The Difference Between Arthritis and Rheumatism
'Rheumatism' is a traditional and non-specific term used in the
East and West to refer to a variety of conditions affecting the
bones, joints, skin, heart, kidneys, lungs. This term is rapidly
falling out of favour in the West today because modern medical
science has discovered that most of these conditions have
different aetiologies (causes) requiring very different
treatments.
You can say that it's a word mainly used in Chinese (&
traditional) societies; it's also used by a minority of
Westerners into homeopathic and alternative medicine. The only
common characteristics among these conditions are: 1) they cause
long-term chronic pain, and 2) they are very difficult to treat.
'Arthritis' is a broad term refers to inflammation of the
joints, but doesn't say anything about the cause. Includes
conditions like osteoarthritis, rheumatoid arthritis, psoriatic
arthritis, infective arthritis, gouty arthritis, etc.
Generally, I'd divide arthritis into 2 big groups:
1) Osteoarthritis (OA) This is primarily a 'wear and tear'
condition affecting older people. Arises from overuse (e.g.
marathon runners), previous injuries (football players),
overweight, heredity. A lot of older Asian women get OA of the
knees while the Americans and Europeans get it in the hips. The
pain is more mechanical than inflammatory. So you get pain in
the later part of the day after a lot of walking and climbing
stairs.
Because it's mainly a mechanical problem, treatment with
painkillers is only a temporary solution. Long-term lifestyle
changes are more important - reduce weight, mobility and
muscle-strengthening exercises, reduce all kinds of
weight-bearing activities (walking, jumping, running, carrying
heavy objects). In severe cases, surgery may be warranted.
2) Inflammatory ('Rheumatic') Arthritis This group comprises
the various types of arthritis which are mainly inflammatory ,
not mechanical, in nature. They usually result from an
auto-immune condition, which causes the body's immune system to
go haywire and attack the joints and other parts of the body.
E.g. rheumatoid arthritis (RA), SLE (skin, kidneys, joints,
brain), psoriasis (skin, joints), ankylosing spondylitis (back,
heart), gout (joints, skin, kidneys), rheumatic heart
disease/fever (joints, heart, skin). All these conditions
require different forms of treatment.
I'll talk a bit about RA, the commonest condition in this group.
Unlike OA, RA can occur at any age and is usually hereditary (we
now have a test for the RA factor in the blood). Pain is usually
in the early morning, worse when it's cold, and gets better with
activity and use. That means an RA sufferer suffers from morning
stiffness and pain, but gets better in the afternoon when it's
warmer and when he has moved around a bit.
Treatment, unlike OA, is mainly through drugs - painkillers,
anti-inflammatory drugs like steroids, cytotoxic drugs like
sulfasalazine and MTX. In Asia, treatment is mainly through
accupuncture, medicated plasters and ointments. With the vast
arsenals of drugs and non-drugs alternative treatments available
today, RA can be controlled very well and the sufferer can
actually lead a very active life. Many OA sufferers on the other
hand may eventually require surgery since we don't have very
effective drugs for OA.