The enchanting rustle of waves, a light breeze, the gentle sun, the cries of seagulls, warm, flowing sand, all this fits into one beautiful word - SEA. In the presence of chronic diseases, it is necessary to measure how one or another natural component will affect the course of the disease. How can a holiday at sea affect the course of arthritis? In which forms of arthritis is it contraindicated, and in which, on the contrary, will it help improve the course of the process?
Here we need to consider several factors at once:
Sunbathing can lead to an exacerbation of the disease if used inappropriately. You need to enjoy your vacation wisely. There is a wonderful expression in Thailand that describes the state of complete happiness: “When the sea is salty enough, when the sun is bright enough, when the water is warm enough...”. So, a patient with arthritis needs to find his optimal set, when all climate parameters will help improve the course of the disease, and not its progression. Often such a selection is made intuitively, the patient subtly feels his condition. It is better to also focus on official scientific data when choosing a place and time of rest.
If the disease worsens, marine procedures should be postponed. A trip to the sea is strictly contraindicated during basic therapy for rheumatoid arthritis. Such a “rest” may lead to the need to increase the dose of drugs, or even the need for inpatient treatment. When a stable remission of the inflammatory process is achieved, you can think about relaxing on the seashore. First of all, you should strive to ensure that this event has a beneficial effect on the condition of the joints. To do this, you need to take into account a number of recommendations:
If for rheumatoid arthritis sunbathing is strictly contraindicated, then for psoriatic arthritis ultraviolet rays are extremely useful and have a beneficial effect on the course of the process. The skin manifestations of this disease subside within 2-3 days of being at sea.
When choosing a vacation spot, you need to pay attention to the influence of climate. A climate that is too humid can lead to an exacerbation of the inflammatory process. When choosing a resort, it is better to consult a doctor. If this is a sanatorium-resort treatment, it would not hurt to study the range of additional physiotherapeutic procedures provided on vacation.
The composition of sea water is of great importance. According to experts, it contains more than a hundred microelements and minerals that have a beneficial effect on joints. Potassium, iodine, bromine, hydrogen sulfide, magnesium, calcium, sulfur - this is not a complete list of these substances. The list of indications and contraindications depends on the composition of sea water.
The healing properties of the Dead Sea are largely associated with the high content of minerals in its composition (260 – 310 g/l of water). The hypertonic composition of the water of this sea makes it almost impossible to drown in it. Water itself holds the human body on the surface of the reservoir. The rich salt composition contributes to
reducing inflammation, swelling of joints, restoring their functions, normalizing the condition of the skin. People from all over the world go to these places for treatment. The high content of salts in the sea itself during evaporation creates their increased concentration in the air. Thanks to this, the sun's rays pass through the salt filter. The tan is more even and the need to use sunscreen to prevent sunburn is reduced.
Swimming in the Dead Sea
The sanatoriums of the Black Sea coast are popular. Sulfide-silt muds of Evpatoria and Saki have a beneficial effect on joints.
No less famous are the health resorts on the shores of the Azov, Mediterranean, Red and Baltic seas. The choice of hospitals is very large.
Since ancient times, bathing has been considered useful for restoring joint function. Swimming helps train muscle tissue throughout the body, since this procedure involves all muscle groups. The unloading of joints in an aquatic environment and the buoyant force of water create ideal conditions for painless joint development.
If you have arthritis, you should avoid hypothermia. When swimming, the water should be warm and comfortable. Cold water causes stiffness and worsening inflammation.
When selecting a load, you need to remember that its increase should be gradual and not cause pain or discomfort. When they appear, you should stop moving, relax and go with the flow of the waves. You can do simple things in water
movements that promote joint development.
After bathing, sand baths, when part of the body is covered with warm sand, will have a warming effect on the joints. Walking barefoot on sand or pebbles will serve as a good massage, additionally training the arches of your feet.
Mud therapy will be an excellent complement to water treatments. With skillful use of a range of natural factors, it is possible to improve the condition of joints, strengthen muscle tissue, increase the range of joint movements, and achieve stable remission of the disease.
Such a vacation will be useful and will be remembered for a long time. To consolidate the effect of this impact, you can repeat your visit to the sea every year. This will help improve your health and leave an unforgettable experience.
Treatment of psoriatic arthritis is carried out jointly by a rheumatologist and a dermatologist. During the period of subsidence of the disease, sanatorium-resort treatment is indicated. Of no small importance in the treatment of psoriatic arthritis is patients’ adherence to a correct lifestyle and regular exercise therapy.
