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Rheumatoid Arthritis Treatment

There is no known cure for rheumatoid arthritis. However, many different types of treatment can be used to alleviate symptoms and give pain relief.

Historic treatments for this condition have included: gold salts, RICE, acupuncture, apple diet, nutmeg, some light exercise every now and then, nettles, bee venom, copper bracelets, rhubarb diet, rest, extractions of teeth, fasting, honey, vitamins, insulin, magnets, and electric convulsion therapy (ECT). Cortisone therapy has offered relief to many patients in the past, but its long-term effects have been deemed undesirable.

(I have seen many cases of rheumatoid arthritis completely clear up after a radical change in diet  -to a diet of plant-based foods -- raw, living foods like nuts, seeds and fruits and veggies.  No grains, dairy or meat etc.-- (nurse's note)

Artrhtis medications - arthritis drugs -- Pharmacological treatment of rheumatoid arthritis can be divided into disease-modifying anti rheumatic drugs (DMARDs), anti-inflammatory agents and analgesics. DMARDs have been found to produce durable remissions and delay or halt disease progression. In particular they prevent bone and joint damage from occurring secondary to the uncontrolled inflammation. This is important as such damage is usually irreversible. Anti-inflammatories and analgesics improve pain and stiffness but do not prevent joint damage or slow the disease progression.

There is an increasing recognition amongst rheumatologists that permanent damage to the joints occurs at a very early stage in the disease. In the past the strategy used was to start with just an anti-inflammatory drug, and assess progression clinically and using X-rays. If there was evidence that joint damage was starting to occur then a more potent DMARD would be prescribed. Tools such as ultrasound and MRI are more sensitive methods of imaging the joints and have demonstrated that joint damage occurs much earlier and in more patients than was previously thought. Patients with normal X-rays will often have erosions detectable by ultrasound that X ray could not demonstrate.

Light exercise may be beneficial for improving blood circulation to joints and thereby allowing white blood cells to get to the area requiring treatment.

There may be other reasons why starting DMARDs early is beneficial as well as prevention of structural joint damage. In the early stage of the disease, the joints are increasingly infiltrated by cells of the immune system that signal to one another and are thought to set up self-perpetuating chronic inflammation. Interrupting this process as early as possible with an effective DMARD (such as methotrexate) appears to improve the outcome from the rheumatoid arthritis for years afterwards. Delaying therapy for as little as a few months after the onset of symptoms can result in worse outcomes in the long term. There is therefore considerable interest in establishing the most effective therapy in patients with early arthritis, when they are most responsive to therapy and have the most to gain.

The Prosorba column blood filtering device - FDA approved it for treatment of rheumatoid arthritis in 1999 . The Prosorba column employs protein A covalently bound to an inert silica matrix. The protein A binds immunoglobulin G (IgG) and circulating immune complexes (CIC). This blocks antigens responsible for autoimmune joint deterioration. But results are not known.

Rheumatoid arthritis treatment also includes rest and physical activity. Regular exercise is important for maintaining joint mobility and making the joint muscles stronger. Swimming is especially good, as it allows for exercise with a minimum of stress on the joints. Heat and cold applications are modalities that can ease symptoms before and after exercise. Pain in the joints is sometimes alleviated by oral acetaminophen (paracetamol). Other areas of the body, such as the eyes and lining of the heart, are treated individually. Fish oil may have anti-inflammatory effects.

Rheumatoid arthritis treatment - other therapies

Other therapies include weight loss, occupational therapy, podiatry, physiotherapy, joint injections, and special tools to improve hard movements (e.g. special tin-openers). Severely affected joints may require joint replacement surgery, such as knee replacement.

Although there is no known cure for rheumatoid arthritis many different types of treatment can be used to alleviate symptoms and give pain relief.



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