Physical therapy

For pain relief and muscle relaxation, e.g. heat or cold therapy, electrotherapy, medical baths, massage, ultrasonic sonography, exercise bath.

Psychosomatics

The aim is to prepare the patient for a life with rheumatoid arthritis and to strengthen the willingness of the patient to cooperate in the therapy. Furthermore, relaxation techniques (e.g. progressive muscle relaxation according to Jacobson) are taught and pain management techniques are learned.

Drug therapy

Of course, drug therapy must also be adapted to the disease activity. Non-steroidal anti-inflammatory drugs (NSAIDs) are used to relieve pain and joint stiffness. Drugs of this group are DIcolfenac, Ibuprofen or the newer COX 2 inhibitors Celebrex ® and Arcoxia ® 90mg.

With low disease activity they can be taken as needed, with medium and high disease activity they should be taken regularly. If the inflammatory activity cannot be controlled with these drugs, additional steroids must be taken. Steroids (cortisone) have a strong anti-inflammatory and immunosuppressive effect.

Depending on the activity of the disease, the dose should be adjusted. When taking steroids (cortisone), the dose should always be observed in order to achieve the optimum effect and to minimize side effects: In case of regular steroid therapy (cortisone therapy) a medicinal osteoporosis prophylaxis is recommended. This should be carried out with calcium, vitamin D (e.g.

Ideos®) and a bisphosphonate (e.g. Fosamax®) or selective estrogen receptor modulators (e.g. Evista®). For any active chronic polyarthritis, long-term disease-modifying antirheumatic drugs (DMARDs) are also indicated.

The mode of action of these drugs is usually unknown, but the activity of rheumatoid arthritis weakens, and the onset of action is often not noticeable until weeks later.Due to the sometimes serious side effects, close medical supervision is necessary. Among the long-term disease-modifying drugs are In case of ineffectiveness or decreasing efficacy, a change of medication can be made or the DMARDs can be combined. In a therapy with methotrexate, undesirable side effects can be counteracted with folic acid preparations without loss of efficacy.

Dose: as low as possible, as much as necessary
The entire daily dose should be taken early in the morning with milk or yogurt
Do not simply stop taking the medicine without consulting your doctor
Regular check-ups with the doctor
In case of acute illness or pregnancy, see a doctor immediately
Pay attention to occurring back pain and inform the doctor
As much physical activity as possible
Daily weighing
For low disease activity: Chloroquine (e.g. Resochin®) Hydroxychloroquine (e.g. Quensyl®) Gold oral (e.g.
Ridaura®)
Chloroquine (e.g. Resochin®)
Hydroxychloroquine (e.g. Quensyl®)
Oral gold (e.g.
Ridaura®)
For moderate disease activity: sulfasalazine (e.g. Pleon® RA) gold parenteral (e.g. Tauredon®) azathioprine (e.g.
Imurek®)
Sulfasalazine (e.g. Pleon® RA)
Gold parenteral (e.g. Tauredon®)
Azathioprine (e.g.
Imurek®)
For high disease activity: Methotrexate (e.g. Lantarel®) D – Penicillamine (e.g. Metalcaptase®) Ciclosoprine A (e.g.
Sandimmun® Optoral) Leflunomide (e.g. Arava®)
Methotrexate (e.g. Lantarel®)
D- Penicillamine (e.g.
Metalcaptase®)
Ciclosoprine A (e.g. Sandimmun® Optoral)
Leflunomide (e.g. Arava®)
For highly acute disease activity: cyclophosphamide (e.g.
Endoxan ®) TNF – alpha – receptor – antagonists (e.g. Remicade®, Enbrel®)
Cyclophosphamide (e.g. Endoxan ®)
TNF – alpha – receptor – antagonists (e.g.
Remicade®, Enbrel®)
Chloroquine (e.g. Resochin®)
Hydroxychloroquine (e.g. Quensyl®)
Oral gold (e.g.
Ridaura®)
Sulfasalazine (e.g. Pleon® RA)
Gold parenteral (e.g. Tauredon®)
Azathioprine (e.g.
Imurek®)
Methotrexate (e.g. Lantarel®)
D- Penicillamine (e.g. Metalcaptase®)
Ciclosoprine A (e.g.
Sandimmun® Optoral)
Leflunomide (e.g. Arava®)
Cyclophosphamide (e.g. Endoxan ®)
TNF – alpha – receptor – antagonists (e.g. Remicade®, Enbrel®)