what they are and how they affect your life

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The term rheumatic diseases Refers to a group of diseases primarily affecting the bones, joints and periarticular structures (muscles, tendons, ligaments, etc.). They can also affect various organs, such as the heart, lungs, digestive tract and kidneys.

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Rheumatic diseases are the most frequent in the world, the first reason for medical consultation and also the first cause of work disability.

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The most common is osteoporosis.

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Many rheumatic diseases are incurable, but their treatment is more effective than that of most incurable chronic diseases. However, to make this possible, early detection is very important.

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Rheumatic diseases and their implications

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Impact

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Contrary to common terminology, rheumatism does not exist. What does exist are rheumatic diseases.

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In Portugal, the prevalence of rheumatic diseases is 56%. They are responsible for 40-60% of prolonged physical disability and loss of autonomy, 43% of work absenteeism and 35-41% of early retirement due to illness.

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Rheumatic and musculoskeletal diseases are the leading causes of sick leave and early retirement in the world. In the European Union alone, it is estimated that it affects more than 120 million people, or a quarter of the population.

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The economic impact of rheumatic diseases on the health care systems of most countries is extremely high, as they are not only the most expensive diseases to diagnose and treat, but they also contribute significantly to lower productivity.

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In addition to these costs, people with rheumatic and musculoskeletal diseases have a lower quality of life than other chronic patients.

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The list of rheumatic diseases is very broad.

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In general terms, these are inflammatory, infectious, metabolic, degenerative, and other diseases that affect bones, joints, and periarticular structures in an acute, subacute, or chronic manner.

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Among the most common rheumatic diseases are the following:

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Rheumatoid arthritis

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A chronic inflammatory disease, of unknown cause, affecting the joints, but which may also affect any organ and cause a wide variety of symptoms.

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Without being the direct cause, psychological factors can precipitate the appearance of this disease, which causes a disturbance of the immune system.

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The most common symptoms are morning stiffness, pain and swelling (enlargement or swelling) of the joints.

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Although there is no cure, early detection of the disease is critical to successful treatment. However, this is a process that takes some time and requires patience on the part of the patient.

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Systemic lupus erythematosus (SLE)

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Inflammatory disease of the connective tissue and of unknown cause, affecting various systems and appliances, often accompanied by erythema of the skin.

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Among the various possible symptoms are the following (among others):

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  • Appearance of a phasic lesion, called erythema malar, affecting the cheeks and the wings of the nose, drawing on the face a kind of butterfly ;
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  • Skin lesion, which may progress to desquamation and atrophy of the skin, most characteristic of the discoid lupus subtype ;
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  • Skin photosensitivity, which causes the skin to redden on contact with the sun, even for a very short time ;
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  • Small wounds in the mouth (oral and nasal ulcers);
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  • Joint pain and inflammation without bone or joint destruction;
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  • Inflammation – sometimes with fluid – serositis of the pleura or pericardium ;
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  • Appearance of protein or albumin in 24-hour urine greater than 500 mg;
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  • Neurological changes, such as seizures or psychosis;
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  • Blood abnormalities;
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For diagnostic purposes, according to the American College In rheumatology, SLE is considered to be diagnosed when at least 4 of the above clinical manifestations occur.

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Among other measures, these patients should follow a diet balanced in proteins, fats, carbohydrates and minerals. Take rest periods throughout the day. Exercise to strengthen muscles and combat depressed mood.

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Ankylosing Spondylitis

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It is a chronic rheumatic disease, inflammatory in nature, which can result in limited movement of the spine due to bony fusion of the vertebrae. It usually begins between the ages of 15 and 30, and its cause is unknown.

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The main symptoms can be: low back pain, back pain (pain in the back), sciatica, stiffness of the spine (more intense in the morning), pain in the heels, tendonitis (especially in the Achilles tendon) and inflammation of the joints of the lower limbs (hip, knees and ankles)

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Treatment is based on three main points: general recommendations, medication and carefully selected physical exercises.

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Uranium decline

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Disease caused by a predisposition to excess uric acid in the blood. It causes very painful flare-ups, usually in the big toe, accompanied by inflammatory signs such as swelling, heat and redness of the joints.

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It can affect other joints, such as the knee, tibiotarsal (ankle = and mediotarsal (instep) joints), but it usually affects only one joint.

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Acute attacks are treated with rest, cold (ice) on the affected joint and colchicine or non-steroidal anti-inflammatory drugs.

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Throughout life, to control the disease, the patient must take hypouricemic drugs prescribed by the physician, in addition to dietary care. It is already known that excessive consumption of meat, animal fats and alcoholic beverages can precipitate gout attacks.

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Osteoarthritis

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It is the most common disease in human beings. It mainly affects the cartilage of the joints, and although it affects both sexes, it has a slight predominance in women after the age of 50.

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In the Portuguese population, osteoarthritis mainly affects the spine, especially the cervical and lumbar areas, the knees, the joints of the hands and the base of the big toe.

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Its cause is unknown. The main symptoms are pain, stiffness, limitation of movement and, in the most advanced cases, deformities.

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The treatment of osteoarthritis is based on the correction of postural defects, involving, in many cases, corrective gymnastics of the spine. Frequent rest, which should not be very long, is fundamental for these patients. As well as the execution of daily exercises prescribed by the doctor under the control of a physiotherapist.

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The drugs used are usually analgesics, non-steroidal anti-inflammatory drugs, joint cartilage protectors and muscle relaxants.

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Osteoporosis

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Osteoporosis is the most common bone disease and affects mainly the elderly and women, especially after menopause. It has several possible causes and can be associated with hormonal factors (type I, postmenopausal osteoporosis) or aging (type II), which affects men and women over 70 years of age and is due to the decrease in intestinal calcium absorption.

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The main symptoms of osteoporosis are pain, bone deformity, and fractures.

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To prevent the disease, it is important to practice sports from an early age, especially for girls, to consume 1 to 1.5 liters of skim milk per day and to discourage excessive consumption of protein, alcohol and coffee. After menopause, women should take calcium supplements.

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In age-related osteoporosis, it is important to boost vitamin D, and there are also medications that help with treatment.

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Among the elderly population, steps should be taken to prevent fractures from falls. These include eliminating excessive furniture in the home, carpets and rugs, and, for example, using non-slip pads in bathtubs.

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Fibromyalgia

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Fibromyalgia is a chronic disease that interferes with the pain control system. It affects more women and is more frequent with age.

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It is characterized by chronic diffuse musculoskeletal pain, which does not improve with rest, and by pain on palpation of a number of specific points on the body known to physicians.

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There is no known cause for fibromyalgia. It can be due to disorders of the nervous system, mental state, sleep and muscles.

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It becomes essential to exclude other causes of chronic pain, as fibromyalgia is a diagnosis of exclusion.

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Cold, dampness, anxiety, excitement and psychological tension aggravate fibromyalgia. On the contrary, dry heat and vacations help relieve symptoms.

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There is no specific treatment, the important thing being the psychological support of the fibromyalgia patient, the practice of aerobic exercises of muscular reinforcement preceded by the application of heat, the maintenance of the body in warmth, the thermotherapy, the massages and the exercises of stretching and the increase of the amplitude of the movements

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Normally, in this type of situation, medications such as amitriptyline (antidepressant) in small doses, a muscle relaxant and, in case of associated depression, medications such as fluoxetine and alprazolam are used.

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When pain is severe, strong analgesics and non-steroidal anti-inflammatory drugs are usually prescribed.

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