Rheumatism is not a disease of the elderly

"Exercise, meat and alcohol are poison for people with rheumatic diseases" - these and other statements are heard again and again. But which of them are true? A fact check.

- "Only old people are affected"

An old woman with bent fingers, a senior citizen in a stooped position - this is how many people imagine rheumatism. "Thanks to major medical advances over the last 25 years, such severe clinical pictures are rarely seen," says Stephan Gadola, rheumatologist and President of the Rheumaliga beider Basel. But rheumatism knows no age limits: "There are also young people with rheumatism - it can even affect small children," says Gadola. Rheumatism is often equated with arthritis, arthrosis or soft tissue pain. "Today, we know of around 400 rheumatological diseases," says Gadola. These include, for example, gout, osteoporosis, lupus and fibromyalgia. A rough distinction is made between inflammatory rheumatism (e.g. arthritis), wear and tear (osteoarthritis), bone, muscle, disc and tendon diseases (e.g. osteoporosis) and chronic back pain. "In total, around 2 million people in Switzerland are affected, one in four disability pensions is associated with a rheumatic disease, and the medical costs per year amount to 23 billion Swiss francs," says Anita Oswald, Managing Director of the Rheumaliga beider Basel.

- "Anyone with rheumatism should take it easy on their body"

This advice was actually given to sufferers in the past. However, the exact opposite is often the case: "Active exercise is a central part of treatment for the vast majority of non-inflammatory rheumatic diseases. In general, you can exercise to the pain threshold with controlled training in non-inflammatory forms," says Stephan Gadola. Joints with osteoarthritis should also be moved, as otherwise the joint capsule shrinks and affected tendons and muscles shorten. "Even people with bone fractures due to osteoporosis should continue to be active," says the rheumatologist. Strength building and balance exercises are also very effective as a preventative measure.

- "Rheumatism is caused by damp weather"

The statement contains a kernel of truth: "Joints react to changes in air pressure. Low-pressure areas can trigger pain in people with osteoarthritis," says Stephan Gadola. However, it is a myth that damp and wet weather causes rheumatism. "The causes of most inflammatory rheumatic diseases are unknown. In the case of non-inflammatory diseases, it is very often incorrect posture, incorrect strain or genetic factors."

- "If you give up meat, sugar and alcohol, you won't get rheumatism"

"Certain rheumatic diseases are actually dependent on diet. The classic one is gout, which is triggered by uric acid crystals. Uric acid is mainly found in meat and offal," says Gadola. Alcohol also increases the uric acid level. This is why gout used to be considered a disease of affluence. According to the rheumatologist, the role of sugar in relation to rheumatic diseases is less well documented: "However, refined sugar has a toxic effect on body cells and can favour inflammatory processes. It therefore certainly makes sense to limit sugar consumption as much as possible." However, avoiding alcohol, meat and sugar does not protect against most rheumatic diseases. However, a balanced diet has a positive influence on general health and is therefore also important for rheumatic diseases. "Especially in old age, enough protein should be consumed to minimise the age-related breakdown of the muscles. Dairy products and calcium-rich mineral water are also important for maintaining bones," says Gadola.

- "Rheumatism is incurable"

"Gout is curable, and certain chronic back pain and muscle and tendon problems can also be cured. Hip osteoarthritis can be virtually cured with a prosthesis," says Gadola. However, autoimmune rheumatic diseases are still not curable today: "Fortunately, thanks to a wide range of modern medicines, we are able to help most people with these diseases to such an extent that they hardly feel their illness in everyday life." If you compare this with the situation 50 years ago, when many inflammatory rheumatic diseases were fatal, this is a huge step forward.

Article by Dina Sambar published in the Basler Zeitung on 7 August 2024