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Medicines for rheumatoid arthritis

10 Jul 18

Medicines for rheumatoid arthritis

Rheumatoid arthritis is a complex autoimmune disease, the causes of which are not fully understood. The immune system malfunctions, causing the body to “attack” healthy cells. This happens with joints; the immune system destroys cartilage and bone tissue.

The disease appears at any age - children and adolescents, young women, and older people are at risk of developing rheumatoid arthritis. There are factors that provoke the disease - genetic predisposition, infections and viruses that have entered the body, hypothermia, stress, intoxication.

Rheumatoid arthritis is treatable. The period from the start of treatment to recovery cannot be predicted; it depends on the characteristics of the body and how much the doctor’s instructions are followed. Rheumatoid arthritis cannot be cured in a month; it takes more time. The patient should be patient and not ignore the stages that make up the complex treatment.

Medicines for rheumatoid arthritis are divided into groups. These are drugs that relieve inflammation, relieve pain, basic drugs, and drugs that reduce the activity of the immune system. A rheumatologist prescribes individual joint treatment for each patient, based on the severity of the disease and individual characteristics of drug tolerance.

Nonsteroidal anti-inflammatory drugs

Treatment of rheumatoid arthritis begins with taking non-steroidal anti-inflammatory drugs - Diclofenac, Ibuprofen, Ketorolac. These drugs are not directly cures for rheumatoid arthritis, but are integral components of treatment.

Diseases of the joints of a rheumatic nature are accompanied by an acute inflammatory process:

  • Severe pain in the joints when moving, at rest, often at night.
  • Swelling of the periarticular area.
  • Redness and increased temperature of the skin around the joints.
  • Increased body temperature.
  • Muscle weakness.
  • General deterioration of condition, loss of appetite, sleep disturbance.
  • Anti-inflammatory drugs relieve these symptoms. Allows you to return to your normal lifestyle without experiencing pain when walking and at rest.

    The drugs are effective, act quickly, and have side effects on the digestive system. Therefore, you cannot select the drug yourself, on the recommendation of a doctor. He will help you choose tablets that will be suitable and will not cause side effects. This is important because patients with rheumatism take such drugs for a long time.

    Often the trigger of rheumatoid arthritis is an infection that is removed from the body. Antibiotics will help - chloramphenicol, bicillin. When chloramphenicol and bicillin are needed:

  • Long-term infectious process in the body.
  • Exacerbation of chronic diseases.
  • Bacterial infection of the joints, accompanied by inflammation in the synovial bursa of the joint.
  • Bicillin will eliminate the source of inflammation, acting directly on the infection, as it has a bactericidal and antibacterial effect. An antibiotic belonging to the penicillin group. Produced in the form of a powder for the preparation of a solution for intramuscular administration.

    Bicillin has a cumulative effect that lasts up to four weeks. Bicillin has contraindications and side effects. You should not take antibiotics without a doctor's prescription. The dosage and duration of taking the drug is determined by the doctor.

    Contraindications to treatment with bicillin:

  • Pregnancy and breastfeeding.
  • Bronchial asthma.
  • Kidney and liver diseases.
  • Use with caution in patients who:

  • Hives.
  • Hay fever.
  • Allergy and hypersensitivity to other antibiotics.
  • It is important that during the injection, bicillin does not get under the skin or into a vein. This will cause complications in the form of Wanier syndrome.

    The choice of antibiotic is made by the doctor depending on the infection and the severity of joint damage.

    During treatment with bicillin, vitamin B and C are prescribed to prevent the development of fungal infection.

    Steroidal anti-inflammatory drugs

    These are hormonal drugs to relieve inflammation and relieve joint pain. The drugs have contraindications and side effects; they should be taken with great caution and only when necessary. These include prednisone, prednisolone. For rheumatoid arthritis they are prescribed in the following cases:

  • Severe joint pain when non-steroidal anti-inflammatory drugs do not relieve pain.
  • To eliminate severe swelling in the area of ​​inflamed joints.
  • To restore limb mobility and relieve pain during movements.
  • Hormonal drugs are produced in tablets for oral administration, solution for intramuscular and intra-articular administration. These drugs have a quick effect, cope with severe pain and relieve acute inflammation, but behind their effectiveness there are side effects:

  • Increase in the patient's body weight.
  • Exacerbation of diabetes mellitus.
  • Weakening of the immune system, which is not bad for rheumatoid arthritis.
  • The destruction of bone and cartilage tissue in rheumatoid arthritis is very bad.
  • The drugs are prescribed in small doses, taken for a short time, so that they do not cause damage to health and the treatment does not drag on.

    Basic therapy forms the main part when treatment of rheumatoid arthritis is planned. These medications fight the main cause of the disease and help restore damaged cartilage tissue.

    Medicines included in basic therapy:

  • Immunosuppressants. Drugs that reduce the activity of the immune system. The more it is suppressed, the less damage it causes to joints. They won’t leave you completely without immunity, but the measure is necessary in the fight against rheumatoid arthritis. A common and effective drug of the group is methotrexate. The patient observes an improvement in his condition after a month. Immunosuppressants (cytostatics) include Arava, Remicade, Cyclosporine.

    Basic therapy drugs, and more, can be obtained free of charge, even without a disability. Talk to your doctor about this.

    Chondroprotectors are “building materials” that restore damaged cartilage tissue of joints. It is not enough to relieve inflammation and relieve pain; it is necessary to restore the joints to return activity.

