In accordance with the recommendations of the European League Against Rheumatism, Methotrexate is prescribed for rheumatoid arthritis immediately after diagnosis. Experts from the American College of Rheumatology also suggest using the “gold standard” treatment for systemic disease first. The drug meets the principles of the “Treat to Target - T2T” program, which was developed in 2008 by representatives of 25 countries in Europe, North and Latin America, Australia and Japan. It includes strategic therapeutic approaches that provide the best results in the treatment of pathology.
Methotrexate is a cytostatic drug from the group of antimetabolites, folic acid antagonists. Cytostatics are antitumor drugs that disrupt the processes of growth and development of tissues, including malignant ones. They negatively affect the mechanism of cell division and restoration. Rapidly dividing cells, including bone marrow cells, are most sensitive to cytostatics. Due to this property, cytotoxic drugs are used to treat autoimmune diseases. By inhibiting the formation of leukocytes in the hematopoietic tissue of the bone marrow, they suppress the immune system.
Immunosuppressive therapy is the mainstay of treatment for rheumatoid arthritis, as the disease is autoimmune. With autoimmune pathologies, the body's defenses begin to fight against its own cells, destroying healthy joints, tissues and organs. Immunosuppressive therapy stops the development of symptoms and inhibits destructive processes in the joints. Cytostatics inhibit the growth of connective tissue in the joint, which gradually destroys cartilage and subchondral bones (adjacent to the joint, covered with cartilage tissue).
The action of Methotrexate is based on blocking dihydrofolate reductase (an enzyme that breaks down folic acid). The drug disrupts the synthesis of thymidine monophosphate from dioxyuridine monophosphate, blocking the formation of DNA, RNA and proteins. It prevents cells from entering the S period (the phase of synthesis of a daughter DNA molecule on the matrix of a parent DNA molecule).
Methotrexate is a first-line drug used in the basic treatment of rheumatoid arthritis. It suppresses the production of not only immunocompetent cells, but also synoviocytes (cells of the synovial membrane) and fibroblasts (the main cells of connective tissues). Inhibiting the proliferation of these cells helps prevent deformation and inflammation of the joint. Methotrexate stops bone erosions that occur as a result of the attack of actively growing tissues of the synovial membrane of the joint.
Methotrexate for rheumatoid arthritis allows you to achieve stable remission. The clinical effect persists even after its discontinuation.
Methotrexate is the most toxic folic acid antagonist. Due to impaired methylation of deoxyuridine monophosphate, it accumulates and is partially converted into deoxyuridine triphosphate. Deoxyuridine triphosphate is concentrated in the cell and incorporated into DNA, causing the synthesis of defective DNA. In it, thymidine is partially replaced by uridine. As a result of pathological processes, megaloblastic anemia develops.
Megaloblastic anemia is a condition in which the body is deficient in vitamin B12 and folic acid. Folic acid (along with iron) takes part in the synthesis of red blood cells. These blood cells play an important role in hematopoiesis and the functioning of the entire body.
With a lack of folic acid, red blood cells that change in shape and size are formed. They are called megaloblasts. Megaloblastic anemia causes oxygen starvation in the body. If the pathological condition is observed for a long time, it leads to degeneration of the nervous system.
When treated with Methotrexate, adverse reactions characteristic of megaloblastic anemia occur. The hematopoietic function is inhibited. If recommended doses are exceeded, the following occurs:
If, in the presence of such symptoms, the drug is not discontinued, serious diseases of the digestive tract develop. Renal tubular acidosis (reduced urinary excretion of acids) and cortical blindness (impaired vision) are sometimes observed.
Methotrexate practically does not break down in the body. It is distributed in biological fluids and 80–90% is excreted unchanged by the kidneys. If kidney function is impaired, the drug accumulates in the blood. Its high concentrations can cause kidney damage.
With long-term treatment, liver cirrhosis and osteoporosis may develop (especially in childhood). While taking Methotrexate, the following occurs:
Alopecia (hair loss) and pneumonitis (an atypical inflammatory process in the lungs) are extremely rare consequences of Methotrexate therapy.
Studies have confirmed the connection between the occurrence of side effects during treatment with Methotrexate and a lack of folic acid in the body. During the treatment of rheumatoid arthritis, cellular folate reserves rapidly decrease. At the same time, an increase in homocysteine concentration is observed. Homocysteine is an amino acid formed during the metabolism of methionine. The breakdown of homocysteine requires adequate levels of folic acid. With its deficiency, the level of homocysteine in the blood increases critically. Its high concentration increases the risk of atherosclerotic vascular damage and accelerates thrombus formation.
