What is rheumatoid arthritis - how and how to treat joint pathology? Rheumatoid arthritis Rheumatoid arthritis treatment in adults.

Rheumatoid arthritis is an autoimmune disease that affects connective tissue and includes systemic complications. First of all, the joints are affected - the disease is characterized by symmetrical polyarthritis of small joints. Extra-articular symptoms include damage to the muscles, heart, lungs, liver, gastrointestinal tract, etc. Rheumatoid arthritis is severe and causes disability in 70% of patients.

The exact cause of rheumatoid arthritis has not been established. Modern scientists are inclined to two main hypotheses for the development of the disease:

1. genetic predisposition- if rheumatoid arthritis was diagnosed in parents, then the likelihood of its occurrence in children increases. The rule of genetic predisposition is pronounced in monozygotic twins. Recent studies have identified certain histocompatibility antigens that code for malfunctions in immune reactions organism. In patients with rheumatoid arthritis, these antigens are present and can be inherited.
2. Viral pathogen- according to clinicians, the vast majority of patients have high titers of antibodies to the Epstein-Barr virus in the blood. It is important to note the similarity between certain fragments of the virus and a portion of the histocompatibility antigen chain. It is also assumed that the herpes, rubella, papilloma B 19, etc. viruses can cause the disease.
3. Bacterial agents- Recent studies have shown that the entry of bacteria into the body is accompanied by an immune response to the so-called "stress" proteins synthesized by microbes. It is assumed that these components are capable of running complex pathogenetic mechanism leading to the formation of rheumatoid factor.
4. Trigger components of the disease- these are conditions that contribute to the launch of a pathological reaction. In healthy people, triggers do not cause disease, but if a person is predisposed, they trigger pathogenesis. These include:
   • frequent hypothermia;
   • smoking and alcohol;
   • joint injuries;
   • hormonal changes;
   • stress;
   • harmful ecology.

According to statistics, the disease develops:

• more often than in men;
• over the age of 45;
• with frequent diseases of the respiratory system, arthritis, anomalies in the development of the musculoskeletal system;
• with burdened heredity;
• in the presence of the above antigens.

The onset and course of the disease

The pathogenesis of rheumatoid arthritis is a very complex autoimmune process. In our article, we will analyze only the key points that allow the ordinary reader to understand the mechanism for the development of pathology. The disease is based on a pathological reaction of the immune system, which attacks healthy cells of the connective tissue, mistakenly recognizing them as foreign. This autoimmune process goes through several stages:

1. Synoviocytes located in the connective tissue produce a large number of inflammatory substances (cytokines) and activate special cells of the immune system - T-helpers of the first type.
2. T-helpers secrete interferon gamma, which activates another immune cells macrophages and monocytes. The latter also produce specialized inflammatory substances:
   • tumor necrosis factor - promotes the release of the liquid part of the blood into the area of ​​​​inflammation, forming edema and inflammation.
   • IL-1 - contributes to the development of osteoporosis in the joint area and an increase in body temperature.
   • IL-6 - activates liver cells that produce a large amount of C-reactive protein, and also contributes to the conversion of B-lymphocytes into plasma cells.
   • IL-8 - increases the concentration of neutrophils in the joint fluid.
3. Plasma cells produce modified immunoglobulins M and G, which attack the connective tissue, and when interacting with unchanged immunoglobulins G, damage microvasculature joint.
4. The secretion of endothelial growth factor leads to additional education in the connective tissue of capillaries, as well as a specialized tissue called pannus. This tissue has signs of a tumor and is able to grow in the joint cavity, causing its deformation.

Classification of rheumatoid arthritis

To formulate the correct diagnosis, the doctor must know the classification of the disease. Clinicians use international classification diseases of the 10th revision (ICD-10), which is more convenient for the correct formulation of the diagnosis. For a patient, this classification is too complicated, so we will analyze the varieties of rheumatoid arthritis according to the following criteria:

1. According to the articular syndrome:
   • monoarthritis- one joint is involved;
   • oligoarthritis- inflammation of two joints;
   • polyarthritis- Involvement of 3 or more joints.
2. According to radiological stages:
   • first- thickening of the cartilage and the walls of the articular bag, small areas of osteoporosis;
   • second– formation of foci of erosion on cartilage, narrowing of the joint space, development of an extensive zone of osteoporosis;
   • third- deformation and periodic dislocations in the affected joints;
   • fourth- complete disappearance of the joint space, there may be signs of bone fusion.
3. According to the clinical picture:
   • low activity– morning stiffness in the joints up to 30 minutes, during the day slight pain, moderate swelling of the joints, erythrocyte sedimentation rate (ESR) up to 30 mm/hour, analysis for C-reactive protein(CRP) +;
   • average activity- stiffness in the first half of the day, moderate pain (possible without load), severe swelling over the affected area. ESR up to 40 mm/hour, CRP ++, elevated level inflammatory enzymes in the blood;
   • high activity- stiffness in the joints lasts all day, complications in the form of a lesion join internal organs, ESR more than 40 mm/hour CRP +++, pronounced predominance of inflammatory enzymes.
4. According to the progression of the disease:
   • very early stage- pathology develops within six months;
   • early stage- the clinic of rheumatoid arthritis is characterized by a duration of symptoms from 6 to 12 months;
   • extended stage- the disease proceeds for more than 12 months without pronounced destruction of the joints;
   • late stage- pathological processes last more than 2 years with severe deformity of the joints.
5. By limiting physical activity:
   • first degree– maintaining working capacity and habitual way of life;
   • second degree- periodic loss from the usual way of life;
   • third degree- inability to work.
   • fourth degree- Lack of self-service, disability.
6. According to laboratory tests for rheumatoid factor:
   • - according to the results, the rheumatoid factor is detected;
   • - No rheumatoid factor.

It is important to mention several options from ICD-10:

1. - is a chronic rheumatoid arthritis that occurs in children with a predominant joint lesion.
2. - inflammation of the joint capsules. The shoulder joints are predominantly affected.
3. - a complication in which an enlarged spleen and a decrease in granulocytes in the blood join the clinical picture.

Symptoms of rheumatoid arthritis

The course and development of the disease is expressed by articular and extra-articular manifestations. The articular lesion develops first and represents an inflammatory polyarthritis. Extra-articular signs, or complications of the underlying disease, are involved in the pathology later, characterized by multiple lesions (skin, muscles, internal organs, fundus, lymph nodes).

Which joints are affected in rheumatoid arthritis?

Arthritis is characterized by lesions of the same type of joints on the right and left sides - for example, arthritis of the knee joints on the right and left. It is important to note that small-caliber joints are predominantly affected.

The onset of the disease is usually preceded by:

• sharp changes in climate - spring or autumn;
• transferred ARVI, pneumonia, etc.;
• stress or psycho-emotional overstrain;
• trauma;
• hormonal changes in the body - puberty, or menopause.

When questioned by the doctor of the patient, the so-called prodromal period or the period of precursors is often revealed, which appears a few weeks before the onset of the disease. This period corresponds to:

• general weakness, loss of strength;
• periodic lack of appetite, weight loss;
• small rises in temperature and sweating;
• slight joint pain and morning stiffness.

The pain symptom in the joints occurs due to the concentration of inflammatory substances in the connective tissue.

The onset of development is usually subacute or latent, in which the symptoms are mild, and the disease progresses gradually - complaints of pain in the joints do not appear immediately. Gradually, the pain increases, forcing a person to see a doctor. Sometimes the disease begins acutely, accompanied by severe joint pain, morning stiffness, and fever.

Above the affected joint, you can find:

• swelling and redness;
• pain reaction when touched;
• an increase in local temperature.

