• regional - bursitis and tendinitis
• generalised - fibromyalgia

Bursitis and tendinitis is the inflammation of the bursa and tendon. (Bursae are small sacs found between the bone and muscle tendon. Tendons are thick fibrous cords that join muscle to bone.) Fibromyalgia is the generalised aching, stiffness and fatigue of the muscles and soft tissues with multiple painful spots in specific muscle area. There is no inflammation of the muscles.

Who Gets Soft Tissue Rheumatism?

Bursitis and tendinitis affect men and women of all age groups whereas fibromyalgia affects more women than men and most are between the ages of 20 and 40.

What is the Cause of Soft Tissue Rheumatism?

The most common cause of bursitis and tendinitis is overuse of affected area during daily activities. Bursitis and tendinitis especially occur in people with bad postures or those who use the affected area in a strenuous positions. Sometimes, the bursa or tendon sheath may become infected. Tendinitis or bursitis may occasionally be associated with diseases like gout and rheumatoid arthritis.

As for fibromyalgia, the cause is unknown. Some believe that fibromyalgia is related to disruptive sleep patterns. Factors that contribute to the development and continuation of symptoms include stress and immune disorders.

What Happens in Soft Tissue Rheumatism?

When there is inflammation of the bursa and tendon, there is pain and stiffness near the joints which may be mistaken for arthritis. The pain is more prominent at night and local swelling can occur. Movements will worsen the symptoms. The bursa and tendon most affected are located around the shoulder, elbow, wrist, hip, knee, ankle and feet. The inflammation is usually temporary but can recur again.

In fibromyalgia, the muscles become too tight and tense. These leads to multiple painful areas like the back of the neck, shoulder and the bony points of the elbows and hips. Some people have symptoms of irritable bowel syndrome and tension headaches accompanying fibromyalgia.

How to Diagnose Soft Tissue Rheumatism?

There are no abnormal blood test or X-rays in soft tissue rheumatism. Underlying diseases that may present with symptoms of soft tissue rheumatism like rheumatoid arthritis and diabetes must be excluded. The diagnosis of fibromyalgia is based on the presenting features of chronic generalised body aches and painful spots of specific location of the body.

How to Treat Soft Tissue Rheumatism?

For bursitis and tendinitis, physical therapy such as splinting the affected area and heat treatment are helpful. Anti-inflammatory drugs and injection of steroids into the affected areas may be used. To prevent recurrence, proper positioning and adequate warm-up before usage of the affected limbs are beneficial.

There is no known cure for fibromyalgia. But physical treatment with heat, massage, regular stretching and range-of-motion exercises are simple and effective measures. Drugs like tranquilizers, muscle relaxants, anti-depressants and hypnotic agents can also be used. Psychological consultation and support is an important part of the management. Lastly, the painful spots can be relieved by local injection of steroids.