  • Alflutop. The drug has proven itself well when it comes to treating arthritis and joint diseases. Alflutop has no contraindications and is safe. Restores cartilage tissue of joints, relieves pain, allowing the patient to reduce the dosage or stop taking anti-inflammatory drugs. Alflutop is produced in a solution for intramuscular and intra-articular injections. The drug is administered once every three days into each affected joint; after six procedures, alflutop is administered intramuscularly.
  • Tetraflex. A chondroprotector that combines the action of an anti-inflammatory drug.
  • Don. Available in tablets and solutions for injection.
  • Movex. A chondroprotector containing diclofenac, which gives it an analgesic effect.
  • Doctors are increasingly prescribing combination drugs containing chondroitin sulfate, glucosamine and an anti-inflammatory element. This allows you to reduce the load on internal organs from taking NSAIDs in their pure form and reduce the amount of medications taken.

    Medicines aimed at treating rheumatoid arthritis are effective. It is important to follow your doctor's recommendations, since many drugs, like bicillin and some anti-inflammatory drugs, have contraindications and special instructions for use.

    How to cure rheumatoid arthritis?

    Rheumatoid arthritis is a common pathology that involves inflammation of peripheral joints. The pathological process involves synovial joints and periarticular tissues, with autoimmune disorders forming the basis of the pathogenesis of the disease. As the disease progresses, destruction of cartilage and bone tissue occurs in the body, and systemic inflammatory reactions develop. Therefore, the question of how to treat rheumatoid arthritis in the most effective way is quite acute in modern medicine.

    Before you read further, I want to warn you. Most of the remedies for “treating” joints that are advertised on TV and sold in pharmacies are a complete scam. At first it may seem that creams and ointments help, BUT in fact they only remove the symptoms of the disease.

    In simple words, you buy a regular painkiller, and the disease continues to develop into a more severe stage.

    Ordinary joint pain can be a symptom of more serious diseases:

  • Acute purulent arthritis;
  • Osteomyelitis is inflammation of the bone;
  • Seps - blood poisoning;
  • Contracture - restriction of joint mobility;
  • Pathological dislocation is the release of the head of the joint from the articular fossa.
  • How to be? - you ask.

    We have studied a huge amount of materials and, most importantly, tested most of the remedies for treating joints in practice. So, it turned out that the only drug that does not relieve symptoms, but truly heals joints, is Artrodex.

    This drug is not sold in pharmacies and is not advertised on TV or on the Internet, and according to the promotion it costs only 1 ruble .

    So that you don’t think that they are selling you another “miracle cream,” I will not describe how effective this drug is. If you are interested, read all the information about Artrodex yourself. Here is a link to the article.

    Features of the pathogenesis of rheumatoid arthritis

    The directions of therapeutic tactics of this disease are determined by its pathogenesis. By blocking pathogenetic links, the therapeutic effect of drug treatment is achieved.

    The chronic inflammatory process in rheumatoid arthritis has the following key points:

  • Activation of immune cells, which include B and T lymphocytes, macrophages, and their subsequent proliferation. This provokes the release of mediator molecules - growth and adhesion factors, cytokines. In addition, autoantibodies are synthesized and immune complexes are formed.
  • The listed processes stimulate angiogenesis, as a result of which new capillaries are formed. Proliferation in the synovial membrane is also activated. COX-2 (type 2 cyclooxygenase) is activated, which causes an increase in the biosynthesis of prostaglandin molecules.
  • Subsequently, an inflammatory reaction develops, proteolysis enzymes are released, osteoclasts are activated - the process of destruction of cartilage and bone tissue of the joints begins, and deformities occur.
  • Based on the links of pathogenesis, the course of drug therapy is determined. There are two possible directions of drug treatment:

  • immunosuppression to suppress the functional activity of immune cells;
  • blocking the biosynthesis of mediator molecules through an inhibitory effect on COX-2.
  • Tactics of therapeutic correction of rheumatoid arthritis

    The answer to the question of how to treat rheumatoid arthritis involves the following areas of therapy:

    Medical practice: more than 30 years.

    I have been treating painful joints for many years. I can say with confidence that joints can always be treated, even in very old age.

    Our center was the first in Russia to receive certified access to the latest drug for osteochondrosis and joint pain. I confess to you, when I first heard about it, I just laughed because I didn’t believe in its effectiveness. But I was amazed when we completed testing - 4,567 people were completely cured of their illnesses, this is more than 94% of all subjects. 5.6% felt significant improvements, and only 0.4% saw no improvement.

    This drug allows you to forget about back and joint pain in the shortest possible time, literally from 4 days, and cure even very complex cases within a couple of months.

  • drug treatment;
  • physiotherapeutic treatment;
  • massage;
  • orthopedic measures;
  • rehabilitation methods.
  • Therapy of rheumatoid arthritis pursues the following goals:

  • Elimination of clinical manifestations of rheumatoid arthritis and achieving a decrease in disease activity up to complete remission.
  • Reducing the rate of progress of changes in the structure and function of cartilage and bone tissue of joints.
  • Correction of the patient’s quality of life, restoration and preservation of performance.
  • Goals may change - this is influenced by the duration of the disease itself. Remission is achievable in the early stages of the disease - up to a year. If the disease continues for a long time, then the likelihood of achieving a full recovery is significantly lower. In this case, more attention should be paid to orthopedic and rehabilitation methods.

    Drug treatment

    As mentioned above, drug therapy for rheumatoid arthritis is aimed, on the one hand, at suppressing immune activity, and on the other, at blocking the synthesis of mediator molecules. The first level of influence is undoubtedly more effective, since it affects the deepest link of pathogenesis.

