What Are Rheumatic Diseases? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Often grouped under the term “arthritis,” rheumatic diseases are autoimmune or inflammatory diseases that cause your immune system to attack your joints, muscles, bones, and organs.

Rheumatic diseases, including most forms of arthritis and spondyloarthropathies (inflammatory spinal conditions), are usually painful, chronic, and progressive, which means they get worse over time.

Early diagnosis and treatment can slow the progression of many rheumatic diseases.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, there are more than 100 rheumatic diseases. (1)

Among the most common rheumatic diseases are:

• Ankylosing Spondylitis (AS) AS is a common type of spondyloarthritis, a type of arthritis that attacks the spine and, in some people, the joints of the arms and legs, according to the American College of Rheumatology. (2) Nonradiographic axial spondyloarthritis is a related condition in which the disease causes symptoms including lower back pain, but unlike ankylosing spondyloarthritis, there is no visible damage on X-rays, notes CreakyJoints. (3)
• Gout Gout is a form of arthritis characterized by the accumulation of urate crystals in a joint — often the large joint of your big toe — causing swelling and pain, according to the Mayo Clinic. (4)
• Infectious Arthritis A sudden and painful form of arthritis brought on by a viral or bacterial infection, infectious arthritis can sometimes lead to permanent joint damage. (5,6)
• Lupus Lupus is a systemic autoimmune disease that occurs when your body’s immune system attacks your own tissues and organs, causing damage to joints and organs, per the Mayo Clinic. (7)
• Osteoarthritis (OA) The most common form of arthritis, OA is an age-related disease that damages cartilage and bone, causing pain and, in some cases, disability, according to the Centers for Disease Control and Prevention (CDC). (8)
• Psoriatic Arthritis (PsA) An inflammatory type of arthritis affecting some people who have psoriasis, PsA primarily affects the skin and joints, notes the Arthritis Foundation. (9)
• Rheumatoid Arthritis (RA) RA is an autoimmune and inflammatory disease that occurs when your immune system mistakenly attacks your own body’s tissues, causing painful swelling, according to the CDC. (10)

Different types of rheumatic disease have different symptoms.

The following are some of the most common symptoms of arthritis and rheumatic diseases: (2,3,4,5,7,9,10)

• Joint pain
• Swelling of a joint or joints
• Joint stiffness that lasts for at least one hour in the early morning
• Chronic pain or tenderness in a joint or joints
• Warmth or redness in a joint area
• Limited movement in an affected joint or joints
• Fatigue

In addition, some rheumatic diseases are characterized by specific symptoms. For example, the majority of people with lupus will experience some form of skin rash along with joint pain with inflammation and fatigue.

Experts don’t know what causes most types of rheumatic disease. However, per Johns Hopkins Medicine, researchers believe that some or all of the following may play a role, depending on the type of rheumatic disease: (11)

• Genes and family history
• Environmental triggers
• Lifestyle choices
• Infection
• Trauma
• Metabolic problems
• Wear and tear or stress on a joint or joints

Genetics are thought to play a role in the development of ankylosing spondylitis, lupus, and rheumatoid arthritis. (2,7,10)

In general, no single test can diagnose a rheumatic disease. Your doctor will want to discuss your symptoms and examine you to check for visible signs of swelling, stiffness, or redness in your joints. If your doctor suspects that you have some kind of rheumatic disease, they will order one or more lab tests to help rule out other potential causes of your symptoms.

Blood tests can help detect markers of inflammation, antibodies associated with certain diseases, and abnormal organ function, among other things. Imaging tests, such as X-rays, CT scans, MRI scans, or ultrasounds of your joints and bones can help detect inflammation and fluid buildup and reveal bone or joint changes.

Some rheumatic diseases, such as lupus, are difficult to diagnose, in part because their symptoms overlap with other conditions.

Learn More About Rheumatic Diseases Diagnosis

Prognosis of Rheumatic Diseases

Prognosis varies depending on the type of rheumatic disease.

In some cases of ankylosing spondylitis, treatment results in disease remission, notes CreakyJoints. (12)

Unlike other types of arthritis, infectious arthritis is usually not a long-term illness, and it’s generally curable. (5)

Lupus is chronic, but most people don’t experience symptoms continuously, and according to the Lupus Foundation of America, with close follow-up and treatment, 80 to 90 percent of people with lupus can expect to live a normal life span. (13)

RELATED: Why Is It So Hard to Find a Rheumatologist?

