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Rheumatological Disorders

Arthritis

Arthritis is characterized by inflammation of one or more joints. Symptoms include joint pain and stiffness and these symptoms generally worsen as you age. There are several different types of arthritis, affecting people in different ways.

 i.        Osteoarthritis / Degenerative Arthritis

Osteoarthritis is the most common form of arthritis and occurs when the cartilage on the ends of the bone wears down over time. The most commonly affected parts of the body are the hips, hands, neck, lower back, and knees. Symptoms include pain, stiffness, loss of flexibility, and bone spurs, among others. Osteoarthritis is a degenerative disease, and people find that as their condition worsens, they are less able to perform activities that they used to be able to do with ease. The pain can often be unbearable and make it nearly impossible to sit, stand, or walk for any length of time.

ii.        Scapholunate Advanced Collapse (SAC)

Scapholunate advanced collapse (SLAC) refers to a pattern of wrist malalignment that has been attributed to post-traumatic or spontaneous osteoarthritis of the wrist. It is a complication that can occur with undiagnosed or untreated scapholunate dissociation.

https://radiopaedia.org/articles/scapholunate-advanced-collapse

iii.        Psoriatic Arthritis

Psoriatic arthritis affects people who have psoriasis – a skin condition that exhibits itself with red, itchy patches. The main symptoms of psoriatic arthritis are joint pain, swelling, and stiffness. These symptoms can sometimes occur before the appearance of the skin condition. The symptoms can affect any part of your body – including your fingertips and spine. There is no cure for psoriatic arthritis, so treatment tends to run towards management of the symptoms. People with psoriatic arthritis demonstrate the same disabling factors as people with osteoarthritis and rheumatoid arthritis. These symptoms can make it extremely difficult for people to function in the workplace on a consistent, reliable basis.

iv.        Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disorder. This means the immune system attacks its own tissues. Rheumatoid arthritis typically involves the small joints in your hands and feet and affects the lining of your joints. Sufferers of rheumatoid arthritis typically experience swelling in the afflicted joints, along with stiffness, and pain. These symptoms can result in joint deformity. In addition to painful joints, rheumatoid arthritis can also cause fevers and fatigue. Repetitive movements can cause inflammation in the hands and wrists, making it difficult to do everyday activities. If the lower extremity joints are involved, one may have a very difficult time standing and walking due to pain and swelling.

Arthritis, Mayo Clinic (Mar. 7, 2018), https://www.mayoclinic.org/diseases-conditions/arthritis/symptoms-causes/syc-20350772

Fibromyalgia

Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues.  Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain processes pain signals.  Symptoms sometimes begin after a physical trauma, surgery, infection or significant psychological stress.  In other cases, symptoms gradually accumulate over time with no single triggering event.  Women are much more likely to develop fibromyalgia than are men.  Many people who have fibromyalgia also have tension headaches, temporomandibular joint (TMJ) disorders, irritable bowel syndrome, anxiety and depression…The pain associated with fibromyalgia often is described as a constant dull ache, typically arising from muscles.  To be considered widespread, the pain must occur on both sides of your body and above and below your waist.  Fibromyalgia is characterized by additional pain when firm pressure is applied to specific areas of your body, called tender points.  Tender point locations include: back of the head; between shoulder blades; top of shoulders; front sides of neck; upper chest; out elbows; upper hips; sides of hips; and inner knees.

Unfortunately, it is unknown what causes fibromyalgia, although several factors are considered, including weight, gender, age, and genetics. We often see insurance companies deny claims because of fibromyalgia, citing a lack of objective evidence.

While objective evidence generally does not exist in these cases, our office has multiple arguments against the insurance company’s insistence on objective evidence to grant benefits.

Fibromyalgia, Mayo Clinic (Aug. 11, 2017), https://www.mayoclinic.org/diseases-conditions/fibromyalgia/symptoms-causes/syc-20354780.

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