    Immunosuppressive therapy is the basis in the process of getting rid of rheumatoid arthritis. The following groups of drugs act as immunosuppressants:

  • Basic anti-inflammatory drugs.
  • Biological agents.
  • Glucocorticosteroid drugs.
  • The use of immunosuppressants in the treatment of the disease is characterized by a slow rate of clinically noticeable effect. It can range from several days to months. Despite the low speed of onset of the effect, it is distinguished by its severity and durability. In this case, inhibition of destruction processes in the joints is observed.

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    Glucocorticosteroids and also non-steroidal anti-inflammatory drugs (NSAIDs) also act at the level of blocking the biosynthesis of inflammatory mediators. The clinically significant effect of anti-inflammatory treatment is achieved faster - a couple of hours is enough to achieve it. But such treatment temporarily relieves symptoms and is not able to stop destructive processes in joint tissues.

    Basic anti-inflammatory drugs

    Basic drugs are the main answer to the question of how to treat rheumatoid arthritis. If the patient has no contraindications to their use, then basic medications are prescribed in any case. The use of drugs at an early stage helps to achieve better long-term results. This phenomenon is called the “therapeutic window”, it refers to the time period when taking medications is most effective in achieving remission.

    Basic anti-inflammatory drugs have the following characteristics:

  • Suppression of proliferation and activity of immune cells.
  • Suppression of the division of fibroblasts and synoviocytes.
  • Maintaining lasting treatment results even after discontinuation of the medication.
  • Delay in the spread of the erosive process in the joint tissue.
  • Induction of clinical remission.
  • Low speed of achieving clinical effect (from one to three months).
  • Basic anti-inflammatory drugs are divided into first-line medications and second-line medications. Drugs from the first group have the best ratio of the effectiveness of use and tolerability of drugs by patients during treatment, so they are prescribed more often.

    First-line drugs include:

    These drugs cause lasting improvement in the condition of patients with rheumatoid arthritis. They are appointed for a period of at least six months. The duration of the appointment is determined by the doctor depending on the patient’s condition. The average duration of a course of therapeutic correction with one drug is from 2 to 3 years. Experts recommend indefinitely long-term administration of maintenance doses of basic drugs in order to maintain a positive clinical effect.

    In case of low effectiveness of monotherapy with one basic drug, the doctor selects an effective combination of several drugs. Among the most effective combinations are the following:

    1. Methotrexate, Hydroxychloroquine, Sulfasalazine.
    2. Methotrexate, Sulfasalazine.
    3. Methotrexate, Cyclosporine.
    4. Methotrexate, Leflunomide.

    In the case of combined use, average dosages of basic drugs are used. In this case, the treatment regimen is selected so that the likelihood of side effects is minimal.

    Biological agents

    How is rheumatoid arthritis treated, besides basic medications? Biological drugs have been used quite successfully. These include products that are produced using biotechnological advances. Biological drugs precisely block key points of the pathological process. These medications include the following:

    Biological agents have a pronounced clinically significant effect and effectively inhibit destructive processes in joint tissues. They are also characterized by rapid onset of action—several days. In addition, biological drugs potentiate the effect of basic anti-inflammatory therapy.

    However, side effects are also typical for biological drugs. These include:

  • inhibitory effect on antitumor and anti-infective immunity;
  • high risk of hypersensitivity reactions and induction of autoimmune processes.
  • Biological drugs are more often used in cases of low effectiveness or poor tolerability of basic therapy.

    Glucocorticosteroid drugs

    This group of drugs is characterized by a pronounced anti-inflammatory effect, which is explained by blocking the biosynthesis of inflammatory mediator molecules - prostaglandins and cytokines, and a decrease in the rate of proliferation due to the effect on the cellular genetic apparatus.

    The effect of glucocorticosteroids is high speed and dose dependent. Taking them can cause serious adverse reactions, the likelihood of which increases with increasing dosage. Side effects include:

  • erosion of the mucous lining of the gastrointestinal tract;
  • Itsenko-Cushing syndrome of medicinal nature;
  • steroid osteoporosis.
  • Glucocorticoids do not provide sufficient control over the course of the disease, so they are prescribed together with basic therapy. Steroid drugs can be prescribed both systemically (intravenous injections) and locally (periarticular and intra-articular administration).

    Nonsteroidal anti-inflammatory drugs

    In modern medicine, the importance of NSAIDs in the treatment of rheumatoid arthritis is gradually decreasing, as new effective pathogenetic treatment regimens appear. The effect of using non-steroidal anti-inflammatory drugs is possible as a result of blocking the enzyme cyclooxygenase, which is key in the process of biosynthesis of prostaglandin molecules. As a result, the clinical symptoms of inflammation go away, but the course of the disease does not stop. Therefore, NSAIDs are prescribed together with basic therapy.

    Non-steroidal drugs also have a number of undesirable effects, including:

  • erosive lesions of the gastrointestinal tract;
  • nephrotoxic effect;
  • hepatotoxic effect.
  • For rheumatoid arthritis, the following non-steroidal anti-inflammatory drugs are prescribed:

    NSAIDs can be used in injection, tablet, or local forms.

    Non-drug treatments

    These include physiotherapy, massage, diet therapy and the use of traditional medicine. With their help, it is possible to improve the patient's condition, but they are ineffective when taken away from drug therapy. Only drug treatment can affect the pathogenesis of the disease and lead to stable remission.