Some rheumatic diseases are chronic or lifelong, including ankylosing spondylitis, osteoarthritis, psoriatic arthritis, and rheumatoid arthritis.

Recovery from an untreated attack of acute gout, however, can take a few weeks. With proper treatment, patients are less likely to experience painful flare-ups, which otherwise might occur several times a year, notes Johns Hopkins Medicine. (14)

Rheumatic arthritis is both progressive and chronic. Damage to the joint bones typically occurs within the first two years. And the earlier you are diagnosed and the sooner treatment starts, the better the long-term outcome. In fact, research published in JAMA shows that when given early on, current treatments can prevent joint damage in up to 90 percent of people with RA. (15)

RELATED: Why Is Early Rheumatoid Arthritis Treatment So Important?

Various types of medication are prescribed to treat rheumatic diseases, along with drugs used to treat the symptoms, including pain and inflammation.

Medications used to treat rheumatic diseases include:

• Corticosteroids
• Disease-modifying anti-rheumatic drugs (DMARDs), which can slow the progression of rheumatic diseases by affecting the body’s immune reactions and inflammatory processes
• Biologics, a subclass of DMARDs that target specific steps in the body’s inflammatory processes
• Janus kinase inhibitors, a DMARD subclass that targets Janus kinase pathways, which are involved in the body’s immune system response

Medications that help with pain and discomfort include:

• Oral analgesics, such as acetaminophen, and prescription narcotics (opioids) like oxycodone and hydrocodone
• Topical analgesics
• Nonsteroidal anti-inflammatory drugs, including ibuprofen and naproxen sodium, and prescription-grade drugs called COX-2 inhibitors

In addition to medications, other treatments may be prescribed for rheumatic diseases, including:

• Specific exercises
• Physical therapy
• Occupational therapy
• Hot and cold therapy
• Splints, braces, and assistive devices
• Surgery

Some rheumatic conditions are best treated with a combination of approaches.

Some rheumatic diseases are treated with specific medications or treatments.

Gout is treated with allopurinol, a uric acid–lowering medicine, as well as corticosteroids such as prednisone.

Lupus is typically managed with NSAIDs, antimalarial drugs such as hydroxychloroquine, corticosteroids, immunosuppressants such as azathioprine, and biologics such as belimumab, notes the Mayo Clinic. (16)

In addition to long-established treatments, researchers are finding new options for people with rheumatic disease. Until recently, the U.S. Food and Drug Administration (FDA) had approved just one biologic medication for nonradiographic axial spondyloarthritis, the TNF inhibitor Cimzia (certolizumab pegol). In June 2020, the FDA approved two additional biologic medications, Taltz (ixekizumab) and Cosentyx (secukinumab), notes the Spondylitis Association of America. (17)

Alternative and Complementary Therapies

Exercise can help people with RA reduce symptoms like pain while also improving functioning and mood. (18)

Some find it beneficial to add massage to their treatment regimen. The gentle kneading can relax muscles and help increase mobility.

In addition, some have found relief from RA symptoms through acupuncture, tai chi, and yoga. (19,20)

Some patients with rheumatic diseases have found that cognitive behavioral therapy (CBT), particularly the form of CBT called acceptance and commitment therapy, to be helpful in relieving symptoms such as pain, fatigue, and brain fog.

Prevention of Rheumatic Diseases

There are no known ways to prevent certain rheumatic diseases, including ankylosing spondylitis, gout, infectious arthritis, lupus, psoriatic arthritis, and rheumatic arthritis.

