis and their caregivers support, updated articles, and patient guidelines among other resources. Lupus Foundation of America A great resource for learning more about this complex and unpredictable disease. National Institute of Arthritis and Musculoskeletal and Skin Diseases On the institute’s website, you can find detailed and helpful information about many forms of arthritis and rheumatic diseases. Spondylitis Association of America On this organization’s site, you can find helpful information about diagnosis and treatment, opportunities to join clinical trials, and support groups. You can also use its directory to find a specialist in your area.