    Orthopedic treatment methods, which include the use of orthoses, surgical methods for correcting deformities, and rehabilitation measures, are most important in the later stages of the disease. They are necessary to improve the functional state of joints and correct the patient’s quality of life.

    Traditional medicine in the treatment of rheumatoid arthritis

    Traditional methods can be used only after the recommendation of a doctor. Effective traditional medicines include the following:

  • Potato compress. To prepare such a compress, you need to grate raw potatoes, place them in a sieve, and then lower them into freshly boiled water for a few seconds. Transfer the pulp into a fabric bag and place it on the affected joints overnight under a film and bandage. It is recommended to carry out the manipulation every day for a whole week.
  • Pine balsam. To prepare such a remedy, you should take 40 grams of pine twigs, a tablespoon of onion peels, a clove of garlic and two tablespoons of rose hips. Pour two liters of boiling water over the ingredients and heat over low heat for 30 minutes. Leave for a day. The resulting infusion must be filtered and then drunk up to one liter per day.
  • Plant leaves. To get rid of joint pain, you can use freshly picked leaves of cabbage, coltsfoot or burdock. First, you need to knead them in your hands and then apply them to the affected joints. After this, wrap it with a cloth and leave it overnight.
  • The role of proper nutrition in the treatment of rheumatoid arthritis

    To successfully correct and consolidate the results of treatment for rheumatoid arthritis, you need to adjust your usual diet. It is important to eat foods such as:

  • asparagus;
  • apples;
  • cherry;
  • Rowan;
  • cowberry;
  • currant;
  • sea ​​​​buckthorn;
  • dogwood;
  • watermelon;
  • fermented milk products and milk;
  • eggs;
  • steamed or boiled fish and meat dishes;
  • vegetables, greens;
  • cereals: buckwheat, millet, oatmeal;
  • bran bread
  • At the same time, you need to give up fatty, smoked, salty and spicy foods, reduce the consumption of spices, flour, alcohol, chocolate and coffee.

    An integrated approach to the treatment of rheumatoid arthritis will reduce the rate of development of destructive processes in the joints or achieve complete remission. It is important to follow all the doctor’s recommendations and adjust the course of treatment for the disease only after his prescription.

    We conducted an investigation, studied a bunch of materials, and most importantly, tested most of the remedies for joint pain. The verdict is:

    All drugs gave only temporary results; as soon as the use was stopped, the pain immediately returned.

    Remember! There is NOT ONE REMEDY that will help you heal your joints if you do not use complex treatment: diet, regimen, physical activity, etc.

    Newfangled remedies for joints, which are replete with the entire Internet, also did not produce results. As it turned out, all this is a deception of marketers who earn huge money from the fact that you fall for their advertising.

    The only drug that gave significant

    the result is Artrodex

    You may ask why everyone who suffers from joint pain doesn’t immediately get rid of it?

    The answer is simple, Artrodex is not sold in pharmacies and is not advertised on the Internet. And if they advertise, then it’s a FAKE.

    There is good news, we have contacted the manufacturers and will share with you a link to the official Artrodex website. By the way, manufacturers are not trying to profit from people with diseased joints; the promotional price is only 1 ruble .

    How can rheumatoid arthritis be treated?

    The question of how and what to treat rheumatoid arthritis is asked by every person who has had to deal with this difficult disease. With this disease, as a rule, mixed symptoms are observed, so in order to avoid serious consequences, you need to think about proper treatment as soon as possible.

    The modern approach involves the use of two types of drugs:

    Surgical treatment is necessary only if severe joint deformation occurs.

    Principle of anti-inflammatory treatment

    It is based on eliminating the symptoms of the disease and includes prescribing non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids (steroid hormones produced in the adrenal cortex) to the patient. They reduce joint pain and inflammation. These medications can make a patient's life much easier, but they will not cure arthritis.

    At the same time, drugs can help when pannus is diagnosed - tissue consisting of lymphocytes and overgrown vessels. It grows quite quickly, causing destruction (destruction) of cartilage.

    If you stop taking medications, the disease gradually returns. That is why they should be taken simultaneously with basic drugs, but first things first.

    Treatment with these drugs should begin with the least toxic drugs that have the property of rapid absorption and excretion from the body. These include:

  • diclofenac (analogues are naklofen and dikloberl);
  • ketoprofen or ketonal;
  • ibuprofen (analogs - ibutard and ibuprom).
  • Piroxicam, indomethacin and ketorolac are considered stronger drugs. However, these tablets may affect the functioning of the stomach, kidneys or cardiovascular system.

    Selective anti-inflammatory drugs

    Extremely effective in the treatment of rheumatoid arthritis. Their advantage is a lower number of side effects compared to the previous group of drugs. These include celecoxib (an analogue drug - Celebrex) and meloxicam (Movalis). They can be taken for both short and long periods of time.

    Drugs in this series include:

  • dexamethasone,
  • triamcinolol,
  • betamethasone,
  • prednisolone,
  • methylprednisolone, also known as metypred.
  • For rheumatoid arthritis, the use of these medications can very quickly relieve pain and improve the general condition of the patient, but the list of side effects that they can have on the patient’s body is quite long.

    One effective remedy is methylprednisolone.

    One of the most effective anti-inflammatory drugs can also be called the drug Mabthera. It is produced in the form of infusions, so its use must be supervised by a doctor or nurse.

    Principle of basic treatment

    Basic drugs are slow-acting drugs, “second-line” drugs. They make it possible to treat by acting on the root cause of the disease. The drugs prevent (in mild cases slow down) the destruction of joints, but they cannot be considered anti-inflammatory drugs. In modern basic therapy, the following drugs are actively used: cytostatics, antimalarial drugs, sulfonamides, penicillamine.

