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14 October, 2019 00:00 00 AM / LAST MODIFIED: 13 October, 2019 11:21:09 PM

Rheumatoid and musculoskeletal diseases (RMDs)

...RMDs have a huge economic burden on global healthcare systems. The costs are associated with diagnosis, treatment, drugs, care, assistive devices, home modifications, and research. In addition, decreased productivity and absence from work as a result of RMDs contributes significantly to these costs
World Arthritis Day
Rheumatoid and musculoskeletal diseases (RMDs)

RMDs are commonly classified into inflammatory and non-inflammatory types:

Common non-inflammatory RMDs consist of degenerative spine diseases, osteoarthritis, osteoporosis and fibromyalgia.

Common inflammatory RMDs consist of rheumatoid arthritis, ankylosing spondylitis, reactive arthritis, connective tissue diseases and polymyalgia rheumatica.

Facts and figures

In the industrialised world, RMDs affect more individuals than any other disease group

RMDs affect both men and women of all ages, including children and babies. However, some RMDs are more common among certain populations. For example, rheumatoid arthritis, scleroderma, fibromyalgia, and lupus predominantly affect women. Spondyloarthropathies and gout are more common in men

RMDs are the biggest cause of sick leave and premature retirement worldwide.

RMDs have a huge economic burden on global healthcare systems. The costs are associated with diagnosis, treatment, drugs, care, assistive devices, home modifications, and research. In addition, decreased productivity and absence from work as a result of RMDs contributes significantly to these costs

If left untreated, some RMDs may reduce life expectancy

Causes, symptoms and

 diagnosis

In some cases, RMDs can be hereditary however a family history of RMDs does not mean you will inevitably get an RMD. RMDs can also be triggered by lifestyle factors such as smoking, excessive weight, sedentary lifestyles, increasing age and having occupations that lead to injury and overuse of joints/muscles, however in some cases the causes are unknown.

Knowing the symptoms and talking to your healthcare professional is the first step in managing any disease. RMDs are associated with a wide range of symptoms, including:

Inflammation indicated by joint swelling, stiffness, redness, and/or warmth

Persistent muscle and joint pain

Tenderness

Extreme fatigue, lack of energy, weakness, or a feeling of malaise

Stiffness and restricted range in movement or flexibility

Joint deformity

Symptoms affecting the internal organs

Invisible symptoms e.g. depression and anxiety

Quick action upon presentation of RMD symptoms is vital and symptoms should be assessed by a physician, preferably a specialist rheumatologist, as early as possible to access appropriate treatment. Early medical treatment of inflammatory RMDs, particularly in the first 12 weeks, can prevent joint and organ damage, improve long-term function, and increase the likelihood of achieving disease remission. Treatment choices should be made in partnership between the healthcare professional and patient, in consultation with the EULAR T2T guidelines and adapted according to individual need.

Treating and managing RMDs

Treatment for RMDs typically focuses on managing the condition to ensure the best possible quality of life. There is no single medication or treatment that works for everyone. However, there are treatments, including medication, that help manage pain and control RMD symptoms. Clinical remission, where the symptoms appear to cease, is increasingly being made possible. Physiotherapy is often advised to reduce the symptoms of certain RMDs.

The prevalence of clinical anxiety and depression in those with RMDs is about twice that seen in the general population – therefore psychological support may also be required.

Self-management is a key part of managing RMDs and can be life-changing. For people with RMDs, self-management means taking control of living with an RMD, encouraging an attitude whereby they accept the condition affects them but does not control them. This management skill is identified as being crucial for emotional and physical wellbeing. This technique, combined with support from local patient groups and organisations can help people manage their RMD.

Tips for living with RMDs

Healthy lifestyle tips for people with RMDs:

Healthy living

Living with a rheumatic and musculoskeletal disease (RMD) can be difficult at times. Take a look at our tips for guidance on how to improve your wellbeing.

Emotional wellbeing

Living with the pain and challenges of a rheumatic and musculoskeletal disease (RMD) can sometimes have a profound psychological, as well as physical, impact on everyday life. It's just as important to consider you emotional wellbeing, as it is your physical wellbeing.

