What is soft tissue rheumatism?
The good function of the musculoskeletal system depends on the integrity of its components (bones, muscles and tendons, joints, bursae and ligaments). When one of these components does not work well, this is reflected in pain and difficulty in performing the movements. In the case of Soft Part Rheumatism or Extra-articular Rheumatism (outside the joints), these symptoms result from injury or inflammation of the structures around the joints (muscles, ligaments, bursae, enthesis and tendons), resulting in bursitis, tendonitis , enthesitis and myofascial pain. These inflammations are usually temporary and do not cause deformity, but they can become chronic.
Why do these inflammations occur?
Most of the time, the inflammation / injury of these structures occurs due to local trauma. This trauma may occur as a single, violent accident with immediate injury, or it may be the result of chronic trauma resulting from postural or occupational addictions.
What are bursitis?
Bursae are small pockets with liquid inside, which have the function of protecting muscles and tendons from contact with bone and facilitating the sliding between structures. Bursitis (inflammation of the bursae) can occur in different parts of the body, but the most common are on the elbows, knees, shoulders and hips.
What are tendonitis?
The tendons are an extension of the muscles and their function is to connect them to the bones. Like bursitis, tendonitis (inflammation in the tendons) can also occur in several locations, the most common being on the fingers (especially the thumb), shoulders and buttocks.
What are enthesitis?
Encephalons are places where a ligament or muscle is inserted into the bone, and can also suffer inflammation (enthesitis). The most common sites of enthesitis are the elbows (common in tennis players and golfers), knees and feet (popularly known as heel spurs and usually associated with inflammation also of the plantar fascia – better known as plantar fasciitis).
What is myofascial pain?
Another type of soft tissue rheumatism is myofascial pain. It is characterized by localized pain in any muscle in the body that radiates with local palpation. This condition is usually associated with vicious postures and trauma due to repetitive movements. The most common manifestation is pain in the cervical region above the shoulders.
How can these conditions be diagnosed?
The diagnosis of all these conditions is based on the patient’s history and clinical examination. X-rays exclude bone abnormalities. Tendons, ligaments and bursae are not visible on radiographs, however the use of ultrasound and, more recently, nuclear magnetic resonance have brought a great help in defining the inflamed site and the degree of inflammation of the lesion.
How is the treatment performed?
Treatment is based on rest, anti-inflammatory medication and physical therapy (for stretching and strengthening the muscles of the affected region). Eventually, at discretion of your rheumatologist in Delhi, corticosteroid infiltration can be quite helpful. Surgical intervention in these cases is infrequent.