If exacerbations are not observed in a patient with psoriatic arthritis, then it is advisable to undergo sanatorium treatment. In cases where sunbathing and sea water have a beneficial effect, this type of treatment can be called the most useful. It also allows you to lengthen periods of remission.
No less effective in combination with the treatment methods listed above is physical therapy or exercise therapy - one of the most important parts of the treatment of psoriatic arthritis.
It helps maintain flexibility and mobility of joints for a long time. Patients are advised to expand their normal motor mode and regularly, twice or thrice a day, perform a suitable gymnastic complex for fifteen minutes.
In the treatment of psoriatic arthritis, a sanatorium can play a key role, since in this case you are subjected to a comprehensive examination of professional specialists with extensive experience and knowledge of the most modern treatment technologies. A wide variety of means and methods of effective treatment are offered.
The most effective methods include types of joint treatment such as balneotherapy and mud treatment, which are offered by most domestic and foreign resorts.
Therapeutic baths in sanatoriums
The procedures of the first type include hydrogen sulfide, iodine-bromine, chloride and sodium baths. Each individual type of bath is characterized by certain features that can have different effects on the human body, which means they will have different effects on the disease. Therefore, only a highly qualified specialist should prescribe a certain set of procedures based on the results of a thorough examination of the patient, the completed form of disease diagnosis and after checking the general health of the patient. All this is also done in order to eliminate the presence of contraindications.
Thus, hydrogen sulfide improves circulation, increases metabolism in tissues, normalizing joints affected by the disease. Hydrogen sulfide baths are prescribed to patients suffering from rheumatoid arthritis who are not severely tormented by the disease and when there are no signs of inflammation.
Salt and sodium baths are prescribed to patients with gouty arthritis, especially during an exacerbation of the disease. Experts prescribe the same bath for people with rheumatoid form, which is inactive and mild. Thanks to these procedures, an anti-inflammatory effect and stimulation of metabolism are achieved. This significantly reduces pain and improves the mobility of diseased joints.
Another type of bath, radon, is recommended for the treatment of arthritis in sanatoriums, especially those where older people live. This type of bath not only normalizes metabolic processes in the joints, but also removes excess uric acid from the body.
Iodine-bromine baths are prescribed to patients experiencing the acute stage of gouty arthritis and a mild form of rheumatoid arthritis or psoriatic arthritis. The peculiarity of these baths is that they are very useful for those who have arthritis due to impaired metabolism, insomnia, and depression. Therefore, it is extremely important to be treated by an experienced specialist who will not only prescribe certain procedures, but will also closely monitor the patient throughout the course of treatment.
Each patient is invited to use the services of all specialists at the sanatorium and undergo a full course of treatment, which includes the need to follow a diet (it is compiled individually for each patient), and the use of anti-inflammatory drugs to promote recovery.
At the same time, the patient is prescribed to attend recreational gymnastics classes. This approach to treatment allows you to see the positive results of your stay in the sanatorium within a few days after arrival.
Mud therapy is prescribed to patients with any form of arthritis, including psoriatic arthritis, however, this universal method has several contraindications for use (people suffering from epilepsy, diabetes, cardiovascular failure, pregnant women, hypertensive patients and patients with polyarthritis with severe degree, expressed in deformation of the articular apparatus). According to modern treatment methods, all leading sanatoriums in our country and foreign countries actively use other methods and drugs in the treatment of arthritis of all types. For example, physiotherapy, reflexology, laser therapy, electrical stimulation. Contraindications to the use of these methods are the same as those found in sanatorium-resort treatment in general. That is, the group not allowed for treatment includes people suffering from mental disorders, patients with HIV and cancer, pregnant women with complications at any stage and women who tolerate pregnancy normally, but if their term exceeds 26 weeks. It is also impossible for those suffering from acute infectious diseases, tuberculosis, or with an exhausted and dehydrated body to come for sanatorium treatment. Therefore, before starting treatment for arthritis and before going to the resort, you will need to contact a medical institution, which may be a regular clinic at your place of residence, where, based on the referral of a specialist, you will undergo an examination, based on the results of which the doctor will decide which sanatorium you prefer.
Medicine has long proven that the treatment of such a common joint disease among humanity as psoriatic arthritis is best treated under conditions of careful supervision by the best specialists; this can be a good private clinic. But the most effective way is treatment in a sanatorium on the Dead Sea. Everyone knows that psoriasis is a chronic disease, and psoriatic arthritis is very prone to rapid and dramatic progression. During long-term observations of patients diagnosed with psoriasis who were treated in Israel, experts found that if psoriatic arthritis is treated there, it is possible not only to eliminate pain and stop the progression of the disease, but also to consolidate the positive results obtained for at least another 1 calendar year. a year during which a patient diagnosed with psoriatic arthritis will not experience severe acute pain and the stage of the disease will not change. This option will be significantly different from those medical procedures that accompany the treatment of rheumatoid arthritis. Therefore, before treating the psoriatic type of disease, you need to additionally consult a dermatologist, take a general blood test and take x-rays of the joints affected by the disease.