There is also stiffness in the joint. Later, mobility decreases, which eventually leads to total absence mobility followed by joint deformity. The most common targets for rheumatoid attack are the joints of the hands and feet, elbows, knees and shoulders. Less commonly involved in the pathology of the hip, sacroiliac and ankle. The exclusion joints in rheumatoid arthritis are the distal interphalangeal (located just above the nail plate), the proximal interphalangeal joint of the little finger, and the metacarpophalangeal joint. thumb(located at its base).

Rheumatoid lesion of the joints of the hand

The purpose of rheumatoid lesions are:

• metacarpophalangeal joints 2 to 5 are joints near the base of the fingers;
• proximal interphalangeal joints from 1 to 4 fingers;
• all joints of the wrist and carpometacarpal joints - a series of small joints in the area of ​​\u200b\u200bthe palm itself.

As a rule, the small joints listed above are the first to be affected. Soreness leads to the fact that the patient is unable to clench the hand into a fist, and the fingers swell greatly. After a few months, the intermetacarpal muscles begin to atrophy, which leads to retraction of the skin on the palm and back of the hand. There are deformations and subluxations of the metacarpophalangeal joints, as a result of which the fingers are bent with a deviation towards the little finger. The little finger itself curves less than the other fingers. Clinicians refer to this deformity as a "major's fin". Then there is a curvature of the fingers according to the “swan neck” principle - the proximal interphalangeal joints of the fingers are bent, and the distal ones are excessively unbent.

Sometimes deformations occur with flexion of the metacarpophalangeal and extension of the lower interphalangeal joints (button loop). All of these changes greatly disrupt the functions of the brush.

Ultimately pathological changes brushes can lead to:

• to shortening of the fingers, fusion of the phalanges with each other and complete loss of mobility;
• tenosiviitis - inflammation of the flexor tendons of the fingers, as well as their synovial canals.

The result of tenosivitis is swelling of the finger and severe pain. With compression of the branches of the median nerve, which pass near the affected joints, loss of sensitivity from fingers 1 to 3 is possible. With prolonged compression, pain can spread to the entire forearm up to the elbow.

Later, the disease attacks the wrist, elbow and shoulder joint s.

Deformation of these joints in rheumatoid arthritis manifests itself after the development of inflammation and is irreversible.

1. Radiocarpal rheumatoid arthritis leads to soreness, swelling of the affected area, limited flexion and abduction of the hand. Wrist arthritis is often complicated by synovitis and median nerve neuralgia.
2. The elbow joint is formed by the articulation of three bones - the ulna and radius bones forearms, and humerus. Therefore, arthritis can affect all three joints that form the complex elbow joint. Local arthritis is accompanied by severe pain during flexion and extension - contracture may develop in an intermediate position. With severe inflammation, it is impossible to carry out rotational movements (supination and pronation).
3. Arthritis of the shoulder joint is characterized by the spread of inflammation to the tendon synovial bags, collarbone, muscle frame. Swelling, soreness and limited movement develop gradually.
4. Inflammation can go to the axillary lymph nodes. Due to the fact that the shoulder joint has only one ligament and is strengthened due to muscle tone, myalgia, turning into atrophy, leads to habitual shoulder subluxations.

The second target for rheumatoid arthritis after damage to the hand is the foot. Most often, inflammation develops in the metatarsophalangeal joints of 2-4 fingers and is accompanied by pain when walking, standing on tiptoe, and jumping. Visually, there is swelling of the dorsum of the foot, hammer-like deformity of the fingers, subluxations of the listed joints, hallux valgus big toe.

Later, inflammation of the synovial bags and synovitis join the arthritis, leading to compression of the plantar nerves. An injured effect on the nerves leads to a loss of sensation in the foot, pain sensations that can rise up to knee joint.

1. characterized by pain, swelling in the knees. The pain is aggravated by flexion movements, during squats, when climbing stairs. Often, with severe edema, fluid balloting is noted when touching the anterolateral region of the knee. Severe pain can lead to the development of contracture in the semi-flexion position, as well as to protrusion joint capsule in the posterior regions (Baker's cyst). Prolonged arthralgia of the knee joint forms an atrophy of the anterior group of thigh muscles.

Temporomandibular joint injury

The temporomandibular joint is combined - its functionality is accompanied by synchronous movements in both capsules. Arthritis is always accompanied only by bilateral soreness. Morning stiffness causes particular discomfort to the patient - due to the difficulty of opening the mouth and pain during chewing, eating is much more difficult. This leads to weight loss, nervousness. In severe cases, neighboring anatomical structures may be involved in the inflammatory process:

• chewing and temporal muscles;
• neighboring cellular spaces;
• parotid salivary gland;
• branches of the trigeminal and facial nerves.

Damage to the joints of the spinal column

Vertebral joints are extremely rarely involved in the clinical picture of rheumatoid arthritis. Arthritis usually develops in the connection of the head with the first cervical vertebrae (atlanto-occipital joint), the connections of the first and second cervical vertebrae (median and lateral atlanto-axial joints). Clinically, inflammation is manifested by pain in the upper neck, characterized by the inability to painlessly turn the head to the side.

Extra-articular manifestations of rheumatoid arthritis (complications)

These lesions occur over a long course of the disease, predominantly in seropositive patients. Clinicians attribute these pathologies to complications of rheumatoid arthritis, since they develop with a systemic effect on the body.

Muscle damage

Myopathy in rheumatoid arthritis begins with the defeat of three groups of muscles of the hand:

• elevation of the thumb;
• elevation of the little finger;
• intermediate muscles.

Later, the myopathy rises and captures the back muscle group of the forearm. On the lower limb, the disease attacks the anterior muscles of the thigh and gluteal region. Myopathy is characterized by pain during muscle contraction, which aggravates movement processes.

Skin changes

For long-term rheumatoid arthritis skin dry and thin, numerous hemorrhages appear on the skin all over the body. The nail plates become more brittle, with transverse striation. Under the nails or near them, small zones of soft tissue death are noted.

These are small dense formations located under the skin. Usually they are mobile and painless, loosely connected to the surrounding tissues. Usually located on the dorsal surface elbow joint, extensor side of the forearm and the back of the head. Sometimes found in the myocardium, heart valves, between the membranes of the head or spinal cord, in lung tissue. They usually form during periods of exacerbations, and during remission they can disappear completely or decrease significantly. There is such serious complication, as rheumatoid nodulosis - the presence of nodules scattered throughout the body with multiple swelling of the joints, the presence of cysts and an elevated level of rheumatoid factor in the blood.

Damage to the lymph nodes

Such a complication is detected during an exacerbation and is characterized by an increase in a number of lymph nodes, usually near the affected joints:

• with arthritis of the joints upper limb there is an increase in the elbow, axillary and cervical nodes;
• temporomandibular arthritis is accompanied by an increase in the submandibular and cervical lymph nodes;
• arthritis of the joints of the lower limb leads to temporary hypertrophy of the inguinal lymph nodes.

Often, lymphadenopathy is accompanied by an enlarged spleen.

Damage to the stomach, intestines and liver

1. The defeat of the stomach is characterized by suppression of the synthesis gastric juice, the formation of numerous erosions and ulcers. The result of such complications are dull pulling pains in the epigastrium, the formation of plaque on the mucous membrane of the tongue, and a decrease in appetite.
2. Rheumatoid arthritis can be complicated by inflammation of the small and large intestines - enteritis and colitis. Intestinal damage leads to acute and chronic pain, bloating, stool disorders, nausea and vomiting.
3. Sometimes the liver increases, its borders expand.

