What Is Rheumatology?
Rheumatology is a branch of medicine that deals with revealing the causes, diagnosis, and treatment of rheumatic diseases.
The rheumatologist treats inflammatory and degenerative joint diseases as well as systemic diseases of the connective tissue (they used to be called collagenosis). Also, working in collaboration with surgeons and traumatologists, these specialists are concerned with suppurative and septic diseases as well as many injuries and orthopedic disorders.
Musculoskeletal conditions are quite common in Russia: they are the third most common health problem in adults. Moreover, the prognosis is still disappointing: the incidence of musculoskeletal diseases is steadily growing. In addition, rheumatic diseases treatment is considered to be one of the most expensive all over the world. Their diagnosis often requires complex tests and examinations, while therapy is long and involves expensive drugs. In neglected cases, surgery followed by comprehensive rehabilitation is recommended.
Rheumatic diseases lead to partial or complete disability in people who started treatment late. There can be a long time period between the day of the first appointment with a doctor and the definite diagnosis since symptoms of musculoskeletal conditions resemble those of other diseases. Patients in Russia can consult dozens of doctors about incorrect diagnoses for months and have no suitable treatment.
Abroad, deliberate attention is paid to rheumatic diseases since the early start of combination therapy enables the patient to keep motor performance and efficiency as good as possible. Rheumatologists work in close collaboration with endocrinologists, cardiologists, surgeons, neurologists, and other specialists. Such an approach makes it possible to diagnose complications and concomitant diseases in time and provide patients with quality treatment and rehabilitation.
The Most Common Rheumatic Diseases
All rheumatic conditions are usually divided into two large groups: inflammatory and non-inflammatory. The first group includes arthritis; it is an inflammatory joint disease with progressing local infection, which affects the whole body. Non-inflammatory joint diseases are comprised of arthrosis, which is characterized by loss of mobility of an affected joint and osteophytes. Unlike arthritis, this disease affects only a certain joint and nearby tissues, but not internal organs. Stage 2 and 3 arthrosis may involve inflammation, which is, however, not chronic and does not cause the initial condition.
Non-inflammatory rheumatic diseases that doctors most often deal with are:
- degenerative diseases of the vertebral column;
- osteoarthritis of major joints (most often, knee and hip joints);
- osteoporosis caused by age-related calcium deficiency;
The most common inflammatory diseases include:
- rheumatoid arthritis
- ankylosing spondylitis (Bekhterev’s disease);
- reactive arthritis (develops in response to an infection caused by germs triggering arthritis)
- systemic connective tissue diseases (systemic lupus erythematosus, scleroderma, dermatomyositis).
Inflammation and immune system failure are common for all rheumatic diseases. The latter makes treatment quite long; there are few really working medications with minimum side effects.
The main task of the therapy for any rheumatic (and other) disorder is curing a patient. However, experts consider long-term remission a success in this case. In remission, a person feels no pain and experiences no disease symptoms; the patients can be active and almost forget about their illness.
Surgery for rheumatic diseases mainly consists of damaged joint replacement: it is called replacement arthroplasty. Also, doctors perform endoscopic surgery on the joints for therapy and diagnosis when necessary. They are minimally invasive and almost never cause any complications. Operations performed in modern operating rooms using advanced foreign technologies enable a person to regain their working capacity as quickly as possible and begin to live a full life. Post-operative rehabilitation also contributes to recovery.
Modern strategies of non-surgical treatment of rheumatology patients enable the doctor to make an adequate treatment regimen based on the person’s age, job, concomitant diseases, and many other factors. Analgesics and nonsteroidal anti-inflammatory drugs are used. Foreign clinics offer modern genetically engineered drugs, which are effective for diseases that cannot be cured with standard treatments. The treatment regimen may include cartilage-repairing drugs with chondroitin and glucosamine and medications containing hyaluronic acid, minerals, and vitamins.
European specialists introduce extracorporeal blood purification techniques. Blood is cleared of antibodies (including autoantibodies), toxic metabolites, and other elements causing the disease and promoting its progression. Extracorporeal blood purification permits doctors to reduce the doses of drugs and frequency of their adverse events as well as to boost their efficacy. This therapeutic technique brings the best results in autoimmune diseases treatment.
Most rheumatic conditions feature:
- steady progression;
- combined damage to various body structures;
- constant and intense pain able to cause depression if it is not relieved effectively;
- decreased activity requiring both adaptation and readaptation to work and everyday life.
All patients of clinics in Israel, Germany, and other developed countries undergo post-therapy rehabilitation, the primary tasks of which are:
- prolonged pain relief;
- maintaining motor performance, increasing the active and passive ranges of motion of the affected joints;
- improving muscles, strength, and endurance;
- psychosocial support and prevention of mental problems;
- preventing joint deformities and eliminating pre-existing ones;
- improving the quality of life of the patient and their relatives.
Foreign specialists rely on the many years of experience of their colleagues and advanced developments of scientists. Large medical and diagnostic centers possess a clinical settings for research in various branches of medicine. An early start of rehabilitation helps prevent joint contractures, improves the overall motor performance, and slows down further diseases progression.