A large increase in homocysteine concentration is due to the tendency for its accumulation in patients with rheumatoid arthritis. Treatment with Methotrexate enhances the negative process, especially at the stage when achieving a therapeutic effect requires increasing doses of the drug.
The administration of folic acid during Methotrexate therapy can reduce dangerous homocysteine levels and reduce the likelihood of developing undesirable consequences. It helps reduce the risk of developing critical conditions in patients who have concomitant cardiovascular diseases.
Treatment with folic acid allows you to avoid other adverse reactions that occur during treatment with Methotrexate. If it is prescribed immediately after the start of a course of therapy with the basic drug or during the first 6 months of treatment, the incidence of gastrointestinal disorders is reduced by 70%. Folic acid helps minimize the risk of developing diseases of the mucous membranes and alopecia.
Folic acid for rheumatoid arthritis is taken daily throughout the entire period of treatment with Methotrexate. The dosage of the drug is selected by the doctor individually. The exception is the day you take Methotrexate.
The daily dose can be taken the next morning. This will make it possible to stop adverse reactions at the earliest stages of their development. In addition, a folic acid regimen may be prescribed, in which a weekly dose of folic acid is drunk once a week. The drug should be taken no earlier than 12 hours after taking Methotrexate.
Treatment of rheumatoid arthritis with Methotrexate is sometimes started even before the diagnosis is confirmed, especially in cases where the pathology is rapidly progressing. The longer the disease develops, the higher the likelihood of disability and death of the patient. Therefore, the activity of the rheumatoid process must be slowed down as soon as possible.
As a rule, a one-time weekly injection of moderate doses of the drug allows you to achieve the desired result within 1-1.5 months after the start of treatment. In some cases, double or triple doses of the drug are necessary to produce and maintain the desired clinical effect.
Since complete remission occurs extremely rarely, treatment is continued for a long time. The minimum course of treatment lasts six months. In 60% of cases it is possible to obtain the required clinical result. To consolidate it, monotherapy is continued for 2-3 years. With long-term use, the effectiveness of Methotrexate does not decrease.
The drug cannot be stopped abruptly. Stopping treatment may cause an exacerbation of the disease. If it is necessary to adjust the dose downward, do this gradually.
If monotherapy does not have the desired effect on the pathological process, Methotrexate is combined with one or two drugs of basic therapy. The best treatment results were observed after using a combination of Methotrexate and Leflunomide. Leflunomide (Arava) has a similar effect. If you take both drugs, they will enhance each other's effects.
A persistent positive result is provided by therapy with Methotrexate in combination with Cyclosporine or Sulfasalazine. The sulfanilamide drug Sulfasalazine helps to achieve a significant improvement in the well-being of patients in whom the disease develops slowly.
When the pathology is difficult to treat, the doctor prescribes a combination of 3 drugs: Methotrexate, Sulfasalazine and Hydroxychloroquine. When using combination regimens, average dosages of drugs are prescribed.
During treatment with Methotrexate and for 6 months after its discontinuation, it is necessary to use reliable methods of contraception. The medication negatively affects the development of the fetus and can cause spontaneous abortion. In men, there is a decrease in sperm count.
Psoriatic arthritis is a chronic systemic disease associated with psoriasis. Psoriatic arthritis is diagnosed in 13-47% of patients with psoriasis. Numerous studies have confirmed the autoimmune nature of the inflammatory process in the joints. Therefore, basic therapy drugs are most often used to treat it. They allow you to slow down the progression of pathology and achieve positive changes that are unattainable with other treatment methods.
The modifying properties of Methotrexate in psoriatic arthritis are beyond doubt. They have been proven by many years of experience. The drug demonstrates an optimal balance of effectiveness and tolerability compared to other cytostatic drugs.
Methotrexate for psoriatic arthritis is used not only to slow down destructive processes in the joints, but also to reduce dermatological manifestations. The medication is the drug of choice in the treatment of generalized exudative, erythrodermic and pustular psoriatic arthritis. It helps alleviate the condition of patients suffering from the most severe forms of dermatosis.
The treatment program is developed individually by the doctor. Begin therapy with small or medium doses. Injections are given weekly. If there is no result, the dosage can be doubled. After the appearance of a stable therapeutic effect, the dose is reduced. Methotrexate can be taken not only parenterally, but also orally.
A significant improvement in the condition of patients occurs within 3-4 weeks after the first dose of the drug. By the end of the second month, all indicators of articular syndrome decrease by 2-3 times. Methotrexate therapy demonstrates excellent results in relation to skin manifestations. In almost all patients, the progressive stage of psoriasis stops. Such a high effectiveness of the drug is due not only to its immunosuppressive effect, but also to its anti-inflammatory effect.
