Still’s disease is one of the rare autoimmune diseases that can be physically and emotionally debilitating. The symptoms often begin suddenly with fever, joint pain and a fleeting skin rash. At first it seems like a harmless infection, but if the symptoms keep recurring or do not subside, there is often more to it. For many sufferers, the path to a correct diagnosis is long and exhausting.
At the Nuhr Medical Center, we take a lot of time for people with rare inflammatory rheumatic diseases such as Still’s disease. We offer comprehensive care that combines modern medical treatment with targeted exercise therapy, naturopathic procedures and psychological support.
What is Still’s disease?
Still’s disease is a rare inflammatory disease in which the immune system reacts incorrectly and triggers severe inflammation in the body. It can occur in both children (systemic juvenile idiopathic arthritis) and adults. The adult form, also known as adult-onset Still’s disease, usually manifests itself in young to middle adulthood. Typical symptoms include high, recurrent fever, migratory joint pain and a salmon-colored rash that is often only temporarily visible.
What forms of Still’s disease are there?
A distinction is made between the juvenile form, which begins in childhood, and the adult form. Both variants show similar symptoms. The course of the disease varies greatly from person to person. Some only experience single episodes, others develop chronic joint inflammation that can cause long-term damage.
What are the causes of Still’s disease?
The exact cause is not yet known. A faulty reaction of the immune system to internal or external stimuli is suspected. Genetic factors could also play a role. The disease often occurs suddenly, sometimes after an infection, without a clear description of the trigger being possible.
What are the symptoms of Still’s disease?
Still’s disease usually begins with a sudden onset of high fever, which often occurs in the evening and reaches temperatures of up to 40 degrees. The fever often comes in bouts over several days or weeks. A salmon-colored skin rash is typical, which is usually not itchy and is mainly visible on the trunk, arms or legs. Joint pain is also one of the most common symptoms. The wrists, knees, elbows and ankles are particularly affected. Many sufferers also report muscle pain, sore throat, swollen lymph nodes or an enlarged liver and spleen.
In some cases, Still’s disease can also affect internal organs. These include inflammation of the pericardium, the lungs or, in very rare cases, the meninges. The disease is characterized by its relapsing course. Some people only experience a few relapses with longer symptom-free phases, while others develop a chronic course with permanent joint involvement.
How is Still’s disease diagnosed?
Diagnosis is often not easy because many symptoms also occur in other diseases. Still’s disease is therefore usually diagnosed as a so-called diagnosis of exclusion. This means that other possible causes such as lupus, sepsis or leukemia must first be ruled out. A thorough physical examination and specific blood tests are important here.
Typical laboratory findings are greatly increased inflammatory values such as CRP and erythrocyte sedimentation rate, an increased number of white blood cells, reduced haemoglobin values and increased liver values. The significantly increased ferritin value is particularly striking, an indication of the activity of the inflammation. Rheumatoid factor and antinuclear antibodies (ANA) are generally not detectable in Still’s disease.
The earlier the disease is detected, the better it can be treated.
How is Still’s disease treated?
The treatment of Still’s disease depends on the severity of the symptoms and the individual course of the disease. In milder cases, anti-inflammatory drugs such as non-steroidal anti-inflammatory drugs (NSAIDs) often help to relieve fever and joint pain. If the inflammation is more pronounced or internal organs are affected, stronger medication is required.
Cortisone preparations are used when acute inflammation needs to be contained quickly. Immunosuppressants such as methotrexate are often used to regulate the dysregulated immune system in the event of a prolonged or recurring course. In more severe cases, modern biologics are available, such as anakinra or tocilizumab. These active substances intervene specifically in the inflammatory processes and make it possible to reduce the cortisone dose and avoid side effects.
Holistic therapy at the Nuhr Medical Center
Still’s disease often affects the joints, and this is precisely where exercise therapy comes in. Gentle, targeted exercise can relieve pain, improve joint function and positively influence inflammatory processes. At the Nuhr Medical Center, our therapists develop individual training programs based on your current state of health. A good balance is important here: overloading should be avoided, but regular exercise keeps the body active and flexible.
Physiotherapy
Physiotherapy helps to relieve tension, build up muscles and improve joint stability. Gentle mobilization exercises, manual techniques and special applications, such as heat treatments or electrotherapy, are combined individually. The aim is to reduce pain, calm inflammation and make everyday movements easier again. Accompanying physiotherapy is an important part of treatment, particularly in the case of recurring episodes or longer-lasting complaints.
Occupational therapy
For many sufferers, Still’s disease also affects their independence in everyday life. This is exactly where occupational therapy provides support: when getting dressed, cooking, writing or using aids. Our occupational therapists will help you to make movements that are easy on the joints and to regain as much function as possible with as little effort as possible. The correct use of supports, splints or gripping aids can also bring great relief.
Support for body and mind
In addition to physical activity, mental health also plays a major role. Chronic illnesses such as Still’s disease often cause frustration, insecurity or exhaustion. At the Nuhr Medical Center, we offer psychological support to develop strategies for dealing with these challenges. Breathing techniques, relaxation exercises or accompanying conversations help to recharge your batteries.
Nutrition and regeneration
An anti-inflammatory diet can provide useful support for treatment. Our nutrition experts will advise you on a balanced diet with plenty of vegetables, high-quality fats and little sugar. In addition, at the Nuhr Medical Center we rely on naturopathic measures and targeted regeneration therapies to bring the body and immune system back into balance.
What can those affected do themselves?
Even though Still’s disease is a rare and serious illness, its course can be positively influenced by your own lifestyle. Regular check-ups are particularly important in order to detect relapses at an early stage and adjust the therapy on an ongoing basis.
Exercise is also part of this. Activities that are easy on the joints, such as swimming or cycling, keep the body moving, promote blood circulation and help to strengthen the muscles. A balanced, anti-inflammatory diet is also recommended. Plenty of vegetables, omega-3-rich foods such as fish or linseed oil and a diet that is as natural as possible support the treatment in a natural way.
Last but not least, dealing with stress also plays a major role. Relaxation exercises, yoga or accompanying discussions with a psychologist help to strengthen mental balance, especially during stressful phases of the illness.
What is the prognosis for Still’s disease?
The course of the disease varies greatly from person to person. Some only experience a single flare-up that heals without permanent damage. Others have recurring inflammatory phases in the course of their lives. However, the most common is a chronic course with persistent joint involvement. In these cases, permanent movement restrictions can occur without treatment.
Even if a complete cure is currently not possible, there are many good ways to control the disease. Modern medication, early diagnosis and a well-coordinated treatment plan can help to significantly alleviate symptoms and improve quality of life in the long term.
How do you live with Still’s disease?
Still’s disease can place a heavy burden on everyday life, both physically and emotionally. Pain, fatigue, insecurity and recurring flare-ups often make work, family and leisure activities difficult. Many sufferers report exhaustion, social withdrawal or the feeling of being alone with the disease.
At the Nuhr Medical Center, we support people with Still’s disease not only medically, but also personally. We take our time, listen and work with you to develop a way to live well with the disease. The aim is not only to be as symptom-free as possible, but also to give you increased self-confidence, new mobility and a feeling of security. Because living with Still’s disease does not mean having to give up the joy of life, but rediscovering it in a new way.
Treatment & Therapy
Different forms of rheumatism also require different treatment methods. Essentially, however, they all aim to alleviate the pain, limit joint destruction and maintain the function of the joint. In addition to pain-relieving medication, exercise is the basis of any rheumatism therapy, for example in the form of remedial gymnastics. Thermotherapy and electrotherapy can also be helpful.
