Rheumatoid Arthritis - Treatment

Rheumatoid arthritis is a chronic, often disabling when not treated properly. An early diagnosis followed by intensive treatment with antirheumatic drugs and sometimes with agents of biological response modifiers can increase your chances of success.
Reduce the symptoms with medication and in some cases, unconventional medicine is useful, especially at the beginning of treatment and periods of relapse. However, they do not change the course of the disease - do not prevent joint damage and disability.
Many advances have been recorded in the last 25 years in controlling rheumatoid arthritis. Research has shown that early treatment with antirheumatic drugs during the first six months of the disease increases your chances of getting a long-term remission.Therefore, for the treatment of choice is antireumaticele AR.
Treatment objectives are to reduce symptoms, inducing and maintaining remission duration, restore and maintain good joint function, preventing disability and disease complications.
Remission is the absence of symptoms of inflammation (morning stiffness and pain), absence of signs of inflammation on physical examination and blood analysis, evolution stopping joint damage, detectable in X-rays.

Symptomatic
Symptomatic treatment is oral anti-inflammatory that reduces joint pain and stiffness, but not stop the disease and prevent any appearance of joint deformities. NSAIDs are used mainly at onset, then intermittently.
Traditional NSAIDs - ibuprofen (Advil, Motrin), naproxen and other NSAIDs are prescribed to reduce symptoms. Aspirin (acetylsalicylic acid) is rarely indicated because it is less tolerated by the digestive system.Side effects - prolonged use of traditional NSAIDs may lead to gastrointestinal side effects (heartburn, ulcers, gastrointestinal bleeding), and other adverse effects (hypertension or renal failure).Therefore, they are used for a short period of time, if necessary.
NSAIDs selective COX-2 inhibitors (or coxibs) - celecoxib (Celebrex), etoricoxib, parecoxib, valdecoxib, rofecoxib. New generation of anti-inflammatory class of cyclooxygenase-2 selective inhibitors (COX-2) acts by inhibiting Cox-2 enzyme, involved in the inflammatory process.This class of drugs has the same effects as traditional NSAIDs, but the advantage of being better tolerated by the digestive system.Using coxibs is reserved for patients at high risk of gastrointestinal complications and reduced risk of cardiovascular disease.These drugs do not eliminate the risk of gastrointestinal symptoms and should be taken in moderation, just as with traditional NSAIDs.
Corticosteroids - Cortisone, prednisone - drugs are effective in reducing inflammation and reducing pain and joint stiffness. Their action is rapid, but short. Corticosteroids may also slow the progression of rheumatoid arthritis and can be taken as tablets or injected directly into joints. To avoid adverse effects, will be prescribed the lowest effective dose for a short period of time.Side effects - long term corticosteroids produce serious side effects, depending on the dose taken - osteoporosis, fractures, hypertension and infections.Acetaminophen or morphine derivatives - are sometimes used to reduce the intense pain
Antirheumatic drugs
Antirheumatic drugs act directly on the disease - the immune cells that attack the joints - preventing or slowing joint damage. These drugs are more beneficial if taken since the onset of illness and may be associated with NSAIDs or corticosteroids. Their effect is felt after a few weeks or even months.Main antirheumatic are: methotrexate (we recommend taking folic acid supplements to reduce adverse effects), hydroxychloroquine, sulfasalazine, etc.. Each of these drugs cause specific side effects.
Biological response modifiers (MRB)
Unlike anti-rheumatic drugs, whose action on the immune system is nonspecific, the class of drugs - biological response modifiers - substances act directly on the considered responsible for inflammation and joint destruction.Biological response modifiers are reserved for patients for whom anti-rheumatic drugs are insufficient. Among the adverse effects of these drugs include reducing the immune response against infection.
The first representatives of this category are infliximab, etanercept, adalimumab. In this category there are the drugs that reduce the effects of interleukin-1 (substance that contributes to inflammation).All these drugs are administered by injection.
Surgery
In cases where joint injuries deteriorating quality of life of patients, surgical intervention may become necessary.
Synovectomy - consists of surgical removal touched by arthritis synovial membrane. This procedure can be performed by surgery or by injecting a radioactive product in the joint. In this case, the excess synovial membrane is destroyed by radioactive product.These measures are temporary, because after a certain period of time synovial membrane will thicken again, and the inflammatory process will be resumed.
Joint replacement - the affected joint can be replaced by an artificial joint. Dentures can be made of metal or plastic. This intervention play joint mobility, while reducing pain and may correct any deformities.This intervention is sometimes proposed before bone and joint injuries become too important.
Physiotherapy and Occupational Therapy
Physical therapy uses exercises tailored to individuals' physical condition, allowing the body to retain mobility and strength, despite the disease. Occupational Therapy proposes concrete solutions for people affected by rheumatoid arthritis in order to perform daily tasks without too much difficulty. For example, several objects and tools can be used without causing pain in the joints, and some stations to alleviate pain and fatigue.The intervention of a physiotherapist, and in some cases, an occupational therapist, helps maintain physical capacities, both in personal life and professional life.
Nutrition
Adopt healthy eating habits is vital to maintaining good health and prevent overweight, which can worsen symptoms. Intake of antioxidants, found in large amounts in fruits and vegetables is extremely important. Some people have found that eating high fat and protein tends to increase pain.