However, in some cases, avoiding or reducing certain triggers can help prevent flares. For lupus, this means avoiding common triggers, such as stress, infections, certain medications, or sunlight, per the Lupus Foundation of America. (21)

For gout, it may help to avoid diuretics (used in treating high blood pressure), drinking alcohol, or consuming foods or drinks high in fructose (like soda) or too many purine-rich foods (such as red meat, mussels, scallops, or tuna), notes the CDC. (22)

Having a rheumatic disease or condition often puts you at risk for developing other health conditions. (2,7,23) Chronic inflammation can lead to other health problems, including:

• Diabetes
• Depression
• Heart disease
• High blood pressure
• High cholesterol
• Kidney disease
• Memory problems
• Osteopenia
• Osteoporosis (low bone mass)

According to the American College of Rheumatology, an estimated 54 million adults in the United States of all ages and genders are currently living with a rheumatic disease. (24)

According to the CDC, 1 in 4 adults have arthritis. In fact, it is the leading cause of work disability, with 8 million working-age adults reporting that their ability to work is limited because of their arthritis. And 24 million adults are limited in their activities by arthritis, with more than 1 in 4 adults reporting severe joint pain, according to the CDC. (25)

Data from the U.S. National Health and Nutrition Examination Survey estimates that up to 1 percent of adults in the United States may have spondyloarthritis, including ankylosing spondylitis. (26)

Gout is more common in men. It is estimated to affect about 9.2 million adults in the United States. (4,27) About 6 percent of men in the United States and about 2 percent of women have gout. Gout is rare in children and young adults, and most women who have it don't develop it until after menopause.

The Lupus Foundation of America estimates that 1.5 million Americans have a form of lupus. According to data from the CDC’s National Lupus Registry network, just over 204,000 Americans experience the most common form of lupus, which is systemic lupus erythematosus. (28) And 9 out of 10 people with lupus are women. Most people with lupus develop the disease between ages 15 and 44. (29)

According to the CDC, osteoarthritis affects over 32.5 million U.S. adults. The risk increases with age, and women are more likely to develop OA than men, especially after age 50. (8)

Psoriatic arthritis affects about 1.5 million people in the United States. The condition usually affects those between ages 30 and 50, but it can start at any age. About 30 percent of those with psoriasis will go on to develop psoriatic arthritis. (30,31)

An estimated 1.5 million adults in the United States are affected by rheumatoid arthritis, and the disease is 2 to 3 times more common in women than in men. (32,33)

Lupus is 2 to 3 times more prevalent among Black, Hispanic, Asian American, Native American, Alaska Native, Native Hawaiian, and other Pacific Islander women than among white women. (28)

The U.S. Department of Health and Human Services' Office on Women’s Health says that Black and Hispanic women usually get lupus at a younger age and have more severe symptoms, including kidney problems, than other groups. (34)

About 10 percent of people with ankylosing spondylitis also have a form of inflammatory bowel disease, according to the Spondylitis Association of America. Inflammatory bowel disease includes both Crohn’s disease and ulcerative colitis. (35)

Lupus typically occurs alone. However, according to the Lupus Foundation of America, some people with lupus experience symptoms typical of one or more other connective tissue diseases, such as celiac disease, rheumatoid arthritis, and autoimmune thyroid disease. (36)

Rheumatic diseases may elevate your risk of fibromyalgia, a chronic disorder that is characterized by pain, fatigue, and mood issues. (37,38,39)

According to the Arthritis Foundation, 20 to 30 percent of people with rheumatoid arthritis will eventually develop an RA-related lung disease, such as interstitial lung disease, chronic obstructive pulmonary disease, or asthma. (40)

In addition, osteoporosis, anxiety, and depression are common in people with RA, notes the Mayo Clinic. (41)

American College of Rheumatology

On this organization’s website, you can learn about common rheumatic diseases and conditions and treatments. The group's Simple Tasks campaign and site offer a forum for patients to share their experiences dealing with rheumatic disease.

Arthritis Foundation

This organization works to empower people with arthritis by supporting research and advocacy. On its site, you can find valuable information about new treatments, drugs, and healthy living.

CreakyJoints

This digital community offers people with arthritis and their caregivers support, updated articles, and patient guidelines among other resources.

Lupus Foundation of America 

A great resource for learning more about this complex and unpredictable disease.

National Institute of Arthritis and Musculoskeletal and Skin Diseases

On the institute's website, you can find detailed and helpful information about many forms of arthritis and rheumatic diseases.

Spondylitis Association of America

On this organization's site, you can find helpful information about diagnosis and treatment, opportunities to join clinical trials, and support groups. You can also use its directory to find a specialist in your area.