Pulmonary complications

The defeat of the lungs in rheumatoid arthritis usually occurs in parallel with the defeat of their membrane - the pleura. The defeat of the pleura is characterized by inflammatory changes - pleurisy.

Pleurisy may be dry or exudative. In the first case, the friction of dry, inflamed pleura during breathing causes severe discomfort to the patient. Exudative pleurisy is characterized by effusion of the liquid part of the blood into the pleural cavity, followed by compression of the lung, which leads to shortness of breath, a feeling of heaviness on the affected side. The defeat of the lungs is manifested by the development of pneumonitis and fibrosing alveolitis. A characteristic feature of complications of the lungs and pleura is the weak effectiveness of antibiotics and the rapid effect of the use of anti-inflammatory drugs.

Heart damage in rheumatoid arthritis manifests itself in the form of the following diseases:

1. Inflammation of the muscle membrane - myocarditis.
2. The defeat of the outer shell in the form of pericarditis.
3. The formation of acquired malformations of the heart in case of damage to the inner lining of the heart - endocarditis.
4. Damage to the pericardial vessels - the aorta (aortitis) and coronary arteries(coronary arteritis).

Inflammatory changes in the heart and blood vessels are manifested by complaints of shortness of breath and chest pain. A more accurate diagnosis is made by a cardiologist after passing the appropriate examination.

Renal complications

Kidney damage in rheumatoid arthritis is carried out with the involvement of the glomerular apparatus in the inflammatory process, resulting in the development of rheumatoid glomerulonephritis, renal amyloidosis. As a result of renal complications, anemia may develop in rheumatoid arthritis, which is formed during the transition of the disease to chronic form.

Damage to the organ of vision

Eye damage in rheumatoid arthritis is very rare and is manifested by inflammation of the outer shell. eyeball- sclera. Inflammatory changes are characterized by severe pain, capillary dilation, and sometimes the formation of small rheumatoid nodules. With combined pathologies, the development of dry conjunctivitis is possible, in which the closure of the eyelid is accompanied by a strong pain sensation.

Complications from the nervous system

Damage to the nervous system is characterized by the following symptoms:

1. Frequent headaches and dizziness indicate a violation of the blood supply to the brain and encephalopathy.
2. A reaction to a change in temperature, increased sweating and a change in diuresis indicate damage to the autonomic nervous system.
3. Weakness in the affected limbs, difficulty in movement speak in favor of ischemic neuropathy.
4. Stitching pains in the extremities and parasthesias occur when the corresponding nerves are pinched and in neuralgia.

Other complications

If rheumatoid arthritis develops long time, the appearance of combined complications is possible - such as inflammation of the pleura and pericardium, multiple hemorrhages on the internal organs.

Establishing diagnosis

Articular lesions occur in the later stages of the disease. Since at the beginning of the disease the articular syndrome does not manifest itself, the diagnosis of rheumatoid arthritis is based on early stages very difficult.

There are certain criteria for the diagnosis of rheumatoid arthritis:

• morning stiffness of the joints for at least an hour;
• arthritis of three or more joints;
• damage to the joints on the hand;
• symmetrical involvement of the joints in the clinical picture;
• the presence of rheumatoid nodules;
• the presence of rheumatoid factor;
• articular x-ray picture.

Diagnosis of rheumatoid arthritis is positive when four of the above symptoms are detected. It is important to note that the first four symptoms should persist for one to two months. Indisputable evidence of rheumatoid arthritis is synchronous minor polyarthritis. To identify the criteria described above, as well as additional diagnostic parameters, laboratory and instrumental methods research.

Laboratory methods

1. Complete blood count - with a high activity of the process, anemia may develop (a drop in hemoglobin, leukocytes). ESR increase in rheumatoid arthritis is an indirect sign of the development of the disease.
2. A biochemical blood test is informative for determining the degree of inflammation activity and identifying complications. First of all, attention is drawn to an increase in C-reactive protein, fibrinogen, seromucoid, sialic acids, haptoglobin, globulins and a decrease in albumin levels.
3. Immunological analysis of blood is one of the informative methods. In favor of rheumatoid arthritis is evidenced by the presence of rheumatoid factor, cryoglobulins. Often, antikeratin antibodies, LE cells, and circulating immune complexes are found in the blood.

Instrumental research methods

Instrumental diagnostics involves the use of methods that allow you to visually determine arthritis. The most common methods include: x-ray examination, magnetic resonance imaging, examination synovial fluid followed by a biopsy.

X-ray examination

This type of study is the most informative, because it allows you to identify inflammation and deformity in the joints. The main radiographic features of rheumatoid arthritis are:

• disseminated or focal osteoporosis;
• reduction of the joint space;
• the appearance of erosion on the articular surfaces.

Radiological stages of rheumatoid arthritis are set by the doctor depending on the listed criteria.

Synovial fluid examination and biopsy

Synovial fluid - produced by the cells of the joint capsule to reduce friction during movement. Thanks to the synovial fluid, the coefficient of friction in the joints is 0.01. Joint fluid reflects all pathological changes in the joint, so taking it for analysis significantly complements the diagnostic criteria. A biopsy of the joint capsule with the presence of fibrin and inflammatory elements will leave the diagnosis of rheumatoid arthritis beyond doubt.

Main characteristics of synovial fluid

Differential Diagnosis

Differential Diagnosis- this is a thorough analysis of the results of the examination in order to screen out inappropriate diagnoses with similar symptoms. Differential diagnosis of rheumatoid arthritis is carried out with reactive arthritis and osteoarthritis.

1. Reactive arthritis- this is a lesion of the joints after suffering diseases of infectious etiology.
2. Osteoarthritis- a set of diseases of various etiologies with damage to the joints with their subsequent deformation.

The main differences between these three types of diseases are shown in the table below.

Differential differences between rheumatoid arthritis, reactive arthritis and osteoarthritis:

Treatment

The treatment of rheumatoid arthritis is a complex complex process that requires a responsible approach from both the attending physician and the patient. According to modern research, it is impossible to cure the disease, therapy is aimed only at relieving symptoms and slowing the progression of joint damage. Treatment includes drug therapy and . Disease prevention includes physiotherapy exercises and spa treatment. As an addition, treatment is possible folk remedies but only under the supervision of the attending physician.

Drug therapy

Drug therapy includes symptomatic treatment - necessary to relieve pain and basic therapy - the purpose of which is to maintain the integrity of the musculoskeletal system and prevent complications.

Relieve pain and inflammation in the joints

The drugs of choice are hormonal painkillers - glucocorticoids. Symptomatic therapy greatly alleviates the suffering of the patient, but does not cure the underlying disease; when it is canceled, the symptoms gradually recur.
NSAIDs for rheumatoid arthritis are prescribed in the following sequence:

• selective NSAIDs- have a minimum of side effects and act for a long time. These drugs are allowed to be taken for a long time - from several months to several years. From this group, the most popular drugs are: Meloxicam, Movalis, Celebrex, Nimesil, Nise, Nimid, Revmoksib.
• non-selective NSAIDs- are appointed when the selective group is ineffective. These drugs have a rapid effect, but have pronounced side effects- especially from the gastrointestinal tract. As efficiency and toxic effects increase, they are divided into the first and second stages. The first stage drugs are Diclofenac, Ibuprofen, Ketoprofen. The second stage is represented by Indomethacin, Ketorolac and Piroxicam. Symptomatic therapy

Attention! If there is no positive effect for a maximum of a week, you should contact your doctor to replace the drug.

