How to treat advanced rheumatoid arthritis

Can rheumato >

Rheumatoid arthritis is considered a very serious joint disease. Developing, it leads the patient to disability. A very large percentage of the population is affected by this disease. In this article, we will try to understand the various approaches in the treatment of the disease.

The possibility of cure

In order to understand how to cure rumatoid arthritis, and whether it can be done at all, you first need to understand what kind of disease it is. Elderly people are at risk, as joint wear is a natural aging process. But it happens that diseases are exposed to young, strong organisms.

The etiology and pathogenesis of arthritis has not yet been fully studied. Arthritis has many forms. Rheumatoid arthritis, for example, is not just a joint disease. With it, the main protector of our body – the immune system – fails. In the autoimmune reaction that accompanies rheumatoid arthritis, aggressive killer cells that must destroy viruses and neoplasms attack normal, healthy cells in the body.

The disease can occur in several forms.

To prevent the craziness of these cells, scientists spent more than a dozen years in laboratories, doing a lot of clinical research. But so far, it has not yet been possible to achieve absolute victory in the fight against this disease. Interfering with the immune system is a very complex and dangerous action. But doctors do not give up and continue to search.

In many ways, modern medicine has moved forward, which means that you should not give up. It is necessary by all means to continue the inhibition of the progression of rheumatoid arthritis. Today we will tell you more about the most effective methods.

Drug treatment

For many years, doctors have made and continue to make attempts to cure arthritis forever. Means of different techniques were used: folk, physiotherapy, the use of various groups of medicines. Today, leading rheumatologists agree that the best treatment for arthritis is that which takes place in a complex.

Regarding drugs, there are three groups that are prescribed most often: non-steroidal anti-inflammatory drugs, basic drugs, and hormones.

Arthritis therapy should be comprehensive

Naturally, these drugs are not the only ones in treatment, they are also used:

  • agents to improve microcirculation;
  • metabolites;
  • drugs that regulate the viscosity and fluidity of the blood;
  • antioxidants, etc.

Any of these remedies have side effects. It happens, when taking several drugs, and this is how drug therapy for arthritis occurs, the negative effects of drugs accumulate in the body. But do not give up treatment. You just need to consult with your rheumatologist who is treating you and draw up a different treatment plan, as refusing treatment will lead to a fatal development of the disease.

Non-steroidal anti-inflammatory drugs actually always have a place to be when it comes to arthritis. But can rheumatoid arthritis be cured forever with their help? Forever this disease is not cured. But you can achieve a period of remission and keep it.

Regarding NSAIDs in this treatment regimen, the following can be said. Preparations come in two directions: general (non-selective NSAIDs) and selective (selective NSAIDs) actions. Selective will be considered in a separate paragraph below, but for now we will analyze what non-selective are.

Non-selective drugs include anti-inflammatory drugs with a general spectrum of action, such as, for example, Diclofenac. This drug successfully relieves inflammation and inhibits the development of the disease, but its non-selectivity leads to a change in other organs, many of which undergo significant lesions. Often “Diclofenac” changes the properties of blood coagulability, hence the frequent bleeding in the list of side effects. In addition to Diclofenac, non-selective NSAIDs include:

Also, non-selective agents with prolonged use cause ulcers in the stomach and intestines. Therefore, the patient undergoing therapy with non-selective NSAIDs should be under the vigilant supervision of a doctor, regularly passing the necessary tests.

Shishkevich Vladimir, orthopedic and traumatologistShishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.

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Selective NSAIDs

The negative effects of side effects in selective NSAIDs are minimized. The practice of using this type of funds suggests that they have both advantages and disadvantages. Take, for example, Nimesulide. A variety from this group of drugs is well tolerated, having anti-inflammatory and analgesic effects, but it also has a thrombogenic effect, as well as a risk of bronchospasm.

Selective NSAIDs include:

NSAIDs do not cure, but extend the period of remission. What type of this type of drug is right for you, your rheumatologist will decide.