If, due to the development of psoriasis, the internal organs of a person are also affected, then treatment will require the participation of other specialists. This indicates that treatment of a disease such as psoriatic arthritis in any of the sanatoriums takes place under the constant supervision of specialists such as a dermatologist and rheumatologist.
Features of arthritis treatment
It is recommended to start visiting the sanatorium once a year immediately with the onset of the disease, without waiting for periods of exacerbation. Considering the fact that arthritis is chronic, health procedures should be systematic. The modern medicines used there can not only remove the pain but also come into serious fight against this disease. The success of treatment is also due to the fact that it occurs in tandem with natural factors. The Dead Sea contains a rare collection of useful chemical compounds and trace elements, for example: chlorides, sulfur, sodium, magnesium, calcium, bromine, etc. Anyone, regardless of age and gender, can visit these resorts and enjoy the healing effects of Dead Sea salts.
Balneotherapy can minimize pain and stress in the joints and help prevent psoriatic arthritis from developing further. It is not recommended to take such treatment for people with a number of concomitant diseases, for example, multiple sclerosis, dermatosis, lupus erythematosus, acute cardiovascular, infectious and other chronic diseases. At the end of the spa treatment, patients can lead an active life for a long time without using painkillers and other medications.
Rheumatoid arthritis is a systemic disease of autoimmune etiology, which usually affects small joints of the human skeleton in the form of polyarthritis and is accompanied by erosive and destructive changes in connective tissues. The etiology of this disease is the subject of debate in scientific circles. There is an opinion that the pathology is genetically determined. The human body produces antibodies against its own cells, resulting in their destruction. It has been proven that the presence of certain viruses in the body significantly increases the risk of developing rheumatoid arthritis. The onset of the disease is acute, reminiscent of the onset of infectious diseases. The patient experiences an increase in body temperature, increased sweating, significantly enlarged lymph nodes, increased fatigue, sudden weight loss, and muscle pain. Rheumatoid arthritis is characterized by signs of polyarthritis: it affects several small joints at the same time (hands, phalanges, feet, etc.), characterized by symmetrical damage to the joints.
The prognosis in the treatment of any disease directly depends on how responsibly the patient treats his health. If the patient is ready to work towards results together with the attending physician, the prognosis is favorable. Otherwise, irreversible changes in the joints may occur, their complete immobility and, as a result, the patient’s disability. What can be done to avoid such developments?
An important role in the treatment of the disease is played by the timeliness of the patient seeking medical help. The sooner a person begins treatment, the greater his chances of a successful outcome.
If you notice similar symptoms, immediately consult a rheumatologist. Never self-medicate or take medications that are suitable for your friends, neighbors or relatives. It is quite possible that in this way you will find a drug that will bring temporary relief, but this will only aggravate the pathological process. The sooner the patient seeks medical help, the more favorable the prognosis.
During the initial visit, it is customary to first interview the patient. During the survey, the clinical manifestations of the disease, its signs and symptoms are clarified. Differentiation from other diseases that are characterized by joint damage is often required. Among them are the following pathologies:
In order for treatment to be effective and the prognosis to be favorable, it is necessary to accurately establish the diagnosis. To achieve this, a number of additional diagnostic measures are usually carried out, such as:
Depending on the clinical course of the disease, your attending physician may prescribe other diagnostic measures and consultations with specialists. All this is necessary for the doctor to make a correct diagnosis. On the contrary, if you have not been prescribed any additional studies, this should alert you. Only on the basis of these data can a final diagnosis of rheumatoid arthritis be made.
If you have been given a definitive diagnosis, do not despair. Modern medicine cannot completely cure rheumatoid arthritis. Achieving a stage of stable remission is not an easy task, but it is quite doable. First of all, you should realize that your life has completely changed. You will have to reconsider a lot, give up some habits, limit yourself in some ways, and constantly undergo medical examination and prevention. Otherwise, the consequences may be irreversible and complications may be fatal.
Today, rheumatoid arthritis is an incurable disease. That is why, if this pathology is detected in you for the first time, a rheumatologist is obliged to register you with a dispensary and send you to a hospital. In a specialized hospital department, a full examination is carried out to clarify the diagnosis and select adequate therapy.
