Arthritis can have different symptoms. Children and adolescents suffer from juvenile idiopathic arthritis (JIA), adults are usually diagnosed with degenerative disease and rheumatoid arthritis. A frequently occurring rheumatic disorder is ankylosing spondylitis (ZZSK). Other spondyloarthritis (arthritis with spine involvement) includes reactive arthritis, psoriatic arthritis and arthritis in the course of intestinal diseases. Pain, swelling, limitation of fitness and other symptoms of arthritis are also associated with arthritis (gout) and systemic lupus erythematosus. Unfortunately, the list of rheumatic diseases is much more substantial – it covers over 100 different disease entities. However, regardless of what caused arthritis, the treatment should be done comprehensively. What therapeutic methods are used to treat rheumatism?
The treatment of diseases affecting the joints is primarily helped by pharmacology – drugs relieve pain, eliminate swellings, restore joint mobility, prevent the spread of inflammation to other organs. In the case of chronic diseases (RA, JIA, ZZSK), the most important is the adoption of classic drugs modifying the course of the disease (gold salts, antimalarial drugs, cyclosporine, methotrexate). These measures delay the process of degeneration of the joints, thanks to which the patient keeps the body functioning for longer.
Because LMPCh begin to work only after 1-6 months of treatment, the doctors focus on the relief of symptoms caused by arthritis. Treatment then involves the adoption of non-steroidal anti-inflammatory drugs and glucocorticosteroids – the latter can also be administered in the form of direct intra-articular injections. Preparations from both groups reduce inflammation, and thus relieve pain, eliminate swelling and improve the physical functioning of the patient. Unfortunately, people taking them are exposed to numerous side effects, therefore NSAIDs and GSK are used only at the beginning or in the event of exacerbation of symptoms.
In severe cases, the treatment of arthritis is enriched with modern biological drugs that not only relieve rheumatic symptoms, but also stop the progression of joint damage. Due to the strong immunosuppressive action, they are introduced only when other medicines have not managed to cope with the symptoms and the disease has come back. In order to increase the effectiveness of treatment, a combination therapy with the combination of biological medicines and disease-modifying drugs (usually methotrexate) is carried out.
However, not all of the above-mentioned preparations are administered to every patient for arthritis, the treatment depends, inter alia, on on the type of disease, the severity of symptoms and the general state of health of the patient. For example, biological drugs are given only in serious cases due to high costs of treatment, while NSAIDs must be extremely carefully administered due to numerous contraindications and side effects.
Chronic inflammation causes limited mobility of the affected joint and progressive deterioration of fitness. Here, the drugs themselves are not enough – for the patient to remain independent for longer, he should actively engage in the healing process. Daily exercises ensure very good results in the treatment of arthritis. Although in the beginning the movement can cause pain, in the long run it helps in nutrition of the articular cartilage and reduces friction between the articular structures. Conscientiously performed gymnastics prevents muscle contractures, strengthens the entire movement system, eliminates morning stiffness, increases mobility in the joint. It is worth taking into account that in some rheumatic diseases (eg, ZZSK) rest paradoxically intensifies symptoms, while physical activity eliminates them. Of course, gymnastics can not be too forceful, that’s why a physiotherapist should choose exercises and show the patient how to do them at home.
In addition to kinesitherapy (treatment with movement), treatment of arthritis can be supported by a variety of physiotherapy treatments, such as:
For the above-mentioned methods to help arthritis, the treatment should be prescribed by a specialist (rheumatologist or orthopaedist) and individually selected for the patient.
People with chronic arthritis often have long-term drug intake and are therefore looking for alternative treatments. They see hope in more or less controversial procedures – from acupuncture and acupressure, through special diets, to hirudotherapy (treatment with leeches). Doing so can cause a lot of damage to the patient. First of all, it gives false hope for a complete cure (arthritis is often chronic) and delays the implementation of specialized therapy. Only properly selected drugs and rehabilitation are able to stop the progress of the disease, improve the patient’s performance and prevent serious systemic complications.
Nevertheless, the patient can also relieve arthritis by himself – home treatment includes on observing a healthy diet rich in vitamins and minerals, maintaining the correct weight, relieving the joints (using sticks, balls, special bands and stabilizers). Cold compresses, ointments and gels can be used for edema, while a high-quality medical mattress helps prevent deformities (especially at AS) and early stiffening.