Basic therapy

In addition to NSAIDs, drugs are widely used, which are the basis for the treatment of rheumatoid arthritis. Basic therapy represents a list of drugs that you will use daily until the end of life. Here is some of them:

    Quinoline preparations – Delagil, Hingamin, Rezokhin, Hydroxychloroquine. Usually prescribed for mild rheumato >

    Salazopreparations – “Salazosulfapir >

All drugs for rheumatoid arthritis can have side effects, so the doctor selects the best means based on the individual characteristics of the patient.

Steroid hormones

Hormone therapy is used for various diseases of the immune system or endocrine disorders.

It is dangerous because it can cause a lot of complications, such as:

  • diabetes;
  • erosion and ulcers;
  • osteoporosis;
  • obesity;
  • hanging hell;
  • violation of the adrenal glands.

But glucocorticoids such as Prednisone, Metipred, Decortin, Medrol can quickly relieve inflammation, for example, by introducing a large dosage, acute inflammation can be removed (this procedure is called pulse therapy) or hormones are taken throughout long term, but in small doses.

Can arthritis be cured forever: prognosis for recovery depending on the species

Only a small proportion of diagnosed arthritis can be completely cured. Therapy of other pathologies is aimed at eliminating painful clinical manifestations and preventing the spread of the inflammatory process to healthy tissues, joints and organs. The goal of treatment is to achieve sustainable remission. At this stage, the person’s condition improves significantly, which allows him to lead a familiar lifestyle. But with incurable diseases, the patient must constantly take drugs that reduce the risk of relapse.

Types of ArthritisPharmacological drugs for treatment
RheumatoidBiological agents (Etanersept, Infliximab, Adalimumab), basic preparations (sulfasalazine, hydroxychloroquine methotrexate, Leflunomide), NSAIDs in the form of injections, ointments, tablets, drug blockades with glucocorticosteroids and anesthetics, stem cell administration
ReactiveNSAIDs (Diclofenac, Nimesulide, Ketoprofen, Meloxicam), intraarticular and periarticular injections of glucocorticosteroids, basic drugs (Sulfasalazine, Methotrexate), biological agents (Etanercept, Infliximab), compresses with Dimexide
InfectiousAntibiotics from the group of macrolides, tetracyclines, semi-synthetic protected penicillins, cephalosporins, NSAIDs, glucocorticosteroids (Diprospan, Dexamethasone, Phlosterone, Triamcinolone), antiviral or antimycotic drugs

Infectious

Doctors give the most favorable prognosis for a full recovery to patients with infectious arthritis. This is an inflammatory pathology of the joints of bacterial, viral, parasitic or fungal origin. Infectious agents penetrate from the primary foci into the joint cavity, starting to multiply actively. The products secreted by them during the life process are toxic to the surrounding tissues, which leads to the development of acute inflammation. Infectious diseases are often accompanied by symptoms of general intoxication of the body – fever, gastrointestinal and neurological disorders. Most often, the development of pathology is provoked by such pathogens and viruses:

  • causative agents of angina, sinusitis, pneumonia, furunculosis, pyelonephritis, cystitis, infectious endocarditis, sepsis;
  • causative agents of tuberculosis, syphilis, gonorrhea, brucellosis.

Often in rheumatological practice, chlamydial arthritis is found, which is a serious complication of chlamydia. Before treatment with the help of laboratory diagnostics, the type of infectious agent and its sensitivity to pharmacological drugs are detected. The main objective of therapy is the destruction of pathogens. For this, antimycotic, antiviral, antibacterial, antiparasitic agents can be used. Then the doctors proceed to eliminate the consequences provoked by the infection. Patients are prescribed massage and physiotherapeutic procedures, yoga, exercise therapy, balneotherapy.

But with an untimely visit to the doctor, it is not possible to completely eliminate all the complications that have arisen. In 30% of patients, residual effects were noted. This is a limitation of joint mobility, contracture, ankylosis (complete or partial fusion of the joint space). Septic arthritis is a serious threat to human life. Some of its forms are so rapid and complicated that the risk of death reaches 5-15%.