Drug treatment of rheumatoid arthritis initially comes down to relieving the patient of pain and inflammation, that is, symptomatic treatment. For this purpose, patients are prescribed fast-acting non-steroidal anti-inflammatory drugs. These drugs can effectively relieve inflammation in the joints and significantly reduce pain, but are not a cure for rheumatoid arthritis. When a patient takes nonsteroidal drugs for a long time, his quality of life improves significantly, constant pain ceases, and joint mobility increases. It is worth noting that when you stop taking these medications, all the symptoms of the disease quickly return and the next stage of exacerbation of the disease begins.
Since the patient has to take medications for quite a long time, their choice is a responsible task that can only be solved by an experienced specialist. During inpatient treatment, the doctor prescribes certain medications and constantly monitors the patient’s condition. If there is a pronounced therapeutic effect, there are no adverse reactions of the body, the patient tolerates the drug normally and all laboratory parameters are relatively normal, then the drug is considered suitable for long-term use.
Another group of drugs that is used in the treatment of rheumatoid arthritis is called basic drugs, that is, those that act directly on the cause of the disease and inhibit the process of joint destruction at the cellular level. Similar drugs are used in oncological practice, however, in the treatment of rheumatoid arthritis, the dosages are more gentle, and the harmful effects on internal organs are minimal.
If the treatment turns out to be ineffective or the patient is found to have an individual intolerance to the components of the drug, then the drug is changed to another and similar observations are carried out. When adequate therapy has been selected, the patient is discharged home under the constant supervision of a rheumatologist, internist or general practitioner.
How often you go for a preventive examination to a doctor directly depends on the nature of the disease, the dynamics of its development and your consciousness. However, you need to visit a doctor at least 2 times a year, regularly carry out all the necessary tests, such as: x-ray or ultrasound, computed tomography, clinical blood and urine tests, biochemical and immunological studies and others recommended by the attending physician. If you notice any signs of exacerbation, you should contact a specialist, as treatment adjustments, replacement of certain medications, etc. may be necessary.
During periods of remission, when the patient does not experience any somatic changes, spa treatment is effective in the treatment of reactive arthritis. Mud treatment has been successfully used. There are specialized sanatoriums in Odessa, Saki, Pyatigorsk, Sochi, Evpatoria, etc. Mud therapy effectively fights inflammation, improves the patient’s immune status, and significantly improves the mobility of affected joints. Treatment on salt lakes (Saki, Ukraine) is also highly effective. Some sanatoriums successfully practice laser therapy, which helps eliminate the symptoms of rheumatoid arthritis. According to the observations of doctors, patients who annually undergo this course of treatment feel much better, their disease relapses less frequently, their quality of life improves, and, accordingly, the prognosis of the disease.
Diet plays an important role in the prevention and treatment of the disease. First of all, it is necessary to exclude carbohydrates that are easily digestible from the diet of a patient with rheumatoid arthritis, namely: honey, jam, sugar, pastries and cakes. If you really want something sweet, you can sometimes allow yourself to eat 1-2 spoons of condensed milk. But you can eat fruits and berries in unlimited quantities, which not only have excellent taste, but also contain a huge amount of vitamins and mineral components that are simply necessary in the fight against illness. Food should be rich in animal proteins: dairy and fermented milk products, eggs and dietary meats (lean pork and beef, chicken, rabbit, turkey, etc.). All dishes must be boiled, steamed or baked in the oven. Fried foods are best avoided. Replace bread with bran bread or any other dietary bread.
In addition, you need to take vitamin and mineral complexes containing calcium and potassium. It is very important for joint diseases to limit salt intake. The daily salt intake should not exceed 3-5 g, whereas we usually use 10-12. Salt retains water in the body, which contributes to the formation of edema, and this only aggravates the patient’s condition.
With early detection of the disease, compliance with all recommendations of the attending physician and regular use of anti-inflammatory and basic therapy, the prognosis is usually favorable. Patients manage to achieve a stage of stable remission, the quality of life significantly improves and joint mobility remains quite high for a long time. However, if the patient neglects treatment, the prognosis is far from rosy. In the absence of adequate therapy, destructive processes in the joint quickly progress, and after 5-6 years, doctors can only declare the patient’s disability. Moreover, if the disease is not treated, extra-articular manifestations of rheumatoid arthritis develop, which makes the prognosis even more unfavorable.
Thus, the prognosis and options for the course of the disease depend solely on the patient himself, on how willing the patient is to conduct a dialogue with the attending physician and strictly adhere to all recommendations.
Since rheumatoid arthritis is considered an autoimmune disease, drug treatment is aimed primarily at suppressing the immune system. For this purpose, various groups of drugs that have an immunosuppressive (immunosuppressive) effect are used.
