Although pain is the most common symptom of rheumatic diseases, more than half of patients do not suffer from arthritis or other connective tissue disease. This is why it is important to evaluate the pain usually caused by soft tissue rheumatism, determine its causes and assess its severity.
According to the World Health Organization (WHO), the most common disorders in the category of soft tissue rheumatism are fibromyalgia, tendinitis, tenosynovitis and bursitis, polymyalgia rheumatica and shoulder and hand syndrome. Soft tissue rheumatism can also cause low back pain.
A clinical characteristic of Fibromyalgia is the presence of triggering sensitive points in the periarticular muscles, sometimes associated with palpable nodules. In most of the studies it has been proven that these trigger points have not been reproduced by different examiners.
The nodules can be detected by different examiners. In general, pain in fibromyalgia does not respond satisfactorily to analgesics and anti-inflammatories.
Tendinitis, tenosynovitis and bursitis
Pain and limitation of movement are the main characteristics of tendonitis, tenosynovitis and bursitis. These disorders are caused by an infection or may be associated with systemic inflammatory disorders of the connective tissue, such as SLE and systemic sclerosis.
For the most part they occur as isolated events, sometimes related to specific trauma or occupational risks involving repetitive movements. The most common sites are the shoulder, elbow, wrist and hand, hip, knee and foot.
Polymyalgia rheumatica causes frequently severe muscle pain around the shoulder and at the pelvic girdle. It is related to age and appears almost exclusively from fifty-five years of age and older. It affects both sexes equally. A prominent symptom is morning stiffness.
In the biopsies of the temporal artery it has been found that around 30% of the patients with polymyalgia rheumatica evidence giant cell arteritis. The latter disorder can cause sudden and irreversible blindness and brain symptoms. However, in general only between 5% and 10% of these patients present clinical symptoms due to arteritis.
Shoulder and hand syndrome
Diffuse and usually painful swelling of the hand follows muscular atrophy, poor circulation and contractures. In most cases there is no apparent cause. However, some cases are associated with preceding disorders, such as myocardial infarction, extreme trauma, cervical spondylosis or bronchial carcinoma.
This entity appears to be a neurovascular disorder that can be resolved as underlying medical problems improve.
How is Hyperbaric Oxygenation Treatment applied?
The action of hyperbaric oxygen dilutes high doses of O2 in the blood plasma that are rapidly used by the cells and reach tissues where the perfusion is compromised. This achieves greater efficiency in the desinflammatory process and the regeneration of tissues in rheumatic diseases.
HBOT produces the following beneficial physiological effects for patients with rheumatologic diseases:
-Vasoconstriction: increasing the availability of oxygen reduces edema and inflammation.
-Osteogenesis: the abundant availability of oxygen in blood stimulates the differentiation of the bone-forming cells; this favors osteogenesis and bone repair.
-It regulates oxidative stress: hyperoxia stimulates the action of antioxidant enzymes and regulates the production of reactive oxygen species (ROS).
-Cellular immunity: improves the immune response and the bactericidal effect of white blood cells.
World Health Organization, Rheumatic Diseases, 1992.
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