Rheumatoid Arthritis: Treatment and Prevention

To date, rheumatoid arthritis cannot be cured. Treatment is aimed primarily at relieving pain, inhibiting inflammation (which at the same time slows progression), and preserving joint and muscle function. Which measures are indicated in individual cases depends on the activity of the disease. In mild forms, the administration of so-called non-steroidal anti-inflammatory drugs (non-cortisone-containing anti-inflammatory drugs), or NSAIDs for short, is sufficient. These drugs relieve pain, swelling and inflammation. However, they do not completely stop the destruction of articular cartilage and have no effect on the progression of the disease.

Side effects of drug therapy

Because of the risk of serious side effects (for example, life-threatening gastric ulcers), these drugs should be taken only under medical supervision over a long period of time. Newer preparations of this group – with the same efficacy – do not seem to cause undesirable effects on the stomach. In severe forms or with high disease activity and the threat of joint destruction, basic therapeutics are necessary, i.e. drugs that have been proven to have a favorable effect on the course of the disease. Gold, chloroquine, D-penicillamine, sulfalazine and methotrexate have proven effective. These drugs take effect slowly (after 6 to 12 weeks at the earliest), and the rate of side effects is relatively high (about 40%). A reliable agent is also cortisone, an endogenous hormone that has a strong anti-inflammatory effect. Cortisone is administered in high doses over a short period of time during the “relapse” and the dose is then gradually reduced. If longer-term administration is required, the dose is kept as low as possible. In this way, a high effect is achieved and dangerous side effects are avoided (see also Frequently Asked Questions).

Biologic immunomodulators

A new group of drugs in which much hope is placed are the “biological immunomodulators” (substances that control the immune response). This group includes interleukins or their inhibitors, immunoglobulins, and tumor necrosis factor-alpha. They are designed to stop the destruction of articular cartilage by inhibiting the body’s “false” inflammatory response. These drugs also cannot cure rheumatoid polyarthritis, but they represent another “therapeutic component.”

Physiotherapy for rheumatoid arthritis.

Regular physiotherapy and physical treatments are at least as important as medication. This alleviates restrictions in joint function and strengthens the muscles. Proven measures include cold applications or-, heat packs (depending on how the patient feels), baths, electrotherapy, light treatments, and massage. In so-called occupational therapy, the affected person learns to cope with functional limitations in everyday life.

Operations

There are numerous surgical procedures developed specifically for rheumatoid arthritis. They are indicated when medications cannot stop rapid progression of joint destruction or when there is disabling dysfunction. If the joint is already destroyed, for example, an artificial joint or joint fusion may be necessary.

Precaution

There is no way to prevent chronic polyarthritis disease – and, unfortunately, no way to prevent its progression other than with medication. Early and carefully administered physical therapy combined with a proven individualized medication regimen is the best approach known to contemporary medicine.

Nutrition in rheumatoid arthritis

Proper nutrition can contribute to the success of therapy as a supportive measure. It makes sense to avoid foods that contain arachidonic acid. These include, for example, eggs, lard, liver sausage, and pork liver. The intake of unsaturated fatty acids (plenty of fish), an adequate supply of vitamins C and E and the so-called trace element selenium (plenty of vegetables and high-quality vegetable oils) and also calcium (milk and dairy products) and vitamin D are recommended.

Important note

Rheumatic diseases, especially rheumatoid arthritis, can be counted among the common diseases. They are not only common, but occur in very different mild or severe courses and in all age groups.In adolescents and young adults, they can lead to considerable impairment of the ability to work, not infrequently even to disability. Caution: In the event of severe complaints, conspicuous physical changes or before taking medication, be sure to consult your doctor or pharmacist. Pregnant women and chronically ill persons in particular must be careful when using certain medications!