This drug is considered the “gold standard” in the treatment of rheumatoid arthritis. It is used both in monotherapy (treatment with one drug) and in combination therapy. Doses are selected exclusively individually using a gradual increase method (2.5 mg weekly). The average therapeutic dose is 7.5 – 25 mg. Methotrexate is prescribed once a week, dividing the dose into three or four doses, 12 hours apart. For example, 20 mg of methotrexate is divided into 4 doses of 5 mg every 12 hours. Thus, the patient takes a dose of 20 mg for 2 days weekly. Afterwards there is a break until next week. The duration of treatment is from 6 to 12 weeks. It is important to know that methotrexate must be taken with folic acid supplements.
As monotherapy, the drug is especially effective in cases of moderate activity of rheumatoid arthritis without systemic manifestations. The dose is also selected individually with gradual saturation of 0.5 grams per week. The standard daily dose is 1 – 2 grams. The duration of treatment ranges from 8 to 12 weeks.
The drug is recommended as monotherapy for any degree of activity of rheumatoid arthritis. The standard dosage is 20 mg per day, but before this, the so-called “loading dose” is used.
It has a powerful immunosuppressive effect, but treatment with this drug requires constant monitoring of kidney function. The daily dose is calculated based on the patient's body weight. So, it is recommended 3 - 5 mg per 1 kg of patient weight. If the patient weighs 60 kg, then the daily dose will be 180 – 300 mg per day (3 or 5 x 60).
Also refers to immunosuppressants from the antimetabolite group. It is prescribed much less frequently as monotherapy due to low clinical effectiveness. The average daily dose is 50 – 150 mg per day. The clinical effect is achieved within 8 – 12 weeks. Azathioprine is not available in Russia and some CIS countries.
These combinations are used when monotherapy has not shown effectiveness. The doses of drugs in them are lower than with monotherapy. Combination therapy is more often than monotherapy complicated by the development of side effects.
Biological drugs are also effective in resistant cases where treatment with other drugs has not been sufficiently effective. Thus, drugs in this category also belong to reserve drugs.
Before use, it is recommended to undergo testing for tuberculosis.
Recommended regimen for infliximab monotherapy:
In some cases, the dose is increased to 5 mg per kg of weight.
Infliximab treatment regimen in case of combination therapy:
The effect of treatment with infliximab is achieved within the first week.
The drug is prescribed intravenously, in a course of two infusions of 1000 mg (total 2000 mg). Between the first and second administration of the drug there is a break of two weeks. To prevent complications, 100 mg of methylprednisolone is administered before rituximab administration. After six months or a year, you can repeat the course.
The drug is prescribed at 25 mg twice a week or 50 mg once a week. Enbrel is administered subcutaneously with a special syringe that comes with the drug.
Since drugs in this group have a weak immunosuppressive effect, their use as monotherapy is not advisable. Most often they are prescribed in conjunction with basic treatment. Glucocorticosteroids are prescribed both systemically and locally. Prednisolone is prescribed at a dose of 10 mg per day, methylprednisolone - 8 mg per day.
From 50 to 150 mg per day, orally after meals.
From 200 to 400 mg per day, in several doses after meals.
From 7.5 to 15 mg per day in two doses.
From 800 to 2400 mg per day in 3 to 4 doses after meals.
From 200 to 400 mg per day.
Anti-inflammatory drugs
This category of drugs can be used in the acute stage of rheumatoid arthritis. Thanks to their complex biochemical composition, in addition to relieving inflammation, traditional medicine has a complex beneficial effect on the body.
A frequently used anti-inflammatory remedy in folk medicine is a decoction of bay leaves. To prepare the drink, grind a tablespoon of laurel and add 2 cups of water to the raw material. Keep on fire for 10 - 15 minutes, then leave to infuse for 10 - 15 hours. Take the product three times a day, one third of a glass. The duration of the therapeutic course should not exceed 2 weeks.
Medicines for reducing pain in rheumatoid arthritis produce a gentle effect, so they will not be able to quickly eliminate pain with their help. To obtain the effect, it is necessary to systematically use the drug according to the schedule specified in the prescription.
Potato compress
Fresh potatoes should be chopped using a grater or food processor. Potato pulp is placed in a bag made of natural fabric, which is heated by steam or in the microwave. The compress is applied to the sore joints and secured on top with polyethylene and a gauze bandage. The procedure is recommended to be performed daily for 10 – 14 days.
To prepare the balm, you need to mix 2 tablespoons of chopped rose hips, a tablespoon of onion peel and 40 grams of pine needles. Add a small clove of garlic to the mixture, which should be crushed into a paste. Then all components of the balm should be poured with 2 liters of hot water. After the balm has been infused for 20–25 hours, it should be filtered and taken half a glass three times a day.