Glucocorticoids in rheumatoid arthritis, they have a strong analgesic effect. They are hormonal drugs Therefore, their overdose can cause the following side effects:

• hormonal disruptions;
• hyperfunction of the adrenal cortex;
• pancreatitis, diabetes mellitus;
• decreased immunity, frequent SARS;
• thrombosis and bleeding;
• the appearance of edema;
• disorders of the gastrointestinal tract;
• other disorders: itching on mucous membranes respiratory tract, diseases of the sense organs.

The drugs of choice are: medrol, diprospan, methylprednisolone, triamcinolol, dexamethasone, betamethasone.

Basic therapy

The basic therapy of rheumatoid arthritis includes a group of drugs with a long-term effect, which significantly slow down the destructive changes in the connective tissue.

Cytostatics- these drugs are used mainly in oncology, but are the best means basic therapy for rheumatoid arthritis. The mechanism of their action is aimed at inhibiting the growth of pannus and slowing down the destruction in the joints.

The most popular cytostatics:

• Arava;
• Remicade.

Biologicals– their action is aimed at binding the tumor necrosis factor, which plays a key role in the pathogenesis of rheumatoid arthritis. An important point is that these drugs are prescribed separately from each other due to the high likelihood of severe side effects.

Drugs of choice include:

• Anakinra;
• Actemra;
• Rituximab;
• etanercept;
• Humira;
• Orence.

Chondroprotectors- is prescribed to restore cartilage tissue and increase its resistance to autoimmune attacks of rheumatoid arthritis.

These include:

• Teraflex;
• Artra;
• Alflutop;
• Hyaluron.

Other drugs of basic therapy - various groups medicines that are aimed at strengthening the immune system:

• Bicilin-3;
• Penicillamine;
• Cycloferon;
• Delagil.

Physiotherapy

Physiotherapy is a set of methods based on therapeutic effect natural and artificially created factors on the human body. The most popular methods of physical therapy for rheumatoid arthritis are massage, electrophoresis, acupuncture and cryotherapy.

Massage for rheumatoid arthritis is used only during periods of remission, during which pain is significantly reduced, swelling subsides, and the patient's general well-being is normalized. Massage is performed by a specialist on the affected joints and surrounding soft tissues.

Useful properties of massage:

• improves blood circulation and tissue trophism;
• promotes absorption of exudate circulatory system and reduces swelling
• prevents local atrophic changes in the muscles;
• prevents the deposition of calcium salts in the joints;
• normalizes movement in the joint, reduces stiffness in the morning;
• prevents joint deformities.

electrophoresis

This is a technique based on the use of drugs and the combined effects of galvanization. Electrophoresis in rheumatoid arthritis has a strong analgesic effect, as it is used in combination with glucocorticoids. The advantage of the method compared to the usual medication is that side effects are minimized, and the effectiveness is significantly prolonged.

Acupuncture and cryotherapy

Acupuncture is a physiotherapeutic procedure based on the reflex effect of needles on certain areas located near large nerves. Cryotherapy is based on exposure to the affected area with cold air, about -180 degrees Celsius. Acupuncture and cryotherapy for rheumatoid arthritis are distracting procedures and are used as an addition to the main methods in order to relieve pain symptoms.

Traditional medicine and rheumatoid arthritis

As folk methods treatments use salt baths, tinctures and decoctions based on leaves and medicinal herbs. For salt baths in rheumatoid arthritis, sea or table salt, magnesium sulfate, potassium bromide are used. Taking salt baths helps to normalize blood circulation, improves local metabolism, and reduces swelling of surrounding tissues.

Prevention

Prevention of rheumatoid arthritis is divided into primary and secondary. Primary prevention means preventing the onset of disease healthy person, and the secondary is aimed at preventing the development of relapses and complications in people suffering from rheumatoid arthritis.

Primary prevention includes:

• diagnosis and treatment of infectious diseases;
• detection chronic infection in the body;
• strengthening immunity and maintaining healthy lifestyle life.

Secondary prevention implies:

• strict adherence to the doctor's recommendations for taking medicines, attending physiotherapy procedures and;
• spa treatment during periods of remission;
• constant exercise therapy.

Rheumatoid arthritis is a serious pathology characterized by damage to the connective tissues of the joints. This disease is chronic and can lead to dangerous consequences for good health. To improve the prognosis of the disease, you should consult a doctor in a timely manner.

Many people are interested in the question, what is rheumatoid arthritis. This term is understood as an inflammatory pathology, which is characterized by symmetrical damage to the joints. Also, the disease can lead to diseases of the internal organs.

The disease is constantly progressing and has a chronic character. Over time, the abnormal process causes deformation and destruction of the joints. The joints lose their functions, and the person becomes disabled.

Sometimes the disease causes damage not only to the skeleton, but also to various organs - the kidneys, muscle tissue, liver, lungs, blood vessels. The development of the disease begins with inflammation that affects the synovial membrane of the articular tissues. After some time, it spreads to cartilage and bones.

The patient's condition is aggravated due to autoimmune reactions of the body. This means that the defense forces destroy their own cells. The small joints of the upper and lower limbs are usually affected. However, sometimes inflammation affects other parts of the body.

Rheumatoid arthritis is characterized by:

1. Pathology poses a serious danger to human health and can be present throughout life. The disease significantly impairs the quality of life, although sometimes the symptoms are blurred.
2. This form of arthritis can occur at any age. Sometimes it is diagnosed even in children.
3. The causes of the development of pathology can not always be established.
4. The disease is characterized by a periodic course. This means that a person has periods of exacerbations and remissions. Sometimes the condition improves suddenly.
5. Rheumatoid arthritis results in symmetrical joint damage.

A good effect from the therapy of the disease can only be obtained if it was started before the process became chronic.

The reasons

The cause of rheumatoid arthritis is not exactly known. Doctors put forward several theories of the origin of the disease. The key factors in the occurrence of the disease include the following:

Excess body weight also leads to increased stress on the joints. This entails the appearance of inflammatory processes and deformities of the joints.

Clinical picture

Pathology has a gradual development. At the initial stage of the appearance of pathology, swelling of the synovial bags occurs. Periodically, a person develops arthralgia and local temperature increases. As the disease progresses, rapid cell division is observed, which is fraught with compaction of the synovial membrane.

At the final stage of the disease, inflamed cells produce a secret that causes damage to cartilage and bone tissues. At this stage, the pain syndrome increases significantly, the articular tissues are deformed and motor activity is impaired.

The disease often affects the knees, elbows, feet and hands. In more rare cases, the abnormal process affects the shoulder girdle and hip joints. Also, pathology can affect the shoulder blades, ankle, wrist joints.

With simultaneous damage to several elements, polyarthritis is diagnosed.

Systemic symptoms of rheumatoid arthritis include the following:

1. Violation of the heart. They manifest themselves in the form of the development of vasculitis, pericarditis, atherosclerosis. Sometimes granulomatous lesions of the valves are observed.
2. Blood pathologies. A person may develop anemia or thrombocytosis. Some people suffer from neutropenia.
3. Difficulty bending joints. Quite often, arthrosis develops, which is an inflammation of the articular processes.
4. Skin diseases. A person may experience mycoses, thickening of the dermis, rheumatoid nodules. Symptoms of psoriasis and livedo reticularis also occur.
5. Respiratory diseases. There is a risk of pleurisy and interstitial abnormalities.
6. Damage to the nervous system. In this case, we are talking about multiple mononeuritis, cervical myelitis, various types neuropathy.
7. Atrophic lesions of the muscles, a decrease in the tone and strength of muscle tissues.
8. Pathology of the kidneys. These include vasculitis and nephritis.
9. Diseases digestive organs. This group includes enteritis, colitis, amyloidosis.

