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I n Italy, rheumatic diseases are the second most frequent cause of morbidity among all affections, after those involving the cardiovascular system, and the first in chronic-degenerative diseases (1). Their prevalence in adult population is 26.7% (2). Rheumatic illnesses differ greatly in their etiology, severity and disease course. However, they all cause significant disability in daily activity and in a socioeconomic context, including the work place. The recent social report on Rheumatoid Arthritis presented by the Censis Foundation , the Italian Society of Rheumatology and the National Association for Rheumatic Illnesses showed significant daily disability in domestic activities in around half of the patients with Rheumatoid Arthritis , and a notable change in the working life of the 22.7% of those interviewed, even resulting in giving up work (3). Many reports have shown the huge impact of rheumatic illnesses (chronic inflamma-tory rheumatisms, fibromyalgia, chronic back pain, osteoarthritis, connective tissue diseases, etc.) on work disability, and the consequent social costs. A survey carried out by the health monitoring service (Osservatorio Sanità e Salute , 2008) reported that, in Italy, total social and health care costs related to chronic rheumatic illnesses amount to over 4 billion euro a year (4). According to the rehabilitation program set out by the Italian Ministry of Health in 2011 (5), patients with rheumatic illnesses can be defined as highly complex cases, as they are affected with chronic diseases, which are often associated with impaired systemic functionality, comorbidity and complications. Thus, rheumatologic rehabilitation is necessary and complex. However, even today, the concept of rheu-matologic rehabilitation is little known and even less applied. This is in stark contrast to the rehabilitation practices in other disciplines, such as orthopedics, neurology, cardiology and pneumology, that often treat also rheumatic patients. Although " rheumatisms " have been among the most well known illnesses since ancient times, and Rheuma-tology has been recognized as a distinct discipline for almost a century (the International League Against Rheumatism was founded in 1927), rheumatologic rehabilitation in various countries, including Italy, has not been identified as a distinct and priority discipline. Cause and effects of this situation are the following: few recommendations and guidelines are available, that, moreover, differ widely in their approach to the rehabilitation of rheumatic patients; ran-domized and controlled studies are scarce and it is difficult or even impossible to carry out double blinded studies; many researches lack in methodological rigor, involve only small …

Rheumatologic rehabilitation: the great expectation for millions of rheumatologic patients