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)
Common Questions & Answers
Signs and Symptoms of Rheumatic Diseases
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
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.
Causes and Risk Factors of Rheumatic Diseases
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
- 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)
How Are Rheumatic Diseases Diagnosed?
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.
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)
Duration of Rheumatic Diseases
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)
Treatment and Medication Options for Rheumatic Diseases
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:
- 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
Some rheumatic conditions are best treated with a combination of approaches.
Some rheumatic diseases are treated with specific medications or treatments.
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.
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)
Complications of Rheumatic Diseases
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:
Research and Statistics: How Many People Have Rheumatic Diseases?
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)
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)
Rheumatic Diseases and BIPOC Communities
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)
Related Conditions and Causes of Rheumatic Diseases
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)
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)
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.
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.
This digital community offers people with arthritis and their caregivers support, updated articles, and patient guidelines among other resources.
A great resource for learning more about this complex and unpredictable disease.
On the institute's website, you can find detailed and helpful information about many forms of arthritis and rheumatic diseases.
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.
Editorial Sources and Fact-Checking
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- Spondyloarthritis. American College of Rheumatology. December 2021.
- Non-Radiographic Axial Spondyloarthritis: What Is It, and How Is It Treated? CreakyJoints. February 8, 2019.
- Gout: Symptoms and Causes. Mayo Clinic. November 16, 2022.
- Infectious Arthritis. Arthritis Foundation.
- Lyme Disease. Centers for Disease Control and Prevention. January 19, 2022.
- Lupus: Symptoms and Causes.?Mayo Clinic. October 21, 2022.
- Osteoarthritis (OA). Centers for Disease Control and Prevention. July 27, 2020.
- Psoriatic Arthritis. Arthritis Foundation.
- Rheumatoid Arthritis (RA). Centers for Disease Control and Prevention. July 27, 2020.
- About Arthritis and Other Rheumatic Diseases. Johns Hopkins Medicine.
- Ankylosing Spondylitis Remission. CreakyJoints.
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- Symptoms and Diagnosis of Gout. Johns Hopkins Arthritis Center.
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- Lupus: Diagnosis and Treatment. Mayo Clinic. October 21, 2022.
- Not One, but Two New Medications Approved This Month for Non-Radiographic Axial Spondyloarthritis (Nr-AxSpA). Spondylitis Association of America. June 2020.
- Katz P, Andonian BJ, Huffman KM. Benefits and Promotion of Physical Activity in Rheumatoid Arthritis. Current Opinion in Rheumatology. May 2020.
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- Common Triggers for Lupus. Lupus Foundation of America. July 18, 2013.
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- Rheumatoid Arthritis: Symptoms and Causes.?Mayo Clinic. May 18, 2021.
- “My Disease May Be Invisible, but I’m Not”; Patients Tell Their Stories During RDAM. American College of Rheumatology. September 2, 2020.
- Arthritis in America. Centers for Disease Control and Prevention. November 8, 2018.
- Reveille JD, Witter JP, Weisman MH. Prevalence of Axial Spondyloarthritis in the United States: Estimates From a Cross-Sectional Survey [PDF]. Arthritis Care & Research. June 2012.
- Singh G, Lingala B, Mithal A. Gout and Hyperuricaemia in the USA: Prevalence and Trends. Rheumatology. June 2019.
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- Lupus Facts and Statistics. Lupus Foundation of America. October 6, 2016.
- Psoriatic Arthritis — Disease Overview. Johns Hopkins Rheumatology. May 7, 2018.
- Psoriatic Arthritis. MedlinePlus. August 1, 2014.
- Arthritis by the Numbers [PDF]. Arthritis Foundation. 2020.
- Rheumatoid Arthritis. MedlinePlus. September 1, 2013.
- Lupus and Women. Office on Women’s Health. February 18, 2021.
- Predicting Crohn’s Disease in Those With Ankylosing Spondylitis. Spondylitis Association of America.
- Common Diseases That Overlap With Lupus. Lupus Foundation of America. February 28, 2014.
- Bhargava J, Hurley J. Fibromyalgia. StatPearls. October 2022.
- Fibromyalgia. National Institute of Arthritis and Musculoskeletal and Skin Disorders. June 2021.
- Fibromyalgia: Symptoms and Causes.?Mayo Clinic. October 26, 2021.
- Rheumatoid Arthritis and Lung Problems. Arthritis Foundation.
- Is Depression a Factor in Rheumatoid Arthritis??Mayo Clinic. December 18, 2021.