    This group of drugs includes: Arava, cyclosporine, Remicade, cyclophosphamide, azathioprine methotrexate. Most rheumatologists consider them the best option for basic therapy; they can help not only with rheumatoid, but also with psoriatic arthritis. Methotrexate for rheumatoid arthritis can be called one of the most potent drugs. If the desired effect cannot be achieved, the doctor may prescribe monoclonal antibodies, which have a similar effect.

    The drug also goes well with folic acid. These are B vitamins. When used, the body produces more red blood cells, which will help reduce pain and slightly reduce inflammation without side effects.

    Folic acid is necessary for the normal functioning of the circulatory and nervous systems

    Methotrexate can be used both in the form of tablets and injections - intravenous injections.

    In general, drugs in this group affect the cells of biochemical substances that aggressively affect the patient’s body and suppress their activity.

    Antimalarials

    Plaquenil and delagil belong to this group. The drugs act slowly and are not very effective, but they are well tolerated by the body and can be prescribed in cases where individual intolerance to the components of other drugs is diagnosed.

    This group includes sulfasalazine and salazopyridazine. The principle of action is similar to antimalarials, but there are few side effects.

    This includes cuprenil. A fairly strong and at the same time toxic drug that allows you to treat arthritis only in cases where other drugs do not help or are not tolerated by the patient’s body.

    Previously, gold preparations were used to treat rheumatoid arthritis, but doctors are gradually abandoning them. The fact is that the quantity and quality of side effects turned out to be too large and strong (“golden” nephropathy or dermatitis). Nevertheless, they are sometimes prescribed, especially at the very beginning of the development of the disease, since the risk of side effects is still low.

    Traditional medicine in the treatment of rheumatoid arthritis

    Since ancient times, traditional medicine methods have been considered very effective in treating a variety of diseases, rheumatoid arthritis is no exception. In this case, folk recipes have an advantage, since in most cases they can be made using improvised means at home.

    When treating this type of arthritis, various rubbing and compresses are effective methods. Such recipes can consist of leaves and roots of plants such as violet, nettle, red clover, cinquefoil, birch, as well as mustard powder and paraffin and other herbal remedies.

    Herbal infusions are an excellent addition to the main treatment

    Infusions occupy a special place in folk medicine. The most popular are recipes with the following herbs:

  • Mix black elderberry flowers (10 g), chopped birch leaves (40 g), finely chopped willow bark (50 g). Brew and take 0.5 cups 4 times a day before meals.
  • Mix black elderberry, stinging nettle, parsley root and willow bark (all 30 g each). Take as described above.
  • The leaves of birch, stinging nettle and tricolor violet are mixed (all 25 g each). Here the dosage can be increased to 4-6 servings (0.5 cups) daily.
  • Recipes are recipes, but it is important to remember that folk remedies can only serve as an auxiliary tool in the fight against illness. They cannot replace drug treatment in any way; they can only enhance the effect of chemical drugs. In this case, taking this or that infusion must be discussed with your doctor, who will help you choose the best decoction in each specific case. It is possible that the drugs described above in combination with any component of the infusions can cause an allergic reaction. You should be vigilant and not show excessive independence.

    ASD for rheumatoid arthritis deserves special attention, since Dorogov’s antiseptic (that’s what the name stands for) has excellent anti-inflammatory and healing properties.

    The use of physiotherapy increases the effectiveness of treatment

    Physiotherapeutic procedures

    Such procedures and therapeutic massage, in which some kind of ointment is used, help treat rheumatoid arthritis and enhance the effect of taking medications. They strengthen muscle tissue, reduce inflammation and improve blood circulation.

    The most common and used procedures are phonophoresis, ozokerite or amplipulse. It is important to remember that such physical therapy is contraindicated if an acute form of rheumatoid arthritis is diagnosed. In this case, the best option would be systematic therapeutic exercises.

    When carrying out physiotherapeutic procedures and massage in general, regularity and strict control by the doctor are important, as this will help consolidate the effect achieved from each session.

    Carrying out independent treatment with various antibiotics without the supervision of a doctor means aggravating the situation and making it difficult for a specialist to prescribe the necessary drugs. Even everyone’s favorite aspirin is best not taken without consulting your doctor.

    Medicines for rheumatoid arthritis

    “Life is in motion” is an expression that everyone has probably heard. Indeed, in order to carry out normal life activities, a person has to constantly move his body in space. In the course of evolution, the body acquired excellent elements that provide this function at the highest level. These amazing parts of the body are joints. All human bones are amazingly strong and elastic individually, which allows them to withstand enormous loads. When combined together, they form an amazingly mobile skeleton that allows you to perform incredible movements. All this is achieved thanks to the coordinated work of the mass of joints.

    Unfortunately, there are diseases, as a result of the progression of which the joints of the body are affected and lose their mobility. As a result, the patient's quality of life is significantly reduced. Rheumatoid arthritis is a very pressing problem in modern rheumatology. This is a systemic disease that affects connective tissue. As a result of its development, the patient's small joints are affected in an erosive-destructive manner. Around the world, about 60 million patients suffer from this disease, which is up to 1% of the entire population.

    What makes the whole situation even worse is that doctors have not yet been able to determine the exact cause of the disease. There are some theories and assumptions, but none of them have found any really significant confirmation. Over time, all the symptoms of the disease steadily worsen, gradually leading to permanent loss of disability by the person. Women are approximately three times more likely to get sick. The average age of the patient when the disease is diagnosed is 30-35 years.