Top tips to manage your

wellbeing:

Keep a diary to note your physical symptoms. Not only could this help with your medical consultations, it may be useful to log your emotions if you find it hard to talk to others about your condition.

Focus on what you can do and what is good in your life, rather than what you can't do.

Talk to someone, whether it be friends, family or others with RMDs. There are plenty of patient support groups you could join to talk through your feelings.

Some people find meditation, visualisation and relaxation techniques helpful.

Physical activity and eating well can raise your spirits and keep you healthy.

Self-management and motivation

Self-managing your rheumatic and musculoskeletal disease (RMD) can have a positive impact on your emotional and physical wellbeing. Alongside support from your healthcare professionals, local patient groups and organisations, you can take action to help manage your RMD.

Top tips for self-managing RMDs:

Check online to see if there are any self-management courses in your area.

Set goals to keep you motivated, for example, attend a yoga class to reduce stress.

Create an action plan towards achieving your goal. Ideally this should include: what, when, where and how often.

Your healthcare team, patient organisations, and family and friends are there to motivate you and encourage you to achieve your goals.

Lifestyle choices

Making healthy lifestyle choices can make a difference to your quality of life when you have a rheumatic and musculoskeletal disease (RMD). Healthy lifestyle choices can help reduce the risk of developing some RMDs. If you are unsure about the best lifestyle choices, make sure you speak to your healthcare professional.

Top tips for making healthy lifestyle choices:

For people with RMDs, smoking can affect the immune system and even increase the amount of pain you feel. There is a vast body of evidence on the dangers of smoking and people with rheumatoid arthritis (RA) are at a higher risk of developing lung cancer and cardiovascular disease.

Stress can alter our behaviour, affect sleep patterns, change our appetite and make us unwilling to communicate with others.

Some of the physical symptoms, such as muscle tension, can also make the pain of RMDs worse. You can use relaxation techniques to help manage stress, along with steps, such as improving your diet and getting more sleep.

RMDs can affect the way you sleep but it is important to get enough quality sleep to protect your mental and physical wellbeing and quality of life.

Drinking too much alcohol or drinking alcohol when taking certain medications can be detrimental to your health. It can affect your balance and increase your risk of falling.

Healthy eating

Eating a healthy and balanced diet is really important for people with rheumatic and musculoskeletal diseases (RMDs).

Some foods can react with medications. Your doctor or nurse will advise you, but you should also always read the “Product Information Leaflet” before taking any medication.

If you have any specific dietary concerns, please talk to your doctor or a medically qualified dietician or nutritionist.

Salt and sugar

Top tips to control your salt and sugar intake:

Try to reduce your levels of sugar as it is high in calories. Watch out for sugar in soft drinks, cereals, ready meals and so on, as well as in confectionery foods. Salt should be limited to 5-6g a day for adults. Too much salt can cause high blood pressure, an increased risk of heart disease and osteoporosis.

Food groups

Be informed about the different food groups and how they form part of a balanced diet.

Carbohydrates provide energy and play a role in the immune system. Sources include:

Breads

Cereals

Rice

Bulgur

Potatoes

Protein essential for growth and repair. Sources include:

Meat

Fish

Poultry

Eggs

Nuts and pulses

Milk and dairy

Fat provides energy and helps absorb some vitamins. Sources of healthy fats include:

Olive oil, rapeseed oil and flaxseed oil

Nuts and seeds

Avocado

Fish

Vitamins and minerals play a major part in ensuring healthy bodily functions. Sources include:

Meat

Fish

Poultry

Eggs

Nuts and pulses

Fruit and vegetables

Milk and dairy products

Fibre fibre is important for bowel function. Sources include:

Fruit

Vegetables

Physical activity and fitness

Being physically active is good for your general health and can have specific benefits for people with rheumatic and musculoskeletal diseases (RMDs).

The most appropriate form of activity will depend on a number of factors, including the type of RMD you have, which joints and muscles are affected and the level of joint and muscle damage. Therefore, it is important to consult your doctor or physiotherapist about the type of exercise most appropriate for your condition.

Cycling

Dancing

Walking

Home and garden

Home gym

Swimming and water exercises

Tai chi, qigong, yoga and pilate.

 

 

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Editor : M. Shamsur Rahman

Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

Editor : M. Shamsur Rahman
Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

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