Rheumatologic conditions
Rheumatic diseases, inflammatory arthritis, connective tissue diseases
Chronic conditionRheumatology covers conditions of the joints, muscles, bones, and connective tissue, and many of them are autoimmune. This overview explains how inflammatory joint pain differs from mechanical pain, and where to read about specific conditions.
What happens
Rheumatologic conditions cause pain, swelling, or stiffness in the joints, muscles, or connective tissue. Some are mechanical, such as osteoarthritis or tendon strain, where pain comes from load and wear. Others are inflammatory, where the immune system attacks joint linings, blood vessels, skin, or organs. These include rheumatoid arthritis, lupus, Sjögren's, scleroderma, polymyalgia rheumatica, ankylosing spondylitis, psoriatic arthritis, mixed connective tissue disease, and dermatomyositis, each covered on its own page. Gout is inflammatory but caused by crystals, not autoimmunity. Telling the types apart matters, because inflammatory conditions can damage joints and organs, and early treatment helps.
Who gets it
Many autoimmune rheumatologic diseases are much more common in women, especially lupus, Sjögren's, rheumatoid arthritis, and scleroderma, often starting between 20 and 50. Polymyalgia rheumatica appears after 50. A family history of autoimmune disease or psoriasis raises the risk.
Common signs
- Morning stiffness lasting longer than 30 to 60 minutes that eases with movement (suggests inflammation)
- Pain that's worse with use and better with rest (suggests a mechanical cause)
- Swollen, warm joints, especially small joints of the hands or feet on both sides
- Low back pain that started before 45, improves with exercise, and wakes you late at night
- Fatigue, low-grade fevers, or weight loss
- Rashes, sun sensitivity, or mouth sores
- Dry eyes and mouth
- Fingers that turn white or blue in the cold
- Muscle weakness, such as trouble climbing stairs or lifting your arms
Labs to ask about
- CRP and ESR
- ANA, followed by more specific antibodies if positive
- Rheumatoid factor and anti-CCP
- CBC, kidney and liver function, and urinalysis
- CK if you have muscle weakness
- X-rays, ultrasound, or MRI of affected joints, and HLA-B27 for some back pain
How it's usually treated
- Referral to a rheumatologist for inflammatory symptoms
- Disease-modifying medicines such as methotrexate or hydroxychloroquine
- Biologic and targeted medicines
- Short courses of steroids to control flares
- Physical and occupational therapy, and regular exercise
Supportive steps to discuss with your provider
- Keep a symptom log, with photos of swelling or rashes.
- Ask whether your pain pattern looks inflammatory or mechanical.
- Bring your family history of autoimmune disease to your visit.
- Ask about vitamin D and bone health, especially if you take steroids.
- Stay active within your limits. Movement protects joints and muscles.
See a doctor promptly if you have
- Sudden shortness of breath or chest pain: call 911
- Fast-worsening muscle weakness, or trouble swallowing or breathing: go to the emergency room
- A single hot, very swollen joint with fever: get same-day care (possible infection)
- A new headache, scalp tenderness, jaw pain when chewing, or vision changes after 50: get same-day care (possible giant cell arteritis)
- Joint swelling that lasts more than 6 weeks, or stiffness most mornings for over an hour
Related conditions
Rheumatoid arthritis
The immune system attacks the lining of the joints, causing painful swelling that can damage cartilage and bone if untreated.
Learn more →Lupus
A whole-body autoimmune disease that can inflame the skin, joints, kidneys, blood, heart, lungs, and brain.
Learn more →Sjögren's disease
The immune system targets the glands that make tears and saliva, causing lasting dryness. It can also affect joints, nerves, and other organs.
Learn more →Scleroderma
The immune system drives thickening and scarring of the skin, and sometimes internal organs, along with damage to small blood vessels.
Learn more →Polymyalgia rheumatica
An immune-mediated inflammatory condition that causes pain and stiffness in the shoulders, neck, and hips, almost always after age 50.
Learn more →Ankylosing spondylitis
An immune-mediated arthritis that mainly affects the spine and the joints where the spine meets the pelvis, causing back pain and stiffness that improve with movement.
Learn more →Psoriasis & psoriatic arthritis
An immune-mediated condition in which skin cells build up too quickly, forming thick, scaly patches. Up to about 1 in 3 people with psoriasis develop psoriatic arthritis.
Learn more →Mixed connective tissue disease
An overlap condition with features of lupus, scleroderma, and myositis, marked by high levels of an antibody called anti-U1 RNP.
Learn more →Dermatomyositis & myositis
Autoimmune conditions in which the immune system inflames the muscles, causing weakness. Dermatomyositis also causes a distinctive rash.
Learn more →
Wondering if your symptoms fit a pattern?
Dr. Lesher is a naturopathic doctor who specializes in women's autoimmune and chronic conditions. Since 2020, she has helped more than 900 patients overcome and heal from their conditions.