Reactive

Even the “neglected” ARTHRITIS can be cured at home! Just remember to smear it once a day.

With this type of disease, the prognosis for a full recovery is less favorable, but a final cure is possible in some cases. The impetus for the development of the pathological process also becomes the penetration of infectious agents into the body – bacteria, viruses, fungi. But in this case, it is not microbes that provoke inflammation, but the response of the immune system to their introduction. The protein structure of pathogens of intestinal, respiratory, and urogenital infections is similar to the structure of the cells of the synovial bag, ligaments, tendons, and cartilage. Therefore, antibodies produced by the immune system attack the body’s own cells, completely destroying them.

An integrated approach to the treatment of the disease is practiced. Therapy is carried out in several stages:

  • destruction of infectious agents with antibiotics or antiviral agents;
  • elimination of the clinical manifestations of arthritis with non-steroidal anti-inflammatory drugs (NSAIDs), glucocorticosteroids, muscle relaxants;
  • correction of the immune response with TNF inhibitor drugs.

To complete recovery, rheumatologists can only give a distant prognosis, and it is quite variable. In more than 30% of patients, symptoms completely disappear within 5-6 months. Subsequently, no symptoms of reactive arthritis occur. In 35% of patients after treatment, relapses with manifestations of pathology were noted, often complicated by dyspeptic disorders. In about 25% of patients, arthritis takes a chronic course, in which the stages of remission alternate with exacerbations. In 5% of cases, pathology is practically not amenable to therapy, provokes the development of ankylosis, and then the patient is disabled.

Rheumatoid

Rheumatoid arthritis is characterized by erosive and destructive lesions of mainly peripheral small joints. Pathology refers to autoimmune diseases and is characterized by a very severe course. In order for rheumatoid arthritis to develop, several factors must coincide. This is the initial penetration into the body or activation of special streptococci, Epstein-Barr viruses, retroviruses, herpes viruses, pathogens of rubella or cytomegalovirus infection, as well as:

  • a sharp weakening of the immune system;
  • genetic predisposition, the presence of special genes to which the immune system reacts inappropriately.

When asked by the patient whether rheumatoid arthritis can be cured, doctors respond negatively. New medicines are constantly being developed, clinical trials are being conducted, including on volunteers. Well-proven stem cell therapy, which improves tissue trophism and stimulates their regeneration. In severe rheumatoid disease, patients are shown blood purification by cryoapheresis, membrane plasmapheresis, cascade plasma filtration. This allows you to prevent further destruction of the joints, damage to internal organs. For the treatment of rheumatoid arthritis, drugs of various clinical and pharmacological groups are used. Basic and biological agents that eliminate painful symptoms are used. At the same time, the immune system prevents the production of special immunoglobulins (rheumatoid factor), which attack the joints’ own cells, skin integuments and internal organs.

If the inflammatory process is isolated in no more than three joints, then there is hope for a favorable prognosis. The prospect is aggravated by polyarthritis, developed systemic manifestations, inflammation, which cannot be stopped by pharmacological drugs.

If the patient seeks medical help when the first, mild pain in the knee or ankle appears, then the chances of a complete cure are significantly increased. This applies even to rheumatoid arthritis, which is difficult to treat. Scientists have proven that taking certain drugs in the first weeks of the development of pathology allows you to completely stop the inflammatory process.

Treatment of exacerbation of rheumatoid arthritis

Exacerbation of rheumatoid arthritis is a period of the disease, characterized by increased pain and rapid progression of inflammatory processes in the joints. The acute form of the disease requires urgent and systemic treatment.