To prepare this product, it is recommended to use fresh homemade chicken eggs. The shelf life of egg-turpentine ointment is short, so it must be prepared once every 2 to 3 days. To prepare the preparation, you should beat raw chicken yolk with a teaspoon of turpentine and the same amount of apple cider vinegar. Apply the ointment to sore joints for 2 weeks before going to bed.
The mechanism of the therapeutic effect of warming drugs is to increase blood circulation, which helps to accelerate the processes of regeneration (restoration) of affected tissues. Such drugs should be used only in the remission phase of rheumatoid arthritis, as in other cases they can cause an exacerbation of the disease.
Ultraviolet irradiation (UVR)
This physiotherapeutic method is prescribed in the acute phase of the disease, since ultraviolet radiation can reduce the level of pain. Also, exposure to ultraviolet radiation helps normalize metabolism in tissues and reduce inflammatory processes.
The radiation dose is determined by the doctor depending on the type and number of joints affected. This type of physiotherapy is not performed for stage 2 or 3 heart failure, severe kidney damage, and various skin diseases.
Laser radiation accelerates the restoration of connective and bone tissue and activates the formation of new cells. Acceleration of regenerative processes occurs due to the fact that laser therapy enhances the activity of the adrenal glands and improves immunobiological processes in the body. Such procedures are carried out at various stages of rheumatoid arthritis, including the acute phase.
This method of physiotherapy is carried out in the subacute course of the disease. Exposure to ultrasound improves blood circulation and reduces tissue swelling, which has a beneficial effect on the patient’s condition. Procedures are carried out every day or every other day, in a course of 6 to 10 effects on each joint. This type of physiotherapy is not indicated for coronary heart disease, thyrotoxicosis (increased thyroid function), and vegetative-vascular dystonia. Also, ultrasound therapy is not performed while taking steroid hormones.
This physiotherapeutic procedure involves the administration of medications using ultrasound. Hydrocortisone is most often used for ultraphonophoresis in rheumatoid arthritis. The therapeutic course includes no more than 10 procedures, the duration of which depends on the stage of the disease.
In the stage of complete remission, the patient is prescribed massage of the projection area of the affected joints in order to normalize the circulation of blood and lymph. Vibration therapy can be carried out manually or using a hardware method. For hardware massage, a special attachment is used, the vibration frequency of which is constantly increasing. With rheumatoid arthritis, the skin loses its elasticity and can be painful. Therefore, before performing any type of massage, the doctor gently rubs the skin to prepare it for more intense effects.
The thermal effect has an anti-inflammatory and absorbable effect, and also stimulates the regeneration of affected tissues. Such physiotherapy procedures are carried out in the remission phase, since in other stages, under the influence of heat, the inflammatory process can worsen.
The most common type of treatment in sanatoriums for rheumatoid arthritis is balneotherapy (therapy with mineral and other waters). Treatment is prescribed in accordance with the clinical picture of the disease, the nature of concomitant pathologies and the general condition of the patient.
Hydrogen sulfide baths
Baths with hydrogen sulfide water have a relaxing effect on muscles and increase tissue elasticity. Such procedures promote dilatation (expansion) of blood vessels and normalization of metabolism. Entering the body, sulfur reduces inflammation and accelerates regenerative processes. Many patients after hydrogen sulfide baths note a general improvement in their well-being. Patients with rheumatoid arthritis begin to complain less of the morning joint stiffness that is characteristic of this disease.
To carry out this type of balneological procedures, natural or artificially radon-saturated waters can be used. Such therapeutic measures are carried out for patients with low activity of the inflammatory process. The degree of exposure to radon on the body is determined by its concentration in water. According to the level of saturation, radon baths can be strong, medium or weak. The healing mechanism of water procedures with radon is a complex beneficial effect on the body. After radon baths, many patients note a decrease in pain, normalization of blood pressure and other positive changes in their health.
Sodium chloride baths are prescribed to patients with mild forms of rheumatoid arthritis. A concentrated salt solution stimulates skin receptors, which leads to increased blood circulation. Activation of blood supply entails improved nutrition of muscles and tissues and normalization of the functionality of internal secretion organs. Salt baths reduce the intensity of pain and inflammation in the joints. Also, water treatments with salt have a tonic effect on the nervous system. After such manipulations, patients experience increased performance and improved mood.
Water with a high content of iodine and bromine normalizes the general mental and physical condition of patients. After such baths, patients begin to sleep better and become less susceptible to depression and other emotional disorders. Iodine-bromine baths have an anti-inflammatory effect, improve blood circulation and normalize the functioning of the immune system.