    Causes of rheumatoid arthritis

    Currently, there are several most likely etiological factors for the disease. Each version has its own advantages and disadvantages. In general, more and more doctors are inclined to believe that rheumatoid arthritis is a multifactorial disease that develops when several causes are combined.

    — Genetic predisposition – patients with this diagnosis have a predisposition to disturbances in the activity of the immune system at the genetic level. Some antigens have already been discovered, the presence of which can lead to changes in humoral and cellular immunity due to exposure to certain infections. You can also trace an increased likelihood of developing rheumatoid arthritis in people whose immediate relatives also had it.

    — Infectious agents that, as a result of their specific properties, can cause changes in human immunity, as a result of which their own protective factors attack their connective tissue. The role of these pathogens is put forward: Ebstein-Bar virus, retroviruses, pathogens of rubella, herpes, cytomegalovirus, mycoplasma. Doctors have some evidence in favor of this hypothesis:

  • In 80% of patients, elevated titers of antibodies to the Ebstein-Bar virus are detected.
  • In lymphocytes of patients with rheumatoid arthritis, Ebstein-Bar is detected much more often than in healthy people.
  • The factors that create the prerequisites for the development of the disease were indicated above. Triggering factors are also identified that provoke its manifestation in a particular patient at a certain time.

  • Hypothermia.
  • Increased exposure to sunlight (hyperinsolation).
  • Intoxication, including microbial toxins.
  • Bacterial infection.
  • Taking certain medications.
  • Dysfunction of the endocrine glands.
  • Emotional overstrain and stress.
  • Interestingly, breastfeeding for two years or more reduces the likelihood of developing rheumatoid arthritis by half.

    The mechanism of development of rheumatoid arthritis

    It has been established that when exposed to one or a combination of provoking factors in the patient's body, an incorrect immune response is triggered. Own cells produce substances that cause damage to the synovial membrane of the joints. First, synovitis develops, which subsequently passes into the proliferative stage and causes damage to the cartilage and bones themselves.

    The immune system also produces pathological cytokines, which have a number of negative properties:

  • provoke the production of increased amounts of pro-inflammatory factors that contribute to further progression of the disease;
  • I activate some enzymes that can destroy the cartilage that covers the joint and provides elastic sliding of surfaces;
  • supply special molecules to the membranes of mast cells that cause these leukocytes to exhibit an autoimmune effect;
  • attract additional immunocompetent cells, which also negatively affect the course of the disease in this case;
  • increased angiogenesis, which allows vessels to grow into the cartilage and makes it easier for aggressive factors to penetrate deep into the cartilage tissue.
  • Classification of rheumatoid arthritis

    There are several criteria by which this disease is classified.

    Clinical and anatomical forms

  • Rheumatoid arthritis (oligoarthritis, monoarthritis, polyarthritis) is a form of the disease in which only the joints are affected, while other organs function normally without dysfunction.
  • Rheumatoid arthritis with systemic manifestations - additionally, autoimmune processes affect the serous membranes of the body (pericardium of the heart, pleura), lungs, blood vessels, kidneys, nervous system, causing the deposition of pathological protein - amyloid - in the internal organs.
  • Rheumatoid arthritis, combined with deforming osteoarthritis, rheumatism.
  • Juvenile rheumatoid arthritis.
  • Characteristics from the point of view of immunology

    Depending on whether rheumatoid factor is detected in the patient’s blood, all cases of the disease are divided into seropositive and seronegative. This is of great importance for doctors during diagnosis and planning of upcoming treatment.

    • Slowly progressive - the disease slowly spreads to other joints over many years, the diseased joints are not severely damaged.
    • Rapidly progressive - the disease very often worsens, gradually involving more and more joints. The articular surfaces undergo significant changes for the worse. The treatment does not have much effect.
    • Without noticeable progression – the most favorable form. With which the patient can live his whole life, maintaining a fairly high quality of life.
    • X-ray stage of the disease

      1. Periarticular osteoporosis is a decrease in bone density due to a decrease in the content of calcium salts in it.
      2. Osteoporosis, supplemented by a slight decrease in joint space.
      3. Narrowing of the joint space and osteoporosis are complemented by multiple disorders.
      4. All of the above is accompanied by bone ankylosis - the main and most persistent cause of decreased mobility up to its complete absence.
      5. Uzures are deep erosions on the articular surface of cartilage.

        Degree of functional insufficiency of the musculoskeletal system

      6. 0 – the patient can perform all movements in full.
      7. 1 – a person cannot fully perform all the movements that provide him with the opportunity to perform his professional duties.
      8. 2 – the patient cannot work due to loss of professional ability to work.
      9. 3 – a person cannot fully care for himself.
      10. Symptoms of rheumatoid arthritis

        At the initial stages, the disease occurs without a clear clinical picture. The patient may not even realize that he has rheumatoid arthritis for years. The leading clinical manifestation of the disease is articular syndrome.