Types and stages of the disease

To choose the right treatment for rheumatoid arthritis, it is important to determine its type. There are such forms of the disease:

1. Seropositive - in this case, it is possible to detect rheumatoid factor in the blood. It is this type of pathology that is diagnosed in 80% of cases. It is usually accompanied by erosive lesions of the joints and pathologies of the internal organs.
2. Seronegative - in such a situation, there is no rheumatoid factor in the blood.

In addition, there are special forms of pathology:

1. Still's syndrome - most often occurs in childhood. It is characterized by an increase in temperature, the appearance skin rashes, swollen lymph nodes, inflammation of the joints and systemic damage to the body.
2. Felty's syndrome - this form of the disease is accompanied by a violation of the functions of the hematopoietic system. Neutrophils, which are responsible for immune function, are destroyed in the spleen. As a result, the abnormal process in a short time affects other organs.

Depending on the level of activity, low, moderate and high degrees of the disease are distinguished. Doctors also note several stages in the development of the disease:

Diagnostic studies

Diagnosis of rheumatoid arthritis begins with an objective examination. This allows the doctor to determine the number of affected joints. In addition, the specialist necessarily evaluates their functions - the volume of motor activity, strength and condition of the muscles, reveals rheumatoid nodules.

Based on the results of the preliminary examination, laboratory tests are carried out:

• Blood tests. With the development of rheumatoid arthritis, the erythrocyte sedimentation rate increases, the amount of hemoglobin decreases, and the C-reactive protein index increases. The study also allows you to detect rheumatoid factor and detect antibodies to the cyclic citrated peptide.
• Synovial fluid analysis. This procedure allows you to identify the presence of active inflammation and rheumatoid factor.

In addition to laboratory analysis appoint instrumental studies.

The most informative procedures include the following:

1. Ultrasound examination of the joints. This will help to identify the presence of excess fluid in the joint, determine the symptoms of inflammatory lesions of the periarticular tissues, an increase in the size of the synovial membrane and cartilage damage.
2. X-ray of the joints. At the initial stage of the development of the disease, this method is not informative enough. In the later stages of the pathology, it is possible to identify bone erosions on the surface of the joints and symptoms of deformity.
3. Magnetic resonance imaging. In the early stages of the disease, this procedure allows you to identify erosive defects in the joints.

Treatment

Methods of treatment of rheumatoid arthritis are selected by a specialist. Therapy of this disease lasts quite a long time. To achieve consistent results, it is very important not to take breaks.

Treatment for rheumatoid arthritis should be comprehensive and solve such problems:

• Eliminate pain, weakness, swelling and impaired motor activity in the joint;
• Prevent articular deformity;
• Increase the duration of human life and improve its quality;
• Extend remission periods and achieve its stability.

Medical therapy

Medicines form the basis of pathology therapy. They should be selected by a doctor, taking into account clinical picture and the severity of the illness.

Means of basic therapy

These drugs are the mainstay of treatment for rheumatoid arthritis. Thanks to their use, it is possible to suppress the source of the disease - the wrong reaction of the immune system. Most often, to eliminate the symptoms of the disease, the following categories of funds are used:

To make the treatment of pathology more effective, several basic drugs are prescribed at once. They enhance the effect of each other and allow you to get faster results. good option will be a combination of methotrexate and cyclosporine. A combination of methotrexate, hydroxychloroquine, and sulfasalazine can also be used.

Non-steroidal anti-inflammatory drugs

These substances are used for emergency assistance when severe pain and inflammation. This group of drugs should be used under the strict supervision of a rheumatologist. After obtaining the effect of the basic means, the daily dosage of anti-inflammatory drugs must be adjusted.

Such medicines do not cure the disease. They successfully cope with the symptoms, allowing you to normalize the quality of life of a person. This group of drugs includes the following:

Piroxicam Indomethacin
Butadion

Such funds eliminate pain and reduce the severity of inflammation in the joints and their bags.

Corticosteroids

Such funds help in difficult cases, when the symptoms of rheumatoid arthritis are quite pronounced. Such substances allow you to cope with intense pain and severe inflammation.

However, they should be prescribed with extreme caution, since corticosteroids are stress hormones. When used orally, such drugs are observed serious blow on the body. For safe treatment of the disease, topical preparations are usually prescribed.

Corticosteroids, which are injected directly into the affected joint, quickly eliminate pain, stop inflammation and improve general state person. However, the therapeutic effect lasts a maximum of a month, and when the drug is canceled, the unpleasant symptoms return.

• Prednisolone;
• Betamethasone;
• Dexamethasone.

Prednisolone Betamethasone Dexamethasone

Physiotherapy methods

After eliminating the acute symptoms of the disease, it is worth treating rheumatoid arthritis with the help of physiotherapy. Such methods reduce the severity of inflammation, eliminate pain, and ensure the restoration of affected tissues.

The most effective methods include the following:

1. Balneotherapy - activates blood circulation, facilitates the flow of nutrients into the joint and increases their susceptibility;
2. Magnetotherapy - reduces the symptoms of swelling, activates the regenerative processes in cartilage tissues;
3. UHF - eliminates pain, copes with swelling, prevents the formation of free radicals;
4. Ultrasonic exposure - activates metabolic processes in the articular tissues, stops the progression of inflammation, stimulates the regeneration of affected tissues, copes with swelling;

Electrophoresis - increases the effect of analgesics, activates blood circulation, improves joint mobility and stops their deformation.

Folk remedies

To eliminate the signs of rheumatoid arthritis, you can use effective folk recipes. However, they are allowed to be used only after consulting a doctor. It should be borne in mind that such substances cannot replace standard therapy for the disease.

The following recipes will help improve the patient's condition:

1. Herbal decoction. For this remedy, you need to take parsley root, elder flowers, willow bark and nettle leaves. Grind all the ingredients, take 1 tablespoon of the collection and pour 250 ml of boiling water. Put the mixture on low heat and cook for 5 minutes. Cool the finished composition and strain. Drink 2 glasses in the morning and evening.

Parsley Root Elder Blossom Willow Bark Nettle Leaves

1. A decoction of chestnut inflorescences. Take 200 g of raw materials, add 100 ml of vodka or alcohol, infuse the composition for 2 weeks in a dark place. Strain the finished product and take 5 drops 3 times a day. This should be done 1 hour before meals.
2. Burdock tincture. Mix the crushed leaves of the plant in equal parts with vodka. Put the finished product in the refrigerator. To use the liquid, you need to take a piece of gauze, fold it several times and moisten it in the solution. Apply to the affected joint. This remedy is good for pain relief.

Nutrition Features

The effectiveness of therapy directly depends on the diet of the patient. Therefore, doctors must prescribe a special diet for people with such a diagnosis. To avoid exacerbation of the disease, you need to exclude such products:

To speed up recovery, it is worth eating fresh vegetables and fruits. It is also good to eat rice. Help improve the patient's condition fish fat and mineral water. In addition, it is worth drinking freshly squeezed juices.

Possible consequences

Sometimes pathology provokes dangerous complications. The consequences of rheumatoid arthritis include the following:

Prevention of exacerbations

To make remission as stable as possible, you should follow these recommendations:

1. Regularly consult with a rheumatologist;
2. Eat right - in the diet should be a lot of fruits and vegetables, as well as foods high in calcium;
3. Stop smoking and drinking alcohol;
4. Do therapeutic exercises;
5. Harden the body;
6. Take multivitamin courses - this should be done 2 times a year;
7. Completely treat colds;
8. To walk alot;
9. Go swimming.