Diet during an exacerbation of the disease
In the acute stage of rheumatoid arthritis, a diet with a low salt content and a reduced amount of calories is indicated. The recommended calorie content of a daily serving of food is from 1700 to 1800 kilocalories. Reducing the amount of calories consumed is achieved by limiting simple carbohydrates in the diet, which include sugar, honey, and wheat flour.
Diet in the subacute period
When rheumatoid arthritis moves into the subacute stage, it is recommended to maintain all nutritional recommendations in the acute phase with minor changes. Thus, it is allowed to increase the amount of protein consumed up to 90 grams per day, sugar - up to 40 grams, table salt - up to 6 grams.
The main recommendation for nutrition during remission with rheumatoid arthritis is to limit the amount of simple carbohydrates consumed. Excess weight puts stress on the joints, which can cause an exacerbation of the disease. Therefore, controlling extra pounds is one of the important tasks of the diet during this period. It is recommended to increase the daily protein intake to 100 grams, as it is necessary to prevent muscle atrophy. The diet should provide calcium and the elements necessary for its better absorption.
Not recommended products
This type of surgical intervention refers to therapeutic and prophylactic operations. During a synovectomy, the inflamed joint capsule is removed. The indications for this type of treatment are inflammation of the synovial membrane of the joint, which does not respond to other types of therapy for 5 to 6 months. Also, this type of operation is indicated for recurrent (returning) inflammation of the same joint, severe pain and persistent pain syndrome. It is most advisable to perform synovectomy before the onset of severe destructive changes in the joints. A timely operation allows you to prevent and delay the formation of contractures (limited mobility) and ankylosis (complete immobility) of the joints.
The purpose of this operation is to immobilize the joint. Arthrodesis is indicated for severely deformed and unstable joints. During surgery, cartilage tissue is removed from the surface of the joint. After this, the joint is fixed in a functional position and secured with a special screw, knitting needle or plate.
During osteotomy, the angle of the joint is corrected. To do this, the bone is sawed in a certain place and fastened again in the required position.
The hip and knee joints most often undergo prosthetics. The service life of an artificial joint varies from 10 to 15 years, depending on factors such as the patient’s weight, level of physical activity and general physical condition. After the prosthesis becomes unusable, a second operation is performed. Secondary prosthetics are more complex, and the effect from it may be less than from the first operation.
Replacement of the knee joint with a prosthesis is indicated in cases where the patient, due to stiffness and pain in the knee, is unable to perform simple actions. This surgical intervention is performed using a minimally invasive (low-traumatic) method, when the doctor performs all manipulations through small incisions. This allows the volume of damaged tissue to be reduced, since the surgeon does not make large incisions. This type of surgical intervention allows you to reduce the time of the operation and speed up the patient’s recovery process.
During this operation, the physician removes the area of the joint affected by the inflammatory process, replacing it with a prosthesis. Hip replacement is performed using traditional or minimally invasive methods. The choice of the optimal method of hip replacement is determined by the doctor.
Exercise therapy can be prescribed at all stages of the disease, after stopping the acute form of the inflammatory process. With a high level of joint destruction, patients are prescribed positional treatment (lying in bed) and breathing exercises.
Before prescribing exercise therapy, the doctor assesses how severely the patient’s motor system is affected. For this purpose, various tests are used, among which the most common is a functional motor study. The doctor asks the patient to perform a series of exercises, for each of which a certain number of points are assigned. Next, depending on the total amount, the level of restrictions and the degree of reduction in the patient’s ability to work are determined.
In some cases, patients with rheumatoid arthritis are recommended to take special medications before doing physical exercise that reduce pain and morning stiffness of the joints.
Physical therapy consists of 3 stages. The first stage is preparatory and is intended to prepare the patient for the upcoming loads. During this period, the patient is taught to breathe correctly and combine breathing with exercise. This is followed by the main stage, the task of which is to strengthen muscle strength and prevent atrophy. This stage is based on various isometric exercises, in which the patient’s body and limbs practically do not move in space. The final period of exercise therapy is based on classes aimed at restoring the functionality of the musculoskeletal system. The last stage of physical therapy involves performing dynamic loads. It should be noted that the distinction between the second and third stages is quite conditional, because they are often combined with each other.
Physical rehabilitation is aimed at restoring the patient after orthopedic or surgical treatment. Rehabilitation measures are based on various physical exercises, sports, and therapeutic massage. There are 3 stages of rehabilitation, the nature and duration of which is largely determined by the type of surgical intervention performed.
