Soft tissue rheumatism (STR) refers to pain, swelling, or inflammation that affects the muscles, tendons, bursae, and ligaments around joints, but not the joints themselves.
Mnemonic: "S.T.R. = Soft
Tissue Rheumatism (Sore Tendons & Regions)"
TYPES OF SOFT TISSUE RHEUMATISM
1. Localized (Regional) Pain Syndromes
- Affects a Specific Joint or Structure → Shoulder, Elbow, Wrist, Hip, Knee, Foot.
- Examples: Bursitis, Tendinitis, Epicondylitis, Fasciitis.
2. Diffuse Pain Syndrome
- Affects Multiple Areas, Chronic Pain → Fibromyalgia, Myofascial Pain Syndrome.
Mnemonic: "L.D. =
Localized, Diffuse Pain"
DISORDERS OF DIFFERENT BODY
REGIONS
1. SHOULDER REGION
(A) Rotator Cuff Disorders
(Impingement Syndrome)
Common Cause: Overuse,
Trauma, Aging.
Symptoms: Pain on active
abduction (lifting arm), difficulty in overhead activities.
Tests:
- Empty Can Test (Jobe’s Test) → Pain on lifting arm in 90° with thumb down.
- Neer’s Test → Pain in full forward flexion (Impingement Sign).
Mnemonic: "R.O.T.A. =
Rotator Cuff, Overuse, Tests (Jobe/Neer), Abduction Pain"
(B) Bicipital Tendinitis
Cause: Chronic Impingement
of Biceps Tendon.
Symptoms: Pain in front of
shoulder, worse with overhead movements.
Test:
- Resisted Supination Test (Pain on rotating palm upward with elbow flexed).
Mnemonic: "B.I.C.E.P. =
Biceps Inflammation Causes Elbow Pain"
(C) Frozen Shoulder (Adhesive
Capsulitis)
Cause: Immobilization,
Diabetes, Hypothyroidism.
Symptoms: Stiffness, Pain,
Limited Shoulder Movement.
Stages:
1. Freezing Phase (Severe Pain, ↓ ROM)
2. Frozen Phase (Stiffness, ↓ Pain)
3. Thawing Phase (Slow Recovery of Movement)
Treatment: Physiotherapy, NSAIDs,
Steroid Injection.
Mnemonic: "F.R.O.Z.E.N. =
Frozen, Restricted, Overuse, Zero Mobility, Extreme Pain, Non-Use"
2. ELBOW REGION
(A) Tennis Elbow (Lateral
Epicondylitis)
Cause: Overuse of Extensor
Tendons (Repetitive Hand Movements).
Symptoms: Pain over lateral
elbow, worse with grip, lifting.
Test:
- Cozen’s Test (Pain on resisted wrist dorsiflexion).
Mnemonic: "T.E.N.N.I.S. =
Tendonitis, Extensor Pain, Non-stop Use, NSAIDs, Injections,
Strengthening"
(B) Golfer’s Elbow (Medial
Epicondylitis)
Cause: Overuse of Flexor
Tendons.
Symptoms: Pain over medial
elbow, worse with wrist flexion.
Treatment: Same as Tennis Elbow.
Mnemonic: "G.O.L.F. =
Grip Overuse Leads to Flexor Pain"
(C) Olecranon Bursitis (Student’s
Elbow)
Cause: Repetitive Trauma,
Infection, Gout, RA.
Symptoms: Swelling &
Tenderness over Elbow Tip.
Treatment: NSAIDs, Aspiration,
Steroid Injection.
Mnemonic: "S.T.U.D.E.N.T.
= Swelling, Trauma, Uric Acid, Drain, Elbow, NSAIDs, Tenderness"
3. WRIST & HAND REGION
(A) De Quervain’s Tenosynovitis
Cause: Repetitive Thumb
Movements.
Symptoms: Pain along thumb
base & wrist.
Test:
- Finkelstein’s Test (Pain on ulnar deviation with thumb inside fist).
Mnemonic: "D.Q.T. = De
Quervain’s, Quick Thumb Pain, Test (Finkelstein’s)"
(B) Trigger Finger (Stenosing
Tenosynovitis)
Cause: Thickening of
Finger Tendon Sheath.
Symptoms: Finger Clicking,
Locking, Painful Movement.
Treatment: NSAIDs, Splinting,
Steroid Injection.
Mnemonic: "T.R.I.G.G.E.R.
= Thickened Tendon, Restricted Movement, Injections, Gripping Pain, Gradual
Onset, Early Stiffness, Relief with NSAIDs"
4. KNEE REGION
(A) Prepatellar Bursitis
("Housemaid’s Knee")
Cause: Repetitive
Kneeling, Trauma.
Symptoms: Pain, Swelling in front
of the kneecap.
Treatment: Rest, NSAIDs,
Aspiration.
Mnemonic: "H.O.U.S.E. =
Housemaid’s Knee, Overuse, Unusual Swelling, Soft Tissue, Exertion"
(B) Iliotibial Band Syndrome
(Runner’s Knee)
Cause: Repetitive Running,
Cycling.
Symptoms: Pain over lateral
knee, worse with flexion.
Treatment: Rest, Ice, NSAIDs,
Stretching.
Mnemonic: "R.U.N. =
Running, Unilateral Pain, NSAIDs"
5. FOOT REGION
(A) Plantar Fasciitis
Cause: Repetitive Stress,
Flat Feet, Hard Shoes.
Symptoms: Heel Pain (Worse in
Morning).
Treatment: Soft Footwear, NSAIDs,
Stretching.
Mnemonic: "P.L.A.N.T.A.R.
= Painful Heel, Long Standing, Arch Support Needed, NSAIDs, Therapy, Avoid
Running"
HOMOEOPATHIC MANAGEMENT OF SOFT
TISSUE RHEUMATISM
- For General Muscle & Tendon Pain:
- Rhus Tox, Bryonia, Arnica, Ruta.
- For Bursitis & Tendinitis:
- Silicea, Ledum Pal, Calc Fluor.
- For Nerve Pain & Entrapment:
- Hypericum, Kali Phos, Causticum.
Mnemonic: "R.B.A.R. =
Rhus Tox, Bryonia, Arnica, Ruta for Muscle Pain"
FINAL REVISION WITH MNEMONICS
- Definition = "S.T.R. = Soft Tissue Rheumatism (Sore Tendons & Regions)"
- Types = "L.D." (Localized, Diffuse Pain)
- Shoulder = "R.O.T.A." (Rotator Cuff, Overuse, Tests, Abduction Pain)
- Elbow = "T.E.N.N.I.S. & G.O.L.F."
- Wrist = "D.Q.T." (De Quervain’s, Quick Thumb Pain, Test)
- Knee = "H.O.U.S.E." (Housemaid’s Knee, Overuse, Swelling, Exertion)
- Foot = "P.L.A.N.T.A.R." (Painful Heel, Long Standing, Arch Support Needed)
- Homeopathy = "R.B.A.R." (Rhus Tox, Bryonia, Arnica, Ruta)