Causes of exacerbation of arthritis

The main causes of relapse of arthritis are a decrease in the body’s defenses and a malfunction of the immune system. But exacerbation of the disease also provoke:

  • infectious diseases. After infections, particles of bacteria and viruses may remain in the affected tissues. In this case, the cells of the immune system recognize them as “foreign” and begin to attack the diseased joints: the pain syndrome and other symptoms of arthritis resume;
  • hormone imbalance;
  • one-time or frequent hypothermia, trauma, excessive load on the joints. Under the influence of all these factors in the affected tissues, metabolic processes worsen. This causes arthritis to worsen;
  • stresses, emotional overstrain.

In Finland, a study was conducted at the University of Turku under the supervision of a professor of psychiatry R. Raymond on the effect of the patient’s mental and emotional state on the course of arthritis. The participants in the experiment were 100 women (women, according to scientists, are most prone to neurosis and the development of rheumatic diseases). All of them were divided into two groups. The first included patients in whom inflammatory processes in the joints appeared after the occurrence of family troubles, conflicts at work. Most of these women were depressed at the time of the study. The second group included women who had no such problems. Many of the patients became ill with arthritis after suffering an infectious disease or hypothermia.

All study participants were monitored for several years. It turned out the following:

  1. The disease progressed faster in women of the first group. Symptoms increased rapidly, there was a frequent exacerbation of rheumatoid arthritis. The treatment of the disease in such patients was longer than in women of the second group. In addition, if they remained in an anxious, depressed state, many drugs were ineffective, causing intolerance or side effects.
  2. In patients of the second group, relapses of the disease were rarely observed. With exacerbation of rheumatoid arthritis, there were practically no difficulties with treatment with medical preparations. In 50% of patients persistent remission of the disease occurred.

Another reason that can provoke the resumption of inflammatory processes in the joints is the change of season. As a rule, the course of the disease worsens in the fall or spring.

The clinical manifestation of acute arthritis

The symptomatic picture of exacerbation of arthritis depends on the localization of pathological processes, the degree of destruction of the joints.

Affected jointsSymptoms of arthritis depending on the stage of degenerative processes
InitialThe second
Phalangeal, carpalDifficulties with simple stepsSwelling and crunching of fingers, their pain when moving
Reduced brush mobility
AnkleBending painSevere swelling and cracking of joints during movement
Swelling in the focus of inflammationLeg pain (can bother both day and night)
HumeralPeriodic mild joint pain after exerciseReducing the amplitude of arm movements
Pain in the muscles of the shoulders, worse with the onset of morning
HipPain in the knees (occur after a long walk, stay in a standing position)Gait change
Joint pain radiating to the knee
KneeSwelling of the knees
Morning stiffness of joints
Skin redness

At the third or fourth stage of arthritis, the patient has complaints of severe pain, a significant limitation of joint mobility and a decrease in physical activity. If the treatment was chosen correctly (a remission of the disease was achieved), the symptoms subside. But with exacerbation of arthritis, the destruction of joints and surrounding tissues occurs much faster. Therefore, during this period, the course of the disease is more pronounced:

  • pain intensity increases;
  • there is a feeling of compression of the joint;
  • movements are difficult not only in the morning, but throughout the day;
  • local and general body temperature rises (from 38 ºC). Specific skin rashes are possible;
  • become more noticeable: redness and swelling of the tissues in the area of ​​the diseased joint;
  • fatigue, partial or complete disability are noted.

Possible complications of exacerbation

During this period, the risk of spreading pathological processes to internal organs increases. The patient may have disturbances in the work of such body systems:

Cardiovascular. With an exacerbation of the disease, the following can be detected:

  • inflammation of the pericardial sac;
  • clogging of blood vessels;
  • granulomatosis of heart valves.

Urinary. Manifestations of acute arthritis:

  • kidney failure;
  • inflammation of the kidneys (pyelonephritis, glomerulonephritis).

Breathing Signs of exacerbation of the disease:

  • the presence of rheumatoid nodules in the lungs;
  • bronchiolitis;
  • inflammation of the pleura of the lungs.

Visual. In the acute period of the course of arthritis, such eye diseases can occur:

Digestive Extraarticular symptoms of acute rheumatoid arthritis:

  • discomfort, a feeling of heaviness in the stomach;
  • lack of appetite;
  • lower abdominal pain;
  • excessive gassing in the intestines.