Vocational rehabilitation
Patients with rheumatoid arthritis require the organization of special professional conditions. This will allow you to maintain the results achieved during the treatment process for a longer period. Contraindicated and recommended working conditions depend on the severity of the disease. Thus, with moderate rheumatoid arthritis, the patient should limit the level of physical and nervous tension, avoid prolonged walking or standing in one place, and refrain from maintaining an uncomfortable body position for a long time. If you have this disease, you should not work in rooms with high humidity, frequent temperature changes and strong drafts.
Social rehabilitation
Patients with rheumatoid arthritis require counseling and adaptive treatment to enable them to manage their needs independently. It is also necessary to inform close relatives and family members of such patients. Installing special devices at home and purchasing a number of products will greatly facilitate the rehabilitation process of a person with rheumatoid arthritis and help him become a socially independent person.
The necessary means of acquisition for emergency rehabilitation include various canes, crutches, and wheelchairs. In the home of patients with rheumatoid arthritis, thresholds are removed, special handrails are installed, and non-slip floors are laid.
In rheumatoid arthritis, osteoporosis occurs for two reasons. Primarily due to metabolic disorders. Thus, with chronic systemic diseases (which is rheumatoid arthritis), an imbalance of protein, lipid, carbohydrate, and mineral metabolism is observed in the human body. As a result, the quality of the mineral composition of bone tissue changes. This leads to a violation of its density, structure and architectonics, that is, to the development of osteoporosis.
Elimination of allergic foods
Experts note that when consuming foods that contribute to the development of allergic reactions, the likelihood of developing or exacerbating rheumatoid arthritis increases. Therefore, to prevent this disease, it is necessary to identify allergenic foods and reduce or completely limit their consumption.
To identify foods that trigger allergies, it is recommended to follow an elimination diet for some period. The principle of this diet is to exclude from the diet a product that can act as an allergen. It is necessary to refuse not only the product in its pure form, but also dishes in which it is included as a constituent ingredient. So, for example, if you refuse milk, you should exclude ice cream, milkshakes, and confectionery from your diet.
Each of these products should be completely excluded from the diet for 10–14 days. Next, for 1 day you need to enter it into the menu, while monitoring your own condition. After 3–4 days, the test product should be reintroduced into the diet and the body’s reaction should be monitored. In case of exacerbation of rheumatoid arthritis, the product must be added to the list of prohibited products and its use must be limited as much as possible. An elimination diet is more effective if all stages of its implementation and the resulting reactions are recorded in a special diary.
Nightshade crops contain a special substance (solanine). In the absence of rheumatoid arthritis, solanine is neutralized by the body, and in the presence of this disease it freely penetrates into the blood. Being toxic, solanine causes joint pain and general deterioration in health.
Tobacco is one of the representatives of the nightshade family. To prevent rheumatoid arthritis, it is recommended to stop smoking cigarettes and other tobacco products.
Being a chronic disease, rheumatoid arthritis requires long-term use of various medications. To allow the body to better tolerate therapy and prevent relapse of the disease, you should limit the intake of foods that put stress on the liver. Dishes cooked in strong, rich meat broths (jellied meat, solyanka, kharcho) worsen liver function. The use of various artificial additives (sugar substitute, flavor enhancer, food coloring) has a negative effect on the condition of the liver. A greater burden is exerted by modified fats (margarine, soft sandwich butter), which are included in chips, fast food products, and confectionery.
Systematic use of medications for this disease can lead to calcium deficiency in the body. An insufficient amount of this mineral can cause the development of osteoporosis, which will accelerate relapse and complicate the course of rheumatoid arthritis. Therefore, when preventing this disease, it is necessary to consume a sufficient amount of foods that contain calcium. In addition, you should take into account that there are foods that can improve or worsen the absorption of this element.
Limited meat consumption
Experts in the field of rheumatoid arthritis note that the condition of many patients improves significantly after limiting the amount of meat consumed. About 40 percent of patients achieve stable and long-term remission when switching to a dairy-plant diet. It should be borne in mind that meat contains a large amount of various vitamins and other useful substances. Thus, meat contains protein, the deficiency of which affects the immune system. Therefore, when giving up meat, you should include a sufficient amount of eggs, fish and dairy products, which also contain protein. Other valuable elements found in meat are B vitamins. To maintain the balance of these vitamins in the body, you should eat nuts, whole grain products, and leafy vegetables.
Patients with rheumatoid arthritis are often overweight because joint pain significantly limits their physical activity. Extra pounds put additional stress on inflamed joints, which negatively affects the patient's condition. Therefore, in order to prevent this disease, it is necessary to reduce the caloric content of the diet.
Each of the exercises in this complex should be repeated 5 times.