Rheumatoid arthritis is a serious pathology that significantly impairs a person's quality of life and can cause dangerous consequences.

To minimize the likelihood of complications, it is necessary to contact a specialist in time and clearly follow his appointments.

Rheumatoid arthritis - ICD code 10 - M05; M06.

For decades, scientists have been trying to find the exact infectious agent that causes rheumatoid arthritis.

Rheumatoid arthritis occurs with a genetic predisposition or after illness with a certain infectious disease.

Genetic predisposition as a factor in the occurrence of rheumatoid arthritis is indicated due to special genes that are found in people who have this disease. Such genes modify receptors on the surface of cell membranes in the body. And it is for this reason the immune system fails, ceasing to recognize its cells.

She begins to produce special antibodies against them, for destruction and removal from the body. These genes include DRB1.

Infectious diseases as factors in the occurrence of rheumatoid arthritis are indicated due to the fact that in the presence of certain viruses in the body, the risk of rheumatoid arthritis increases.

These viruses include:

• Rubella;
• Herpes;
• Epstein-Barr virus;
• Hepatitis B, etc.

Symptoms of rheumatoid arthritis

With rheumatoid arthritis, not only the joints are affected, but also various organs and systems of the body.

The main patterns of the development of the disease:

• most often the disease begins in the cold season;
• provoke the disease viral and bacterial infections; trauma; operations; allergies, etc.;
• there is a slow increase in the symptoms of the disease;
• the lesion begins with small peripheral joints of the hands and feet;
• Gradually, pathological processes involve other organs and systems of the body.

The symptoms of rheumatoid arthritis differ at different stages of the disease.

At the initial stage (in the latent period) of the disease before the onset clinical symptoms the patient notes:

• The appearance of constant fatigue;
• The appearance of weakness;
• Weight loss;
• Unreasonable increase in body temperature;
• The appearance of muscle pain;
• Increased sweating.

In most cases, with the appearance of rheumatoid arthritis, the patient complains of:

1. Pain in the joints, which is characterized by the following symptoms:

• Pain of an inflammatory nature;
• Constant;
• Aching;
• The undulating nature of the pain - in the evening there is an increase in it;
• The pain is relieved by taking anti-inflammatory drugs;
• The joints hurt symmetrically.

2. Pain in the muscles: prolonged aching pain is a symptom that accompanies acute inflammation.

3. Fever. High temperature is a reflection of the inflammatory processes taking place in the body. The higher the temperature rises, the more active and faster the disease develops.

4. Stiffness in the joints in the morning. A symptom such as joint stiffness from half an hour to an hour or more in the morning after sleep is one of the symptoms of rheumatoid arthritis. At this time, there is a limitation of mobility and pain in the affected areas with any movement.

Such morning symptoms are manifested due to the fact that during the night fluid accumulation (inflammatory exudate) occurs in the joint cavity, and there is also a violation of the daily rhythm of the release of glucocorticoid hormones.

Gradually, the progression of these symptoms occurs, as a result of which the functions of the joints are disturbed and deformations appear in them.

Video - Rheumatoid Arthritis

Diagnosis of rheumatoid arthritis

Diagnosis of the disease is mainly based on the evaluation of laboratory tests and instrumental examination of the joints.

Laboratory diagnosis of rheumatoid arthritis

Laboratory studies of rheumatoid arthritis are of the first and second categories.

Table - Indicators of a laboratory study of common signs inflammatory process

Table - Research on specific markers of rheumatoid arthritis

About such analyzes as ESR, C-reactive protein and rheumatoid factor, you can read in more detail in the following articles:

Methods of instrumental research of rheumatoid arthritis

Instrumental research methods consist in diagnosing the degree of damage to the joints of rheumatoid arthritis, its prevalence, stage, etc.

There are following methods instrumental diagnostics diseases:

1. arthroscopy;
2. X-ray of the joints;
3. Joint scintigraphy;
4. Biopsy of the synovial membrane of the joint;
5. Magnetic resonance imaging (MRI);
6. Ultrasonographic examination (ultrasound) of the joints and internal organs.

Table - Methods instrumental research

Criteria by which a doctor diagnoses rheumatoid arthritis

When making a diagnosis, the doctor takes into account all of the following signs:

• patient complaints;
• laboratory research;
• results of instrumental studies.

Diagnostic criteria:

1. Morning stiffness of the joints that lasts more than an hour.
2. Arthritis of small carpal and interphalangeal joints.
3. Symmetric arthritis is a mutual lesion of the joints most often involved in the pathological process.
4. Swelling of at least three of the following groups of joints, on both sides:

Hand joints:

• Interphalangeal proximal;
• Metacarpophalangeal;
• wrist;
• Elbow.

Leg joints:

• knee;
• Ankle;
• Metatarsophalangeal.

1. The presence of rheumatoid nodules, which are diagnosed only by a doctor.
2. Determination of rheumatoid factor in the blood by any available laboratory method.
3. Inherent x-ray changes in the joints and bones characteristic of rheumatoid arthritis.

The presence of four or more of the above criteria leads to the diagnosis of rheumatoid arthritis.

Treatment of rheumatoid arthritis

The main treatment for rheumatoid arthritis consists of the use of medications by mouth and in the form of local anesthesia and physiotherapy.

Medical treatment

Medical treatment during exacerbation of rheumatoid arthritis consists of:

• anti-inflammatory drugs;
• tumor necrosis factor inhibitors;
• steroid drugs.

Treatment of rheumatoid arthritis consists of two stages:

1. At the first stage, the acute phase of the disease is stopped. Treatment of the acute phase is to reduce the inflammatory process. For this purpose, non-steroidal anti-inflammatory drugs (NSAIDs) are primarily prescribed.
2. At the second stage, maintenance therapy is carried out.

Table - Drug treatment of rheumatoid arthritis

Local treatment

Local treatment of rheumatoid arthritis consists in the external application of ointments, creams to inflamed areas in order to relieve inflammation and reduce pain.

1. diclofenac,
2. indomethacin.

You can make a compress yourself by combining several medicines of this group.

For example:

1. mix diclofenac, dimexide, heparin and lidocaine in equal proportions;
2. apply this solution to a gauze bandage and apply to the diseased joint;
3. keep the compress for 1.5 hours before bedtime.

The action of such a compress is due to its constituent components:

• diclofenac and dimexide give an anti-inflammatory effect;
• heparin, which increases vascular permeability, promotes rapid and deep penetration of drugs into the body;
• lidocaine anesthetizes and reduces irritation in the tissues.

Physiotherapy

Simultaneously with the use of medications for rheumatoid arthritis, physiotherapy is prescribed to:

1. Reducing pain in joints and muscles;
2. Reduced morning stiffness;
3. Increasing the activity of the patient.

The following physiotherapy treatments may be applied:

• galvanic currents;
• Paraffin, ozocerite applications;
• ultrasound;
• Irradiation with infrared rays.

Treatment during remission

During the period of remission, the treatment of the disease continues. It can be based on the use of cytostatic drugs that have a depressing effect on all cells of the body.

These drugs are very highly toxic, so they are used with extreme caution.

The most common drugs in this group are:

1. Azathioprine;
2. Leflunomide;
3. Cyclophosphamide.

For the purpose of preventive measures during the remission period, it is necessary:

1. Consult a rheumatologist once every six months.
2. Do exercises, gymnastics, walk on massotherapy, relax in sanatoriums with procedures for the joints.
3. Perform sanitation of chronic foci of infection (tonsillitis, chronic sinusitis, pneumonia, pyelonephritis, etc.)
4. In case of instability in the joints and to prevent the development of further deformities, it is necessary to use orthopedic splints, simple supporting devices.