Over 6 months of therapy, positive dynamics of dermatosis develops in 90% of patients, as evidenced by numerous reviews. Almost every fifth patient managed to achieve complete remission of the articular syndrome.
Reviews of the results of using Methotrexate indicate its effectiveness. But many patients complain of adverse reactions.
It should be remembered that unauthorized prescription of Methotrexate can negatively affect your health. This drug is prescribed only by your doctor!
Rheumatoid arthritis is a chronic disease in which autoimmune inflammation occurs in joint tissues, leading to the destruction of bones and cartilage.
Methotrexate is one of the mandatory components of treatment; the drug is used in most cases. Thanks to methotrexate, a person’s condition can be alleviated, that is, it can reduce joint pain and stiffness of movement, as well as suppress the inflammatory process for a long time.
Methotrexate causes disturbances in the following organs and systems:
It is noted that such side effects may not always develop. If you take folic acid, the likelihood of disruptions in the body's functioning is minimized.
Currently, scientists around the world are actively creating more advanced treatments for rheumatoid arthritis. Quite effective new drugs – “biological agents” – are already known, for example:
However, methotrexate will remain the drug of choice for rheumatoid arthritis for many years to come, since it is highly effective when used in the required dosages.
At its core, methotrexate acts as an antagonist of folic acid. When a drug enters the human body, it enhances chemical reactions and the synthesis of adenosine, a substance that has a significant effect on inflammatory and immune reactions.
When using methotrexate, massive cell death occurs, provoking an inflammatory process in the joints. Methotrexate effectively inhibits the synthesis of substances that trigger and maintain inflammation.
At the same time, methotrexate increases the rate of formation of substances with anti-inflammatory effects.
As a result of this work, inflammation of the joints decreases, which means that stiffness and pain - typical symptoms of rheumatoid arthritis - go away.
Methotrexate is a truly effective remedy, however, it is quite unsafe. An overdose of the drug or its improper use leads to significant side effects. Due to this feature, methotrexate for rheumatoid arthritis can only be prescribed by a rheumatologist.
This specialist must correctly select the minimum effective dose of methotrexate and combine it with other basic medications.
Below are all the positive and negative features of methotrexate, with dosages used in the treatment of rheumatoid arthritis being implied:
Methotrexate has a low cost; literally every patient who needs the drug can buy the drug.
The cost of one pack of tablets costs about 250 rubles. This amount of methotrexate is enough for about 2 months of treatment.
Therapy with methotrexate is very long-term, it lasts for many years. Treatment can be lifelong. Only with such an approach can it be possible to suppress inflammation in the joints and reduce the external manifestations of arthritis, that is:
Despite numerous reviews, the well-being due to taking methotrexate is deceptive, because if you stop taking the medicine for a while, the condition will immediately worsen.
Due to the nuances of the action of methotrexate, there are the following rules for its use:
Methotrexate is most often taken in tablet form. If there is insufficient absorption, then the drug is prescribed by injection.
In the early stages of therapy, the lowest possible dose is prescribed. Subsequently, the amount of the drug is increased, depending on the possible side effects specifically for this patient. Inflammation in the joints should decrease significantly, and side effects should not occur.
Methotrexate is not approved for use by all categories of patients. The rheumatologist must know well not only the indications, but the reasons why the use of the drug is undesirable.
The most common contraindications are:
For rheumatoid arthritis, methotrexate is often prescribed in combination with certain other drugs.
During an exacerbation of the disease, you can achieve a rapid reduction in pain when taking methotrexate with drugs from the group of non-steroidal anti-inflammatory drugs. We are talking about meloxicam or celecoxib. Methotrexate is also prescribed with glucocorticoids.
The combination of methotrexate with biological agents shows sufficient effectiveness in treatment:
This combination reduces inflammation in the joint and its symptoms such as stiffness and pain. In addition, joint destruction is successfully prevented.
Methotrexate is often prescribed for certain types of cancer.
Today, methotrexate is one of the most cost-effective, effective and safe drugs against rheumatoid arthritis. For most patients this is the most suitable option.
But it is necessary to remember that the drug has side effects, as evidenced by numerous reviews.
Psoriatic arthritis is a form of arthritis that affects people with psoriasis (a complex skin disease). Many people first develop psoriasis and later develop joint inflammation - arthritis. But sometimes arthritis precedes psoriasis.