      11. Morning stiffness is a specific manifestation of the disease, which the patient does not focus on. During sleep, the synovial membranes of the joints become somewhat inflamed due to a decrease in the secretion of glucocorticoids at night. Sometimes patients simply cannot take off the blanket normally. After about an hour, all symptoms disappear and the person can move actively.
      12. Periodic joint pain, loss of appetite, fatigue, weight loss - all this can be noted in the prodromal period.
      13. Acute pain in the joints, fever - this is how the patient’s illness begins. The most commonly affected joints are the hands and feet, wrists, knees and elbows. Other joints are affected less frequently. There is swelling around the joint, and the surface of the skin has a higher temperature than on the rest of the body. Also, the joint area is hyperemic due to inflammatory processes.
      14. On palpation, the joints are painful, movement in them is limited. As the disease progresses, proliferative processes begin to predominate, and significant limitation of mobility, deformation and subluxation of the joints may occur.
      15. Rheumatoid nodules are a specific manifestation of the disease, in which dense subcutaneous formations can be palpated on the extensor surface of the joint. This sign is one of the important diagnostic criteria for rheumatoid arthritis.
      16. Also, the patient may be affected by almost all organs in the body, depending on the degree of activity of the process, but this is observed relatively rarely.

        Diagnosis of rheumatoid arthritis

        Laboratory research

      17. Complete blood count - reveals anemia, an increase in erythrocyte sedimentation rate, an increase in the number of leukocytes.
      18. Biochemical blood test - allows you to determine the degree of activity of the inflammatory process.
      19. Immunological blood test - rheumatoid factor can be determined, sometimes immune complexes are detected.
      20. Instrumental diagnostics

      21. X-ray examination of joints - the classification describes all the criteria that doctors use when determining the X-ray stage of the disease.
      22. Radioisotope study - the injected element actively accumulates in the affected joints, and normal synovial tissue does not attract so many atoms.
      23. Joint puncture and examination of synovial fluid.
      24. In the most severe cases, a biopsy of a section of the synovial membrane is performed.
      25. Rheumatoid arthritis: treatment

        Systemic treatment of this disease involves the use of the following main groups of drugs:

      26. non-steroidal anti-inflammatory substances;
      27. basic drugs;
      28. hormonal substances (glucocorticoids);
      29. biological agents.
      30. Nonsteroidal anti-inflammatory substances

        These drugs have proven themselves well in the treatment of rheumatoid arthritis for a relatively long time and are still first-line treatments. They make it possible to relatively quickly stop acute manifestations of the disease and sometimes achieve stable remission - a condition in which there are no symptoms of the disease and the patient can live a full life.

        If a patient sees a rheumatologist during the acute period of the disease, then non-steroidal anti-inflammatory drugs alone cannot be used; they are supplemented with high doses of glucocorticoids. This treatment method is called pulse therapy.

        The effect is achieved by blocking cyclooxygenase, an enzyme that normally breaks down arachidonic acid to form prostaglandins and other biologically active substances that play an important role in the development of the inflammatory response.

        Older drugs inactivate cyclooxygenase-1, due to which, in case of overdose, renal and liver function impairment may occur, and encephalopathy may develop. Modern drugs used to treat rheumatoid arthritis are more selective and less dangerous, so patients have nothing to fear.

        Doctors avoid combining non-steroidal anti-inflammatory drugs with each other, since in this case the likelihood of the patient developing adverse reactions significantly increases, but the therapeutic effect remains practically unchanged.

        Basic drugs for the treatment of rheumatoid arthritis

        The most popular and effective medications for the treatment of rheumatoid arthritis currently are: gold preparations, methotrexate, leflunomide, penicillamine, sulfasalazine.

        There are also reserve drugs: cyclophosphamide, azathioprine, cyclosporine - they are used when the main drugs do not give the desired effect.

        Until relatively recently, doctors preferred to gradually increase the dose of the drug received by the patient (the pyramid principle). It has now been proven that when starting treatment using high doses, more impressive results can be achieved by changing the nature of the disease. Newly discovered rheumatoid arthritis is characterized by an almost complete absence of changes in the patient’s joints and a high probability of long-term remission.

        If during the first months of the disease treatment with basic drugs does not bring the desired effect, then doctors combine them with glucocorticoids. Hormonal drugs reduce the activity of the inflammatory process and allow you to select effective basic therapy. It is believed that doctors should select an effective treatment for rheumatoid arthritis with drugs from this group within six months.

        During treatment, the patient must periodically undergo a medical examination to check for side effects from taking medications and assess the degree of activity of the disease itself.

        This group of drugs can be used in different ways.

      31. In the form of pulse therapy, the patient takes high doses of the drug in combination with substances for the basic treatment of the disease. This allows you to very quickly reduce the activity of the process and eliminate inflammatory phenomena. However, the course of taking the drug cannot be long due to the high likelihood of side effects.
      32. In the form of a course of treatment to suppress the inflammatory response when other substances are ineffective. In this case, the dose is significantly lower, and doctors try to select it in such a way that the patient takes the minimum hormone that will have the necessary effect.
      33. Local therapy - in the composition of ointments that lubricate the affected joints. The indication in most cases is oligoarthritis or monoarthritis of large joints. They can also be used if there are contraindications to systemic treatment with hormones and a significant predominance of local symptoms over general ones.
      34. Intra-articular injection of a gel containing hormonal drugs. This allows for a relatively long period of time (up to a month) to ensure continuous exposure of the drug to the damaged articular surface.
      35. Monoclonal antibodies to certain cytokines neutralize tumor necrosis factor, which in the case of rheumatoid arthritis provokes damage to its own tissues.

        There are also studies suggesting the use of lymphocyte differentiation regulators as a treatment for rheumatoid arthritis. This will avoid damage to the synovial membranes by T-lymphocytes, which are incorrectly “directed” to the joints by the immune system.

        Today we will talk about some types of arthritis, what their symptoms are and what prevention methods will help prevent this disease. Many medical forums discuss arthritis and methods of combating this disease. Clinics that provide treatment for this disease are discussed. And if you decide to contact one of these medical institutions, it would be a good idea to look for reviews of arthritis treatment in such clinics.