How to treat exacerbation of rheumatoid arthritis?

The first thing to do with an exacerbation of the disease is to see a doctor. He will conduct an examination and select a treatment. It should be aimed at:

  • reduction of pain and inflammation;
  • slowing the progression of destructive processes;
  • prevention of complications.

As a rule, with exacerbation of rheumatoid arthritis, enhanced treatment with drugs of the following groups is recommended: non-steroidal anti-inflammatory drugs, basic ones, glucocorticoids. As you recover, the dosage of the medicine may be reduced.

Contraindications in the acute period of arthritis

With an exacerbation of rheumatoid arthritis, you can not resort to treatment with folk remedies. Applying compresses and warming ointments, prepared according to the recipes of alternative medicine, can cause an increase in pain.

During this period of the course of the disease, it is not recommended to visit a sauna or bath, massage sessions. Physiotherapeutic effects on diseased tissues are also contraindicated.

In the acute phase of arthritis with severe pain, rest is necessary: ​​you must refuse to perform work associated with increased load on the joints.

How to prevent exacerbation of arthritis

Gymnastics helps to prevent exacerbation of rheumatoid arthritis and achieve positive results from its treatment. During the period of remission of the disease, you can perform the following exercises:

  1. Starting position: lying on your back, keep your legs and arms straight. Slowly raise the upper limbs to the head, then lower it. We do this 5 times.
  2. We bend the hands and toes until a slight tension sensation arises. We fix the position for a short time, after which we relax the limbs. The exercise is repeated 5 times.
  3. Starting position: sitting on a chair (bed). Hands are bent at the elbows, we put the hands on the shoulders. We make circular revolutions with the limbs, without taking them from the shoulders. The number of repetitions is 10 (5 forward and the same back).

To prevent exacerbation of arthritis, it is also recommended:

  1. Avoid joint injuries.
  2. Dress warmly in the cold season.
  3. Visit the pool (at least 2 times a week).
  4. Healthy food. The menu must include chicken eggs, low-fat fish and meat, dairy products, fresh vegetables and fruits, cereals. For arthritis, it is not recommended to use: marinades, fatty dishes, smoked meats, pastries, strong tea (coffee) and chocolate. It is undesirable to add sharp and spicy seasonings to food.
  5. Maintain a healthy lifestyle: stop smoking, minimize alcohol consumption.
  6. Fully relax.
  7. Control body weight.
  8. Refuse to wear high-heeled shoes.
  9. In time to treat infectious diseases.

The causes of exacerbation of rheumatoid arthritis are many. It is important to identify the factor provoking an increase in the symptoms and progression of the disease in time, and to begin taking therapeutic measures. To prevent the occurrence of relapse, you need to be regularly examined, follow the recommendations for prolonging the remission of the disease.

Can rheumato >

Rheumatoid arthritis is considered a very serious joint disease. Developing, it leads the patient to disability. A very large percentage of the population is affected by this disease. In this article, we will try to understand the various approaches in the treatment of the disease.

The possibility of cure

In order to understand how to cure rumatoid arthritis, and whether it can be done at all, you first need to understand what kind of disease it is. Elderly people are at risk, as joint wear is a natural aging process. But it happens that diseases are exposed to young, strong organisms.

The etiology and pathogenesis of arthritis has not yet been fully studied. Arthritis has many forms. Rheumatoid arthritis, for example, is not just a joint disease. With it, the main protector of our body – the immune system – fails. In the autoimmune reaction that accompanies rheumatoid arthritis, aggressive killer cells that must destroy viruses and neoplasms attack normal, healthy cells in the body.

The disease can occur in several forms.

To prevent the craziness of these cells, scientists spent more than a dozen years in laboratories, doing a lot of clinical research. But so far, it has not yet been possible to achieve absolute victory in the fight against this disease. Interfering with the immune system is a very complex and dangerous action. But doctors do not give up and continue to search.