Joint pain, stiffness and swelling are among the main symptoms of psoriatic arthritis. Any joints are affected, including the small joints of the hands and the spine. The development of the disease is unpredictable: from moderate manifestations to pronounced changes in the joints. The course of psoriasis, like psoriatic arthritis, is wavy, and exacerbations can be followed by periods of complete absence of complaints.
Today, treatment consists of reducing the severity of the disease and preventing joint damage. Although there are no drugs that completely cure psoriatic arthritis, without treatment and regular exercise, the course of this disease can be very severe.
Both psoriasis and psoriatic arthritis are chronic diseases; over the years they tend to progress and become protracted, but there may be periods of “quiet” (remission), when the symptoms go away and the condition returns to normal, alternating with periods of exacerbation. As a rule, deterioration (improvement) of the condition of the skin and joints occurs simultaneously.
The main manifestations of psoriatic arthritis:
Specificity of joint damage in psoriatic arthritis.
There are five main types of psoriatic arthritis, which can occur over time in the same person:
If you have psoriasis, be sure to tell your doctor about any additional joint pain. Psoriatic arthritis can begin suddenly or gradually, but either way, the disease can seriously damage your joints if left untreated.
Psoriasis is a skin disease in which plaques form on the skin, consisting of dense areas covered with dry, keratinized layers of skin cells. Arthritis causes pain and stiffness in the joints. Both diseases belong to the group of autoimmune diseases, that is, they occur when the immune system, which normally protects the body from harmful agents such as bacteria and viruses, mistakenly begins to attack healthy cells and tissues. An abnormal immune response causes joint inflammation and overproduction of skin cells.
It is not yet entirely clear why the immune system attacks healthy tissue, but heredity and environment are thought to play a role. Many people with psoriatic arthritis have close relatives (parents or siblings) with psoriasis, and researchers have discovered specific genetic markers associated with the disease. If one of your close relatives suffers from psoriatic arthritis, this does not mean that this disease will develop in you, it only means that you have a predisposition to this disease. Physical trauma or an infectious (viral) disease can trigger the development of psoriatic arthritis in people with a hereditary predisposition.
Psoriatic arthritis can be painful and damage your joints, even with treatment. Some types of psoriatic arthritis can present additional difficulties, such as:
There is no specific test to confirm psoriatic arthritis, so the doctor will evaluate all the symptoms and prescribe tests to rule out other possible causes of the disease, which have similar complaints, such as osteoarthritis and rheumatoid arthritis.
There is no specific treatment for psoriatic arthritis, and the main goal is to reduce inflammation in the affected joints to prevent pain and loss of function.
Drugs used to treat psoriatic arthritis:
All medications are prescribed only by a doctor, taking into account the course of the disease, the risk of side effects and the presence of concomitant diseases.
The help of a surgeon is rarely resorted to, only in cases where conventional treatment does not give a good result and does not alleviate the symptoms.
The good news about psoriatic arthritis is that you can do a lot on your own to keep yourself in good health. These measures will help significantly relieve symptoms without causing side effects:
Doctors call the combination of psoriasis and rheumatoid arthritis psoriatic arthritis; its symptoms with photos and treatment will be covered in detail in this article.
Medical statistics claim that about 10% of psoriasis patients additionally treat joint damage. Typically, the pathology affects the skin, forming red scaly plaques on it, and only after this do patients complain of pain in the limbs or spine.
But sometimes patients come to see a doctor and have joint problems despite relatively healthy skin.
Experts classify psoriasis as a psychosomatic pathology. Based on the results of some studies, scientists have established a connection between the development of psoriatic arthritis and abnormalities in the human nervous system. It has been noticed that women suffer from the disease more often than the stronger sex. This is explained by the increased emotionality and excitability of women who have a hard time accepting unfavorable moments in life.
Thus, psoriasis damage to the joints occurs against the background of constant stress, being in nervous tension, fears, and other troubles. By reacting to external stimuli with every cell of his body, a person prone to psoriasis receives new inflammation. But now it covers the osteoarticular apparatus. The second name for this inflammation is psoriatic arthropathy.
Other causes of psoriatic arthritis are:
Factors that provoke psoriatic arthritis include bad habits and immunodeficiency conditions. Experts also put forward the theory of heredity, which increases the likelihood of developing arthritis in the presence of family cases of the pathology.