You may also be interested in:

People who are faced with rheumatoid arthritis experience unbearable pain and often lose not only their ability to work, but also the ability to move and serve themselves without outside help. Modern techniques, hardware and medications make it possible to quickly defeat a complex disease. How to accurately diagnose, what to focus on and whether it is possible to prevent the development of rheumatoid arthritis, we will try to tell in this article.

Erosive-destructive effect on the peripheral, mainly small joints, ultimately leading to extensive inflammation of the extremities. Inflammation goes like an avalanche from small foci to extensive damage to the tissues and cartilage of the arms and legs.

Rheumatoid arthritis symptoms

• Inflammation of synovial membranes.
• granulation tissue is formed.
• Large-scale growth of neoplasms and penetration into the cartilage of the joint.
• Complete or partial destruction of the articular bags.

Signs of rheumatoid arthritis usually appear simultaneously in the upper and lower limbs. First appear in the hands and feet. In the absence of the necessary treatment, the deformity can quickly become critical. Lead a person to a complete loss of mobility. As the disease progresses, it becomes exacerbated and affects all joint capsules, making the use of arms and legs almost impossible.

Modern medicine does not yet know the mechanism of occurrence and development rheumatoid joints. The main reason is believed to be genetic predisposition and exposure to external infections. Often the root cause is a poorly treated viral, colds. The basis of pathogenesis can be considered the development of autoimmune changes under the influence of unknown viruses.

Types of disease

The annual appeal for help is at least 1.3% of the population. The average incidence does not exceed 0.02%. Basically, the disease affects people who have passed average age. Women are much more likely to experience manifestations of the disease. If there is a person in the family suffering from this disease, there is a high degree of probability that children and grandchildren will also be his victim.

Among the main types are:

• Infectious. It affects the joints due to viral infections.
• or Still's disease. It is characterized by fever and exacerbation of anemia. In the chronic form and poor treatment, it can affect the cardiovascular system and lungs, affect the eyes and nerve endings.
• Genetic. It affects mainly people with a predisposition to the disease at any age.

early signs of rheumatoid arthritis

Often people who have had a cold on their feet without proper professional treatment begin to feel some discomfort during sudden exertion, long walking or long work with their hands. You should be more careful about the appearance of swelling in the phalanges of the fingers. Rheumatoid arthritis, diagnosed in a timely manner, can be overcome by prescribing appropriate treatment and strictly following the doctor's instructions. Subacute or acute course will instantly affect performance.

The first signs include:

• A sharp deterioration in well-being and rapid fatigue, turning into a chronic state.
• The muscles are in a flabby state and do not tolerate prolonged work.
• Jump-like decrease in weight to minimum values.
• Frequent seizures and sharp pains for no apparent reason in the limbs.
• The temperature can change dramatically within the subfibral level and stay from 37 to 38 degrees.
• Unreasonable sweating and the appearance of an unpleasant odor.

If a person does not pay attention to the appearance of such symptoms and does not take the necessary measures, the disease can develop spasmodically and quickly. Then there are changes in the joint capsules leading to more serious consequences and possible loss of joint mobility. The appearance of the whole complex of symptoms and a sharp deterioration in well-being signals the transition to the chronic stage.

Symptoms characteristic of rheumatoid arthritis of the joints

Numerous clinical researches made it possible to accurately identify the symptoms that indicate the development of the disease. Physicians, when taking patients, should highlight key points confirming the development of rheumatoid arthritis by collecting an anamnesis.

The main features include:

• Characteristic. They begin and continue haphazardly and have the character of gnawing and aching.
• In the morning, it takes a considerable amount of time to overcome the stiffness of the joints and restore their mobility.
• The appearance of swelling. Persistent redness and partial deformation of the articular capsules.
• With a long absence proper treatment, joint mobility can be completely impaired and lead to partial paralysis.

The doctor conducting the examination must pay attention to the patient's reaction to lateral palpation of the joint. Articular bag affected by rheumatoid arthritis has high temperature, and the skin is brighter in color and denser in structure. The specialist can easily feel the rheumatoid nodules, which accurately indicate the development of the disease and the transition to the acute phase. There are three main degrees of development of rheumatoid arthritis.

1. Short. The patient rates the pain on a scale of three to ten. Morning stiffness lasts no more than half an hour. ESR within 15-30. SRP two plus.
2. Average. Pain above four. Morning stiffness lasts 12 hours. ESR 30-45. SRP plus three. Pronounced swelling and redness.
3. High. Pain above six. The stiffness does not go away and does not allow normal movement. ESR more than 45. CRP four pluses. The joints practically do not bend and do not allow to move independently deformed.

Characteristic extra-articular symptoms

are clearly expressed in the absence long-term treatment and the transition of rheumatoid arthritis to a chronic form. They may develop gradually or abruptly. It all depends on the course of rheumatoid arthritis.

• The manifestation of myositis, a sharp weakening of the muscles, partial or complete atrophy of tissues.
• Changing the structure of the skin. The appearance of dryness, peeling and partial necrosis of diseased areas.
• Reduced blood flow to the phalanges of the fingers leads to changes in the nails. Dashes appear, the structure becomes highly brittle.
• Pronounced rheumatoid nodules with a diameter of up to two millimeters near the affected articular bags.

The most severe cases are accompanied by damage to the gastrointestinal tract, nervous and lymphatic systems.

Cordially vascular system may undergo major changes. Lack of correct effective treatment can affect the functioning of all internal organs and lead to death.

rheumatoid arthritis treatment

After collecting an anamnesis, conducting a full course of examinations with tests, the doctor will make a diagnosis and choose a treatment method. The more accurately the patient complies with all the prescriptions, the more likely it is to be cured of an insidious and dangerous disease. Complex forms are treated in a hospital under the constant supervision of doctors and using all the medications and hardware of modern medicine.

The drugs used include:

• Non-steroidal anti-inflammatory drugs. Diclofenac, ibuprofen, nimesil.
• base complex. Methotresat, gold preparations, leflunomide.
• Hormonal substances for individual use. Regulator of differentiation of lymphocytes.
• biological agent. Prednisolone, dixitasone, methylprednisolone.

Medicine is able to quickly cope with the disease when right choice treatment methods. The ideal option is to go to the hospital and undergo a full course of treatment using all the means available in the arsenal, including hardware, physiotherapy and medication. For a complete cure, it is necessary to set strictly defined goals and gradually follow the doctor's prescriptions.

• The maximum reduction in symptoms, and, if possible, the complete elimination of manifestations of rheumatoid arthritis.
• Prevention of partial or complete destruction of joint capsules, deformation, tissue changes.
• It is necessary to achieve positive dynamics as soon as possible, in the treatment of relieving the patient of pain and restoring joint mobility.

Physiotherapy procedures

They are prescribed only after the end of the acute stage of rheumatoid arthritis. It is necessary to get rid of edema, make sure that the tests have returned to normal and mobility has been restored. Massage and other physical effects stimulate metabolic processes and can cause exacerbation. Properly selected exercises and gentle massage stimulate blood flow, which helps to remove toxins faster and enrich the joints with the necessary microelements for tissue regeneration.

Ozokerite, paraffin, UHF and others procedures help to restore the functioning of the joints. When discomfort you should immediately consult a doctor to change the method.

Surgical intervention

A quick operation can radically change the situation and make the treatment more effective for frequently inflamed joints and deformities of the articular capsules. The surgeon removes the synovial membrane of the joint, resulting in long-term relief and gradual recovery. Prosthetics is indicated for people whose joint capsule is completely destroyed and it is no longer possible to restore the normal functioning of the body. The most common are hip and knee replacements.