        What is arthritis? Arthritis is when inflammation occurs throughout the body. The causes of arthritis are due to the fact that the body cannot cope with infections or there is a metabolic disorder. This disease disrupts the functioning of not only joints, but also internal organs - kidneys, liver, heart. In addition, there are differences by age category: people under 40 years of age most often suffer from arthritis; even in children, arthritis can manifest itself, which is called juvenile arthritis.

        Arthritis: symptoms and their classification

        Pain. This is perhaps one of the most likely symptoms of arthritis. Regarding arthritis, the pain does not subside even when standing still. It is characterized by night pain, around 3-5 am. By the way, some users search for photos of arthritis on the Internet in order to compare the symptoms of the disease. But this is wrong, if you have any doubts, it is better to go straight to a consultation with a doctor!

        Stiffness and decreased mobility. Arthritis is characterized by stiffness not only in the joints, but throughout the body.

        Deformation. With arthritis, the symptoms of this disease can be: swelling, inflammation, increased temperature at the site of inflammation (touching the area of ​​inflammation can sometimes feel hot), dense nodules appear.

        Acute arthritis may be accompanied by the following symptoms:

      36. inflammation of the eyes (feeling of sand in the eyes);
      37. psoriasis;
      38. increase in body temperature;
      39. increased sweating or chills;
      40. discharge from the genitals;
      41. weakness.
      42. Some types of arthritis

        Polyarthritis. An acute recurrent disease that occurs when the body is particularly sensitive to infectious diseases (most often streptococcus or staphylococcus).

        With the flu, joints and muscles can become inflamed, and many people know about this. Most people with the flu complain of weakness, joint and muscle pain, cramps and stiffness. At the height of the flu, the joints are least likely to suffer, but after some time (about 2 weeks) the risk of arthritis increases significantly.

        Tuberculous arthritis. At this time, tuberculous joint disease is extremely rare. Large joints are most often affected, especially the spine. This disease is characterized by gradual development, and pain is noted both during movement and at complete rest.

        The occurrence of swelling is a consequence of the appearance of exudate in the recess of the joint or when periarticular tissues are damaged. The color range of the skin remains virtually unchanged. If left untreated, an abscess or fistula may develop.

        Brucellosis arthritis. This type of arthritis is most often caused by a brucellosis infection. Often observed with an increase in local temperature or during exudative processes (swelling occurs). If a joint is infected with a brucellosis infection, the disease begins to progress rapidly, gross destruction of bone tissue appears and ankylosis of the joint develops.

        Purulent arthritis. This type of arthritis occurs when an infection gets into the joint, most often due to staphylococcus. There are two types of purulent arthritis: primary and secondary purulent arthritis. In primary arthritis, infection occurs through surgery, biopsy, or open wounds. In secondary arthritis, the infection leaks into the joint from neighboring tissues or hematogenously (sepsis).

        Lyme disease. A multisystem infectious disease that has many clinical forms of manifestation. The causative agent of this disease is the spirochete Borrelia Burgdaiteria, the largest species of spirochete, which can cause significant immunological disorders. Ticks and lice are the most common carriers of the spirochete. There are several stages of this disease:

      43. Erythematous stage. Neck stiffness, arthralgia, and fever are observed. It is detected mainly in the summer, lasting about 2 weeks.
      44. Neurological stage. Duration from 7 days to 30 days.
      45. Arthric stage. A few months later the patient develops arthritis.
      46. These stages are divided conditionally, because arthritis can manifest itself at an early stage, and at a later stage only neurological disorders of the body can be observed.

        Preventive measures for arthritis

        Moderate physical activity

        Movement is life, said Aristotle. Therefore, fitness, and in general any load within reasonable limits, helps the body feel much better. Namely: strengthens the muscle corset, improves blood circulation, and reduces weight. This is very important to know when fighting arthrosis and arthritis. As with everything, it is also necessary to observe moderation, because improper execution of exercises or an excessive increase in load on the joints can lead to injuries, and as a result, to a worsening of arthritis. At first, you should definitely consult or work with a trainer, especially if you have joint pain. You can also perform joint gymnastics for prevention - these exercises are quite simple and do not require the supervision of a fitness instructor or special equipment. An excellent move in the fight against the disease is swimming in the pool. This is due to the fact that in water the load on the joints is much less than on land.

        It is necessary to pay attention to the fact that we are talking about the prevention of arthritis and arthrosis. If you have been diagnosed with one of the diagnoses, then classes can be carried out only after consultation with your doctor and only under the supervision of a specialist who will personally develop a special training program for you. If the form of arthritis is acute, then it is necessary to completely exclude fitness activities.

        A good way to prevent arthritis is:

        • wearing comfortable shoes;
        • body weight control;
        • avoiding hypothermia of joints;
        • elimination of stress, a healthy lifestyle, and sleep and rest patterns (for arthritis, a sanatorium will be one of the best solutions).
        • To quickly overcome the disease arthritis, you need to review your daily diet. It is best to avoid foods high in fat; it is also a good idea to stop eating red meat. It will be beneficial for your body to include fruits and vegetables, fish and seafood in your diet. Gelatin and cartilage (for example, jellied meat) are useful for joints and bones. It is also recommended to increase water consumption to at least 2 liters. Some people ask: can you drink alcohol if you have arthritis? In no case! It is imperative to stop drinking alcohol. On the contrary, you should start taking calcium and vitamins A, B and D.

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