Rheumatic conditions are managed by rheumatologists, but their specialism is diverse. As osteopaths we tend to encounter the conditions that affect joints. Rheumatoid arthritis and related conditions are the ones we come across the most.
What is a Rheumatic Condition?
These conditions are autoimmune and often inflammatory. They encompass joint conditions, but also cross over to things like inflammatory bowel disease (IBD). We consider rheumatoid arthritis to mostly be a condition of joints, but it is associated with heart and eye problems too. “Rheumatism” can be used to refer to anything from tendonitis to fibromyalgia and pain syndromes.
Ankylosing Spondylitis and AxSpA
Figures suggest that AxSpA could be a much more common condition than we think, but as its symptoms cross over with generic lower back pain, it can often slip through the net. Unfortunately, this is a condition that really benefits from early diagnosis and treatment. Medication is available to slow or even prevent disease progression- but only in those who have been diagnosed.
The name ankylosing spondylitis describes it well: fusion and inflammation of the spine. This presents as episodes of increased pain, followed by further restriction of movement. This restriction is progressive and does not ease at any point. The body’s attempt to repair the spine after inflammation results in the laying down of bone over the joints themselves.
Secondary symptoms include inflammation of tendons where they meet bone (like the Achilles), inflammation of the eye, and swelling of the fingers.
Rheumatoid Arthritis (RA)
RA most commonly affects small joints. Joints in the neck are more likely to be affected than other areas of the spine, and the feet can show symptoms too. The hands can be severely affected, with deformities developing over time. The image below shows two examples of deformities to hands. Boutonniere deformities are swellings that become hard at the joints of the thumb or fingers. In contrast to osteoarthritic knuckle swellings, these may begin with heat and redness before burning themselves out.
Psoriatic Arthritis
Psoriasis affects roughly 2% of the population. Of people with psoriasis, roughly 5% will develop psoriatic arthritis within 20 years. Symptoms often affect the same that are affected by psoriasis, such as hands, elbows, and knees. Like AS/AxSpA, there can also be enthesitis and swollen fingers.
How can Osteopathy Help with Rheumatic Pain?
Sometimes patients come to us with rheumatic conditions, never having had any investigations or diagnosis done. With some conditions taking an average of 8.5 years to be diagnosed, we are in a good position to direct you to the consultant you need. One of the key features that sets these conditions apart from “wear and tear” is the inflammatory picture. Although there is some inflammation with osteoarthritis, it is not at the same level. Some inflammatory signs that may lead us to consider something rheumatic include:
morning stiffness lasting more than half an hour
symptoms worsening after exercise
symptoms worsening after prolonged rest
Alongside supporting you in finding a diagnosis, we can offer symptomatic relief. Due to the nature of these conditions, we cannot cure them. We can help you find the balance between too much and too little activity to minimise inflammatory episodes. As always, we will also look elsewhere in the body for any compensatory patterns that stem from the condition or make it worse.
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