According to the degree of joint damage, psoriatic arthritis is classified as:
The primary symptoms of psoriasis arthritis depend on the influence of various factors. Inflammation in the joints can occur unnoticed by the patient or manifest itself abruptly. In general, the symptoms of arthropathy are similar to those of ordinary arthritis. However, it has its own features that make it possible to diagnose psoriatic joint damage. These include:
When diagnosing psoriatic arthritis, it is important to take into account the similarity of the clinical picture with other types of the disease. Differentiation is made possible by the purplish-bluish color of the swollen, painful skin covering the joints. The doctor should pay attention to the asymmetry of joint damage - it is present in most patients.
An important sign of PA is pain in the heels and damage to several joints in the toe.
The patient’s complaints, lifestyle and medical history help to establish an accurate diagnosis. To develop rational therapy, it is advisable to send the patient for an X-ray examination, blood and intra-articular fluid analysis. An increase in the level of fibrinogen, globulins, immunoglobulins A and G, and sialic acids is visible in the blood. In the joint fluid, the looseness of the mucin clot and an increase in neutrophils are determined.
In all its manifestations, psoriatic arthritis is shown in the photo; an experienced doctor will prescribe treatment, referring to specific symptoms.
Video: arthropathic psoriasis.
The therapeutic course is developed by a doctor based on the results of a comprehensive examination and review of the medical history. The goals of drug treatment of psoriatic arthritis are:
To achieve these goals, the patient is prescribed different groups of medications. For example, anti-inflammatory non-steroids are prescribed to relieve pain, increase joint mobility and narrow areas of inflammation. After taking Diclofenac or Ibuprofen, swelling in the problem area subsides.
The use of glucocorticosteroids achieves rapid elimination of psoriasis symptoms. To avoid the development of adverse reactions from systemic therapy, drugs of this group are administered directly into the joint cavity.
Doctors often prescribe Methotrexate for psoriatic arthritis, but there are conflicting reviews about it.
There is no 100% evidence of its effectiveness, but doctors say that a weekly dosage of 15–20 mg is acceptable. During therapy, patients are advised to monitor the state of renal-hepatic activity. If your health worsens, you should contact your doctor and discuss the issue of completely stopping the drug or reducing the dose. Methotrexate is powerless in the treatment of spondylitis and spinal arthropathy.
To eliminate the manifestations of rheumatoid arthritis developed due to psoriasis, patients are offered sulfasalazine for treatment.
An antibiotic with anti-inflammatory properties is prescribed at a dosage of 2 g for a long time. When prescribing a drug to a specific patient, the doctor must take into account the possibility of side effects, especially from the intestines. Treatment of psoriatic arthritis of the spine with Sulfasalazine gives poor results. Whether it is worth prescribing it, the doctor decides on an individual basis.
High effectiveness in the fight against joint disease is shown by:
Physiotherapy is a good tool for drug treatment of PA. The patient is given phonophoresis and electrophoresis with glucocorticosteroids, laser irradiation of the blood and magnetic therapy, and therapeutic exercises are developed.
Regardless of the chosen treatment tactics, doctors give psoriasis patients important advice - to maintain a normal weight, because excess body weight increases the load on the joints.
When receiving treatment for psoriatic arthritis at home, the patient must monitor his diet. To strengthen the skeleton, it is recommended to enrich the diet with phosphorus and calcium products.
A diet for joint disease should maintain a balance of acids and alkalis throughout the body. To do this, the patient should include more alkali-forming foods in the menu. These are grapes, apples, natural citrus juice, alkaline water. Nutrition for psoriatic arthropathy is based on the Pegano diet. Its main principles are increasing acids and alkalis to the permitted level and increasing water consumption.
The patient should eat according to the following rules:
In general, the daily diet should be low in calories. Since physical activity is contraindicated in case of serious changes in joints, only proper nutrition will help stabilize weight.
As for drinks, lingonberry tea will be beneficial for arthropathy. It is prepared from 2 tsp. dry crushed lingonberry leaf and water (200 ml). After boiling the mass for a short time, it is cooled and filtered. Drink any amount of tea throughout the day.
A remedy for psoriasis from lingonberry leaves is prepared according to another recipe. Pour 20 g of dry raw material over a glass of boiling water and wait for the product to steam. This takes approximately 20 minutes. Warm steam is taken several times a day, one tablespoon at a time.
A phyto-decoction, replacing regular drinks, is prepared from blackberry and heather leaves (5 g each), birch and coltsfoot leaves (20 pcs each). The collection is poured with a glass of cold water and boiled at moderate temperature for 15 minutes. Drink the decoction repeatedly throughout the day. Single dosage – 200 ml.
To reduce pain in the joints, healers advise using herbal hot pads. They are made from black elderberry, sweet clover, hops and chamomile. The above-ground parts of the plants are heated in water, squeezed out and placed in a linen bag. A “pad” is applied to the affected area for 20 minutes. Treatment is carried out daily for 2 weeks.