In many ways, modern medicine has moved forward, which means that you should not give up. It is necessary by all means to continue the inhibition of the progression of rheumatoid arthritis. Today we will tell you more about the most effective methods.

Drug treatment

For many years, doctors have made and continue to make attempts to cure arthritis forever. Means of different techniques were used: folk, physiotherapy, the use of various groups of medicines. Today, leading rheumatologists agree that the best treatment for arthritis is that which takes place in a complex.

Regarding drugs, there are three groups that are prescribed most often: non-steroidal anti-inflammatory drugs, basic drugs, and hormones.

Arthritis therapy should be comprehensive

Naturally, these drugs are not the only ones in treatment, they are also used:

  • agents to improve microcirculation;
  • metabolites;
  • drugs that regulate the viscosity and fluidity of the blood;
  • antioxidants, etc.

Any of these remedies have side effects. It happens, when taking several drugs, and this is how drug therapy for arthritis occurs, the negative effects of drugs accumulate in the body. But do not give up treatment. You just need to consult with your rheumatologist who is treating you and draw up a different treatment plan, as refusing treatment will lead to a fatal development of the disease.

Non-steroidal anti-inflammatory drugs actually always have a place to be when it comes to arthritis. But can rheumatoid arthritis be cured forever with their help? Forever this disease is not cured. But you can achieve a period of remission and keep it.

Regarding NSAIDs in this treatment regimen, the following can be said. Preparations come in two directions: general (non-selective NSAIDs) and selective (selective NSAIDs) actions. Selective will be considered in a separate paragraph below, but for now we will analyze what non-selective are.

Non-selective drugs include anti-inflammatory drugs with a general spectrum of action, such as, for example, Diclofenac. This drug successfully relieves inflammation and inhibits the development of the disease, but its non-selectivity leads to a change in other organs, many of which undergo significant lesions. Often “Diclofenac” changes the properties of blood coagulability, hence the frequent bleeding in the list of side effects. In addition to Diclofenac, non-selective NSAIDs include:

Also, non-selective agents with prolonged use cause ulcers in the stomach and intestines. Therefore, the patient undergoing therapy with non-selective NSAIDs should be under the vigilant supervision of a doctor, regularly passing the necessary tests.

Selective NSAIDs

The negative effects of side effects in selective NSAIDs are minimized. The practice of using this type of funds suggests that they have both advantages and disadvantages. Take, for example, Nimesulide. A variety from this group of drugs is well tolerated, having anti-inflammatory and analgesic effects, but it also has a thrombogenic effect, as well as a risk of bronchospasm.

Selective NSAIDs include:

NSAIDs do not cure, but extend the period of remission. What type of this type of drug is right for you, your rheumatologist will decide.

Basic therapy

In addition to NSAIDs, drugs are widely used, which are the basis for the treatment of rheumatoid arthritis. Basic therapy represents a list of drugs that you will use daily until the end of life. Here is some of them:

    Quinoline preparations – Delagil, Hingamin, Rezokhin, Hydroxychloroquine. Usually prescribed for mild rheumato >

    Salazopreparations – “Salazosulfapir >

All drugs for rheumatoid arthritis can have side effects, so the doctor selects the best means based on the individual characteristics of the patient.

Steroid hormones

Hormone therapy is used for various diseases of the immune system or endocrine disorders.

It is dangerous because it can cause a lot of complications, such as:

  • diabetes;
  • erosion and ulcers;
  • osteoporosis;
  • obesity;
  • hanging hell;
  • violation of the adrenal glands.

But glucocorticoids such as Prednisone, Metipred, Decortin, Medrol can quickly relieve inflammation, for example, by introducing a large dosage, acute inflammation can be removed (this procedure is called pulse therapy) or hormones are taken throughout long term, but in small doses.

Anatoly Kudravets

Anatoly Kudravets, Orthopedic Traumatologist. He works with severe cases, practices operative methods of treating connective tissues

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