Surgery can help with:

• Severe pain and low effectiveness of drugs.
• Correct deformed joints, restore their mobility and the ability to move normally.
• Partial or total loss joint mobility.

Proper nutrition for rheumatoid arthritis

Rheumatoid arthritis of the joints requires adherence to a certain diet. A strict diet will help normalize metabolic processes and guarantee the intake of essential vitamins and minerals. Losing weight will help relieve additional stress on the joints. In order for the body to effectively fight the disease, it is required:

• Increase the proportion of plant foods in your diet, be sure to include fresh vegetables and fruits.
• Remove from the diet any foods that cause allergies.
• Do not eat products with a large amount of dyes and chemical additives.
• Calculate your daily diet in such a way that a lot of calcium and potassium are always present in food.
• Do not abuse spicy, salty and fatty foods.
• Avoid sweet and starchy foods.
• Try to get rid of excessive consumption of coffee, alcohol and cigarettes.

Disease prevention

You need to get rid of it as soon as possible bad habits. Drinking alcohol, smoking and being overweight are major risk factors. At the first signs of viral infections, treatment should not be neglected. A few days in a warm bed, consulting a doctor will help you quickly restore health and prevent rheumatoid arthritis from developing. Active lifestyle. Sports and daily walks in the fresh air will ensure normal blood circulation and rapid tissue regeneration.

Studies of specialized clinics say that rheumatic arthrosis of the joints can shorten life by fifteen years. By contacting a doctor in time for help, you can live a full life for a solid period of time. An insidious disease can lie in wait at any age and it is required not to miss the opportunity to get rid of rheumatoid arthritis. Qualified advice from a specialist will help you quickly get rid of the disease.

What is rheumatoid arthritis (polyarthritis)

Rheumatoid arthritis of the joints is a systemic autoimmune disease of the connective tissue, which is characterized by damage to the small joints. If we are talking about multiple lesions of the joints, then such rheumatoid arthritis is called rheumatoid arthritis. Treatment of rheumatoid arthritis (polyarthritis) of the joints should be directed to antibacterial, antiviral therapy, elimination chronic inflammation, removal of pain syndrome and autoimmune manifestations, restoration of metabolism in the articular cartilage, prevention of further destruction of cartilage.

Symptoms of rheumatoid arthritis (polyarthritis)

1. Symptoms of inflammation of the joints (increased temperature of the skin above them, swelling, pain) are permanent (and not only in the acute phase, as in reactive arthritis). The pain is constant, worse at rest, often in the morning, patients are very difficult to tolerate it, do not sleep well, are nervous. Swelling of the joints can be from slight to such an extent that the limbs generally lose their usual shape: they are barrel-shaped, inflammatory changes in the joints of the hands lead to the fact that the fingers take the form of sausages.
2. Rheumatoid arthritis usually affects small joints (in contrast to osteoarthritis and reactive arthritis, which are characterized by damage to large joints).
3. Rheumatoid arthritis, unlike arthrosis, is characterized by morning stiffness lasting more than 1 hour. At the same time, rheumatoid arthritis of the joints causes atrophy of the muscles located near the affected joint over time. Over time, it will only progress. When compared with arthrosis, then muscle atrophy is not typical for arthrosis.
4. A very common symptom of rheumatoid arthritis is the symmetry of joint damage. For example, rheumatoid arthritis of the fingers. Under the condition of early diagnosis and timely initiation of treatment, further development of the disease can be prevented, otherwise all joints can gradually be included in the pathological process. Most often in rheumatoid arthritis, damage to the interphalangeal and wrist joints is noted (in 55% of cases), the shoulder joint is relatively rarely involved in the process, hip joint is affected in 40% of cases (especially in middle-aged people), damage to the knee joint is most common in young people and children. Ankle joints suffer less frequently (in 5% of cases), damage to the joints of the feet occurs very rarely (mainly with a common "malignant process").
5. Rheumatoid arthritis (polyarthritis), regardless of the severity of the disease, is often accompanied by conjunctivitis ( inflammation of the mucous membrane of the eye). Children with rheumatoid arthritis often develop serious illnesses eyes with lesions of the sclera, the inner membrane of the eye, in 1.2% of cases (in severe cases) developed complete blindness. Damage to the eyes is due to the similarity in the structure of the synovial membrane of the joint and eye tissues, therefore, the inflammatory process with the formation of rheumatoid nodules also captures eye tissues.
6. Inflammatory changes in the lungs of varying severity occur in 50% of patients with rheumatoid arthritis. Usually, inflammatory changes in the lungs are latent at first, patients may notice dry cough and shortness of breath with exacerbation of the articular syndrome, in the future with a severe course of the disease connective tissue is affected and the membrane (pleura) of the lungs and severe pneumonia and pleurisy develop, leading to fibrous degeneration of the lung tissue (replacement of lung tissue by connective tissue that cannot perform respiratory function and can lead to death from respiratory failure).
7. Liver damage in rheumatoid arthritis (polyarthritis) is very rare (in 1.5% of cases), damage to the gastrointestinal tract is associated with side effect drugs for the treatment of rheumatoid arthritis, and is quite rare. But kidney damage is considered the most common cause lethal outcome. In the kidneys, the same process occurs as in the lungs: as a result of inflammation, the kidney tissue is replaced by fibrosis, and the kidneys stop doing their job. Damage to the internal organs occurs, as a rule, in the absence of treatment for rheumatoid arthritis at the 3-4th year from the onset of the disease, and is considered a complication. However, there are known cases of fulminant course of rheumatoid arthritis, when within a month death occurred from acute pulmonary and kidney failure. The reasons for this course of the disease have not yet been elucidated; at autopsy, instead of the lungs and kidneys, a conglomerate of connective tissue with numerous rheumatoid nodules is found.
8. Already in the early stages of rheumatoid arthritis (polyarthritis) are detected nervous system disorders in the form of increased irritability or, conversely, isolation, increased sweating (especially of the palms and soles), dryness, skin depigmentation, brittle nails, and also in the form of trophic disorders that are so characteristic of rheumatoid arthritis.
9. Anemia due to a slowdown in iron metabolism in the body caused by impaired liver function; decrease in the number of platelets.

So, rheumatoid arthritis, - the main characteristics:

1. the presence of an infection;
2. autoimmune component;
3. the presence of an inflammatory process;
4. damage to the joints of the fingers and toes;
5. pain syndrome;
6. damage to nails and mucous membranes (eyes, Bladder, etc.).
7. nervous system disorders.

Causes of rheumatoid arthritis (polyarthritis)

The cause of rheumatoid arthritis is unknown. Possible causes include microbial or viral infections, trauma, allergies, heredity, nervous stress, excessive emotional stress(For young women, childbirth can be stressful.) Further development of the disease associated with autoimmune processes: damaged by microbial or viral infection joint tissues become “alien” for the body, and the body begins to “destroy” them, contributing to the further development of the disease.

Treatment of rheumatoid arthritis (polyarthritis)

Treatment of rheumatoid arthritis (polyarthritis) should be directed to:

1. antibacterial, antiviral therapy;
2. elimination of chronic inflammation;
3. removal of pain syndrome;
4. autoimmune manifestations;
5. restoration of metabolism in the articular cartilage (i.e. prevention of further destruction of cartilage) and maximum preservation of the function of the affected joints;
6. correction of the psycho-emotional state, elimination of symptoms of chronic fatigue and the effects of stress;
7. detoxification of the body, - the removal of toxins formed due to the vital activity of viruses and bacteria;
8. restoration of the affected mucous membranes (bladder, etc.).