Homemade ointment for the treatment of psoriatic arthritis is made from several ingredients:
Dry plants are crushed to form a powder, mixed with oil and petroleum jelly until an ointment-like mixture is obtained. It is used to treat swollen skin.
To apply compresses, you can prepare a carrot product. Fresh peeled root vegetables are passed through a fine grater and olive or sunflower oil, as well as pharmaceutical turpentine (5 drops each), are dripped into the pulp. The thoroughly mixed composition is applied to the problem joints and bandaged. Compresses can be alternated with bandages flavored with aloe pulp. The course of treatment is 10 days.
A preparation for taking baths for rheumatoid arthritis is prepared from the rhizome of cinquefoil. 1 kg of raw materials is boiled in a cotton bag. Take 3 liters of water. The decoction is added to the bath while bathing.
Here is an unusual recipe with lilacs. The buds of the bush are considered an effective remedy against arthropathy. They are collected in the amount of two heaped glasses and filled with vodka (250 g). The dishes are wrapped in warm rags and taken out to a dark place for 10 days. From the 11th day, the tincture is used to wipe the affected areas of the body in the morning and evening. 2 weeks of such therapy - and the patient will feel much better.
If it is possible to obtain Ginkgo biloba, it can be used to make an anti-inflammatory agent.
Several fresh leaves of an exotic plant are washed and air dried. The prepared raw materials are crushed to a pulp and eaten without additional ingredients. Do this every time before eating, measuring out 1 tsp. phyto product.
Good ointments are obtained from marsh cinquefoil. The upper inflorescences are passed through a meat grinder and the mixture is transferred to a glass jar. Then it is filled with sunflower oil so that there remains a gap equal to the thickness of two fingers to the edges of the neck. The top of the dish is covered with a gauze bandage, and the composition is kept in the sun for 40 days. Next, the mass is squeezed out and used for daily lubrication of articular surfaces.
Arthritis is a disease that affects the joints. It manifests itself as severe pain in the legs and arms during movements, walking or lifting weights. This disease brings a lot of discomfort to a person and simply forces him to live by its rules.
Treatment of arthritis is very complex and lengthy. It is possible to completely eliminate the inflammatory process in the joints only in isolated cases. But do not despair, since today there are a huge number of ways to slow it down and slightly improve the patient’s condition. And one of these methods is a special diet for arthritis.
Many people believe that a diet for joint arthritis is not effective. However, this is not the case. After all, our body exists and works at the expense of food, or rather all the elements that it contains.
For arthritis, foods that contain omega-3 fatty acids are beneficial. Penetrating into the body, they lubricate the joints, slowing down the inflammatory process and improving their motor activity. Therefore, the patient’s diet should contain a lot of fish (you can eat absolutely all varieties) and vegetable oil.
But since with this disease you cannot gain weight, because this only increases the load on the diseased joints and worsens their condition, nutritionists still recommend eating fish with a minimum amount of fat.
Fish can be eaten not only in its pure form, but also prepared from it in various dishes. It is best if they contain vegetables rich in antioxidants. These are lettuce, bell peppers and broccoli.
The diet for rheumatoid arthritis involves drinking plenty of fluids, which prevents the accumulation of salt in the body, which causes swelling. Therefore, you need to drink a lot and often. Naturally, it is best to give preference to regular drinking water, as it best promotes the removal of salts. But it can also be replaced with natural juices.
Orange, pomegranate and pineapple juices are beneficial for arthritis. They contain many antioxidants, which not only remove everything harmful from our body, but also help relieve inflammation and eliminate pain.
Pomegranate juice is especially good at eliminating joint pain. It is recommended to drink 2-3 tablespoons daily. If you cannot drink it in its pure form, then dilute it in cold water or tea.
When it comes to therapeutic diets, the use of spices is often limited or eliminated altogether. But not in this case. For arthritis, the use of spices is even considered beneficial.
Ginger, turmeric, and cloves are especially beneficial. They can be added to various dishes. They will not only help improve their taste, but will also reduce pain in the joints. By the way, these seasonings go well with fish, which is very useful for arthritis.
During the treatment of arthritis, the most important thing is to avoid “misses” that will lead to relapse. This means that you need to do everything possible to ensure that the condition of your joints remains at least at the same level. And the diet in this case will also come to your aid.
There are foods that are simply strictly forbidden to consume if you have affected joints. This:
These products contain omega-6, which is very harmful for arthritis. It contributes to exacerbation and severe pain in the joints. Therefore, their use should simply be avoided.
