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Chronic polyarthritis
contents
- definition
- symptoms
- Disease mechanism and possible causes
- diagnosis
- treatment
- Naturopathy
definition
Chronic polyarthritis is an inflammatory rheumatic disease of the synovial membrane (stratum synoviale) and other connective tissue structures, the trigger of which is a misdirected immune system reaction (autoimmune disease). Often a so-called rheumatoid factor can be detected in the blood, which according to the international classification of diseases defines a "seropositive chronic polyarthritis" (ICD10 code: M05). However, the disease also occurs as "other chronic polyarthritis" (ICD10 code: M06) without rheumatoid factor. Synonyms for the symptoms are rheumatoid arthritis, primarily chronic polyarthritis or progressive chronic polyarthritis. Rheumatoid arthritis was first described to the public around 1800 by the French surgeon Dr. Augustin Jacob Landré-Beauvais (1772-1840).
Joint inflammation in chronic polyarthritis can cause long-term significant deformities of the joints. (Image: ivandanru / fotolia.com) symptoms
Joint pain, which initially presents in the middle and base joints of the fingers and appears symmetrical on both hands, are often the first, clearly noticeable signs of chronic polyarthritis. They are caused by inflammation, which also causes swelling and overheating, as well as a feeling of stiffness in the affected joints. In some patients, this inflammation first occurs in the large joints, such as the knee or hock. Morning stiffness, combined with nonspecific general symptoms such as increased fatigue and decreased performance, weight loss or increased basal temperature, are sometimes early evidence of chronic polyarthritis.
In any case, such an inflammatory phase in the joints is to be regarded as the first episode of disease, the intensity of which can vary greatly individually. Even the time interval to a renewed inflammatory phase may vary, but from now on, those affected must always expect another boost. Although a few patients are spared recurring symptoms, the majority are confronted with numerous other episodes of the disease over the course of their lives.
Repeated onset, inflammation of the joints over time results in an increased loss of cartilage and bone mass, which results in massive impairment of joint function. The joints deform more and more in the course of the disease, until they finally stiffen completely. The surrounding ligaments and vision are also affected by the joint deformity and because many sufferers avoid movement in the face of pain, a muscle atrophy sets in relatively quickly. In the course of chronic polyarthritis, deformations of the joints may cause the pain to persist between periods of inflammation and cause long-term patient suffering. Also often form at the joints so-called rheumatoid nodules, which are noticeable as thickening in the tissue.
At times, chronic polyarthritis also affects other systems of the human organism outside the musculoskeletal system. While rare, this can present life-threatening complications, such as: a pleurisy, vascular inflammation, pericarditis and other serious diseases.
A proliferation of the synovial membrane causes the pathological changes in the joint structures in chronic polyarthritis. (Image: bilderzwerg / fotolia.com) Disease mechanism and possible causes
While the mechanism of chronic polyarthritis is currently well-researched, a clear cause of the disease has yet to be determined. Here are several possible triggers in the discussion. The mechanism is known to cause proliferation of the synovial membrane and increased release of synovial fluid in the inflammatory phases, leading to degradation of the cartilage and bone mass. A disturbance in the immune system is the trigger for this process. What causes the reaction of the immune system to go astray remains unclear. Genetic predispositions, smoking and a problem of white blood cells or B-lymphocytes are discussed as risk factors. But also viruses and bacteria are considered as triggers or influencing forces.
For unknown reasons, women are significantly more affected than men, and although the disease can theoretically occur at any age, the symptoms for most sufferers are first seen between the ages of twenty and thirty.
diagnosis
The diagnosis of chronic polyarthritis is usually based on a criteria catalog, from which four points must be met. However, the reconciliation requires a thorough medical history with a detailed description of the symptoms that occur. The criteria used for the diagnosis include:
- Joint pain and swelling in the middle and base joints of the fingers, the wrists, or the large joints,
- Symmetrical appearance of joint inflammation on both halves of the body,
- morning stiffness in the joint for more than 60 minutes,
- noticeable rheumatic nodules,
- recognizable, typical joint changes in imaging examinations (X-ray, skeletal scintigraphy, etc.),
- Rheumatoid factor or antibodies in the blood against certain proteins (so-called CCP) in the blood detectable.
If four of these criteria are met, medical professionals usually assume a reliable diagnosis.
In addition, symptoms can be classified according to severity, ranging from simple joint swelling without compromising joint structure to the most severe degenerative changes with deformities and stiffening.
treatment
The symptoms of an acute episode are usually treated with so-called nonsteroidal anti-inflammatory drugs (NSAIDs). They have an anti-inflammatory effect and are said to relieve the pain. If the NSAIDs do not show the desired effect, cortisone can also be used to control the inflammation of the joints. However, this treatment is only for the relief of acute complaints. In addition, a basic medication is provided to reduce the occurrence of renewed episodes of intensity and frequency.
Non-steroidal anti-inflammatory drugs (NSAIDs) as well as cortisone preparations are used for the treatment of acute patients in the acute phase. In addition, a long-term basic medication is being used. (Image: tashatuvango / fotolia.com) Often, the basic drug treatment with methotrexate, but also various other agents can be used. Here, rheumatologists make an appropriate selection based on the individual symptoms. The effect of this basic medication is only effective after weeks to months, but it can demonstrably contribute to significantly reducing and sometimes completely avoiding the deformities of the joints. Therapeutic options include so-called biologicals, antibodies directed against inflammatory cytokines, such as adalimumab and rituximab.
Last but not least, it is also possible to take action against the disease or its consequences. Thus, the growths of the synovial membrane can be surgically removed or deformities of deformed joints can be corrected. Also, an artificial replacement of the joints by a prosthesis is possible. However, these measures are ultimately only symptom relief - a cure is not possible with their help.
Accompanying movement or physiotherapy after the phases of inflammation have subsided, is intended to prevent possible movement restrictions in the joints and at the same time strengthens the often weakened muscles. In more severe forms, occupational therapy is appropriate to make life easier for those affected. Also, sometimes a therapeutic support in coping with the mental stress associated with the disease is helpful. Because the diagnosis "chronic polyarthritis" brings massive cuts in the old days and long-term risk of disability with what many sufferers can handle only with difficulty.
Naturopathy
In addition to the manual therapies that can be used against long-term impairment of joint function, naturopathy also offers good approaches to relieve the acute discomfort during a disease spurt. Here, especially cold applications such as cold reels or the bath in ice water often used naturopathic measures. Heat treatments such as fango packs or warm hay bags can be used between the attacks.
A short bath of the affected joints in ice-cold water relieves the hang glans during the acute episodes of illness. (Image: ironstealth / fotolia.com) Various medicinal plants are also attributed in natural medicine a positive effect against the symptoms of chronic polyarthritis. Here are as traditional remedies for the joint complaints, for example, full baths with nettle addition, external applications with St. John's wort oil, thyme oil and vermilion tincture and tea based on yarrow or agrimony. Also, the consumption of fresh dandelion stems is a positive effect in the inflammatory-rheumatic complaints awarded. Furthermore, herbal remedies from the root of the devil's claw are increasingly being used for the treatment of chronic polyarthritis due to their anti-inflammatory effect.
Various herbal ingredients, such as the dried root of the African devil's claw, are used to treat chronic poyarthritis. (Image: Heike Rau / fotolia.com) Other naturopathic procedures that may be applied include, for example, acupuncture, hydrotherapy, homeopathy and Schüssler salt therapy. All in all, a large number of naturopathic treatment approaches are available, which can also enable a lower dosage of the basic medication. However, these are not to be evaluated as an alternative but as a supplement to the basic medication. (jvs, tf, fp)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)