Rheumatology deals with the conservative, non-surgical treatment of parts of the musculoskeletal system (tendons, muscles, ligaments) other than joints. This speciality of internal medicine covers more than 100 different complex diseases, collectively known as rheumatological diseases, and includes many forms of arthritis, as well as lupus and Sjogren’s syndrome. Rheumatology is derived from the Greek word rheumatism, meaning “that which flows”, and was first used in the 17th century to describe arthritis as a condition that flows throughout the body.
The fields of rheumatology and orthopaedics often overlap. But while orthopaedics uses both physical and surgical interventions as part of its treatment, rheumatology treats with various movement therapies (physiotherapy, physiotherapy). In our specialised clinic, it is also possible to use soft laser (1800 mW Safe laser) for pain and anti-inflammatory treatments, lymphatic drainage, physiotherapy and therapeutic massage.
We use different injection techniques (topical, steroid injections, spinal blockade treatment, collagen therapy, hyaluronic acid joint filler) and kineziotape treatments. Prescription and training in the use of medical devices is possible.
Back pain, from the waist to the neck, is the most common musculoskeletal complaint today. The intensity of the pain may vary from time to time, it may restrict free movement, but it can often radiate to the hips and legs. If the pain radiating to the legs is severe, if there is numbness or weakness in the feet, which may be accompanied by faecal or urinary problems, fever or abdominal pain, you should seek medical advice as soon as possible. Progressive osteoporosis is also associated with pain due to a series of vertebral collapses.
In most cases, sedentary work and a sedentary lifestyle are behind the complaints. However, after lifting a heavy object, the muscles and ligaments in the back may become stretched, while the discs may become slightly compressed due to weakness and fatigue of the supporting muscles. These symptoms and the resulting complaints can be prevented by regular exercise and a sufficiently strong core musculature.
In addition to a physical examination, neurological, imaging or laboratory tests may also be needed to identify the problem. Simple X-rays can show the condition of the bones, bone density scans can show the extent of osteoporosis, while CT or MRI scans can give an accurate picture of the nerves surrounding the spinal column.
If the symptoms are mild and there is evidence of a lesion in the facet joints of the spine or wear and tear of the discs, lifestyle changes, physiotherapy and short-term use of non-steroidal analgesics may be sufficient. However, if a disc protrusion or disc herniation develops, the nerve root or nerve cord exiting the spinal canal is put under pressure. This means that the disc between the vertebrae, which provides the flexibility and pliability of the spine, loses its support and protrudes backwards, possibly tearing the outer fibrous sheath and causing the inner elastic part to come out.
Pressure on the sciatic nerve, known as sciatica, radiates outwards to the nerve supply area and causes sharp pain shooting down the buttocks towards the legs. The pain can vary from mild to excruciating burning, with numbness, pins and needles, loss of sensation, starting mildly and gradually increasing. The pain usually affects one of the lower limbs, following the path of the nerve. In the case of acute, severe spinal pain, it is recommended to spare the spine if possible, and to provide pain relief and reduce inflammation.
In addition to painkillers and anti-inflammatory drugs, the rheumatologist may use muscle relaxant medication, local steroid injections at the site of pain or short infusion treatments called ischial infusions. As the severe pain and inflammation decrease, physical exercise, relaxation and stretching of the affected area, as well as postural exercises and lifestyle changes, will be given priority. If conservative treatment is ineffective, paralysis, faecal dysfunction or urinary retention, surgery may be necessary.
In lymphoedema, the lymphatic system is deficient, causing a leakage of proteinaceous fluid into the space between tissues. This abnormal accumulation between tissues is called aqueous humour or oedema. The lymphatic system performs a sort of cleansing, filtering function, which is very important in the fight against pathogens and in the functioning of the immune system.
The lymphatic system consists of blood vessels and lymph nodes. The lymphatic vessels run partly in parallel with the venous system and partly independently of it. Lymphatic fluid, also known as lymph, is produced when the entire volume of fluid carried to the organs by the arteries cannot be returned by the reflux system, so the residue is returned to the collecting arteries through the lymphatic capillaries by the lymphatic circulation.
Before the lymph flows into the venous system, it passes through a series of lymph nodes, which act as tiny filters to cleanse the lymph of cells and other components that our body does not need or that could be harmful to us. Since the lymphatic vessels flow into the collecting ducts, a deficiency in the lymphatic system may also be related to a deficiency in the venous system, because if the venous circulation is inadequate, the lymph cannot flow into the veins but stagnates in the lymphatic vessels. Treatment is always complex and involves a combination of several methods! One of these is the use of elastic bandages or stockings on the affected limb, prescribed by the doctor and made to measure and tailored to the individual. This is complemented by a special massage, called lymphatic drainage, which can be performed by a trained professional, either manually or with a special machine. In addition, special exercises carried out with the help of a physiotherapist and, if necessary, the use of drugs to improve venous circulation may also form part of the therapy.