You can eat and drink in limited quantities:
The diet for arthritis of the hands and feet allows the following foods and dishes:
It is allowed to eat boiled eggs, but no more than one and without the yolk. All dishes should be prepared with minimal addition of salt. If possible, it is better to abandon it altogether. Salt promotes fluid retention in the body, which can lead to edema. Therefore, its consumption should be minimized.
Remember that it is impossible to cure arthritis by diet alone. An integrated approach is needed. Strictly follow all the doctor’s recommendations, regularly carry out medical procedures (physical therapy, massage, etc.), stick to a diet, and only then will you be able to feel your illness receding!
Psoriatic arthritis, a disease of inflammatory nature, occurs against the background of skin lesions (psoriasis). The symptoms of the disease are very similar to those of rheumatoid arthritis, but the treatment of psoaritic arthritis is much more complicated, since its exact cause has not yet been established. As a rule, patients in the age category from 30 to 50 years are ill, with varying degrees of severity of lesions - from mild to disabling.
Symptoms of psoriasis and psoriatic arthritis:
During the development of psoriatic arthritis, a gradual change in the patient’s behavior occurs; with prolonged pain symptoms and spots, the person becomes irritated and sleeps poorly. Sometimes the disease can appear suddenly, or it can take quite a long time after the first signs of articular syndrome.
From the onset of skin syndrome to the onset of arthritis (as well as vice versa) a different amount of time can pass - from 2 weeks to 10-15 years. Often the dermatosis is limited in nature, in some cases the patient has a characteristic lesion of the nails - pinpoint depressions (thimble symptom) with clouding of the note plate, pronounced transverse and longitudinal grooves. As a rule, the nails are thinned and there are signs of atrophy (onycholysis), but most often the symptoms of psoriatic arthritis are similar to the signs of nail fungus (mycosis). That is why diagnosis when recognizing the disease must be thorough.
Variants of the classic manifestation of psoriatic arthritis occur in only 10% of patients with psoriasis. In 70% it manifests itself as mono- or oligoarthritis of large joints (ankle, knee, rarely hip)), in 15% polyarthritis is registered (affecting more than 3 joints. Many pathological manifestations of psoriatic polyarthritis are very similar to the clinic of RA, sometimes eye lesions appear (iritis, episcleritis, conjunctivitis).The closeness of the clinical picture of PA to Reiter's disease is explained by the presence of lesions in psoriatic arthritis of the oral mucosa and genital organs (ulcers).
Psoriasis arthritis in its malignant form manifests itself as damage to internal organs only in men, mainly under 35 years of age and suffering from atypical psoriasis (universal psoriatic erythroderma, pustular psoriasis). Characteristic symptoms:
The heart suffers the most (a type of myocarditis), and hepatitis or hepatolienal syndrome may develop. The peak of the disease is marked by signs of diffuse glomerulonephritis; renal amyloidosis may subsequently develop. What is psoriatic arthritis in its malignant form? These are symptoms of encephalopathies involving subcortical formations; the patient may experience seizures, delirium, and sometimes polyneuritis or peripheral neuritis.
The main difference between the manifestation of the disease in children is that the articular syndrome develops much earlier than the skin syndrome.
The manifestation of psoriatic arthritis in children (squamosal lichen) is the frequent occurrence of chronic dermatosis of a wave-like course with erythemo-papulosquamous elements on the skin. The etiological factor that provokes psoriatic arthritis has not yet been established; numerous theories on this matter have not received practical confirmation. The medical history of young patients may contain numerous photos with peculiar changes in the skin and joint damage. Features of the course of childhood psoriasis are rare joint damage, exudative rashes on the skin (atypical localization - skin folds), infrequent damage to the nails.
In a child with psoriatic arthritis, the articular syndrome may appear earlier than the skin variant; most often the joints of the first fingers and the distal interphalangeal sections are affected. A characteristic sign is “pencil in a cap,” when a cup-shaped deformation of the proximal part of the phalanges is formed. In addition, the child begins to experience pain in the heels, and early damage to the big toe develops. If psoriasis arthritis is suspected, information about close relatives with a history of the same disease is very helpful in making the correct diagnosis in the baby.
Treating psoriatic arthritis is quite a difficult task; unfortunately, complete recovery is impossible to achieve, but it is necessary to significantly improve the quality of life, achieve stable remission and prevent changes in the joints.
