Does Exercise Help Palindromic Rheumatism?

Palindromic rheumatism or palindromic arthritis is a rare inflammatory condition that is characterized by flare-ups that begin in one joint but may spread to others before finally subsiding. Palindromic rheumatism affects both men and women equally and typically develops between the ages of 20-50.

Because the condition is so rare, little research is available on palindromic rheumatism. Studies have reported that during episodes of palindromic rheumatism, inflammatory cells move into the joint lining, causing the characteristic redness and swelling in the affected area. It is unknown what causes this reaction, although genetic factors have been suggested. Other possible causes include infection, hormonal imbalances, and even trauma.

Some research has reported a link between skin allergies and palindromic rheumatism, but more studies are needed to determine if allergic reactions are a direct cause.

Symptoms of palindromic rheumatism may include:

• Warm, tender joints
• Inflamed, painful tendons
• Red skin over areas around the joint
• Fatigue
• Nodules under the skin near affected joints
• General malaise
• Mild fever
• Recurring attacks of joint swelling, pain, and stiffness that develop suddenly and can last from a few hours to days

Symptoms can occur in one joint or multiple joints. Palindromic rheumatism most commonly affects the joints in the fingers, wrists, or knees. Between attacks, the joints return to normal; days or months may pass between attacks.

Although palindromic rheumatism has no cure, medications, lifestyle changes, and physiotherapy can help relieve pain and inflammation. Your physician may advise you to take:

• Nonsteroidal anti-inflammatory drugs to help relieve pain and inflammation
• Corticosteroids (oral or injected) to relieve inflammation
• Disease-modifying antirheumatic drugs such as methotrexate, hydroxychloroquine, and colchicine, which may reduce the frequency of attacks.

Lifestyle changes can also help you manage symptoms:

• Eat a well-balanced diet.
• Get plenty of rest.
• Exercise. When you have an episode of palindromic rheumatism, reduce physical activity if your condition gets worse. You can increase your physical activity when the episode has ended.

Palindromic rheumatism has a mixed prognosis; one-third of patients experience remission, one-third experience recurrence, and one-third progress to rheumatoid arthritis.