For psoriatic arthritis, two main groups of drugs are prescribed:
The standard treatment for psoriatic arthritis is medications that relieve acute inflammation in the joints, pain and swelling. NSAIDs of the selective type, act selectively - meloxicam, nimesulide, are well tolerated by the body, maintain normal functioning of the gastrointestinal tract. In addition, their anti-inflammatory activity is much more pronounced than that of non-selective NSAIDs (ibuprofen, diclofenac, indomethacin).
Steroid hormones (hydrocortisone, prednisolone, polcortolone) also work well against inflammation, but it should be taken into account that with psoriatic arthritis a paradoxical reaction may occur - an exacerbation of the disease with a worsening of skin and joint manifestations. Although ideally, hormones are designed to relieve acute manifestations of arthritis and high temperatures.
A good effect in the treatment of psoriatic arthritis is achieved by the use of topical steroids (intra-articular injections of Kenalog or Diprospan), which quickly relieves inflammation in articular syndrome, increases the mobility of large joints and reduces pain.
The disease, unfortunately, is incurable, but the development of the pathological process can be significantly delayed if you strictly follow the doctor’s recommendations.
“Disease-modifying” drugs can change the course of the disease for the better. Methotrexate - will be able to control the skin form of the disease while simultaneously “monitoring” arthritis. But, it is necessary to take into account that you will have to take methotrexate for several months under the constant supervision of a rheumatologist (monitoring the level of liver enzymes in the blood). It is necessary to periodically adjust the dosage of the drug, taking into account the peculiarities of the course of psoriatic arthritis in the patient, in order to cure the disease. The presence of a diet, avoidance of alcohol and folic acid supplements when prescribing methotrexate are mandatory.
In order to qualitatively influence the pathogenesis of the disease, to reduce the likelihood of destruction of cartilage and bone tissue, drugs are prescribed for psoriatic arthritis that suppress the immune system and have cytostatic properties (suspend cell division): gold drugs, cyclosporine, sulfasalazine, colchicine. The effect of the drugs is cumulative, so the effect of treatment can be observed after several months.
Salazopyrine helps some patients with symptoms of psoriatic arthritis, but it does not alleviate skin symptoms. In severe cases of the disease, your doctor may prescribe azathioprine. A new drug, leflunomide, was developed relatively recently, and its use has shown positive results in psoriatic arthritis (you need to monitor the level of liver enzymes).
Infliximab, adalimumab and etanercept are new biological drugs that allow you to control the activity of skin and joint manifestations. But such therapy for psoriatic arthritis is prescribed in extreme cases, when there is no effectiveness from the use of common drugs, since such drugs are very expensive.
When treating psoriatic arthritis, it is necessary to influence both the joint process and skin manifestations. Especially “winter” forms of the disease require ultraviolet irradiation, the use of topical ointments (sinalar, fluorocort), vitamin therapy (B1,6,12,A) and sedatives (elenium, valerian, seduxen).
Treatment of psoriatic arthritis with folk remedies involves the use of auxiliary products and recipes, the composition of which must be discussed with the attending physician. It is not recommended to use home remedies on your own to avoid intensifying the pathological process. It is impossible to completely cure psoriatic arthritis with homeopathy, but it is possible to significantly improve the general condition of the patient’s body and achieve long-term remission.
Alternative medicine methods can be an excellent addition to general treatment of the disease.
The following recipes are recommended for the treatment of psoriatic arthritis:
Skin symptoms of psoriatic arthritis can be treated with pleasantly scented herbal baths that are easy to prepare. They relieve fatigue and pain from the entire body, cleanse the skin, calm the nervous system and regulate metabolic processes.
The diet for psoriatic arthritis is designed to improve the general condition of the patient and reduce the acute manifestations of the disease. It is recommended to switch to the following types of products during treatment:
The diet includes complete abstinence from all bad habits, smoking, alcohol consumption (including beer), and low-quality food with preservative additives. You should forget about meat, mushroom and fish broths, smoked meats, pickles, legumes, sorrel, spices, and sauces. The diet focuses on vegetarian food, but it is allowed to eat dietary meat (turkey, chicken, rabbit), quail and chicken eggs. Your doctor will tell you more about nutrition when prescribing treatment.
The consequences of psoriatic arthritis are often favorable, but depending on the severity of the disease, the patient may receive disability (usually group 3 for a year). In severe forms of psoriasis (palmoplantar, erythroderma, exudative, most pronounced in open areas of the skin), especially with aggravating lesions of internal organs, disability is also provided.
Unfortunately, there is no universal treatment for psoriatic arthritis; the patient will have to strictly monitor his health for the rest of his life, avoid provoking factors and take medications prescribed by the attending physician.