Welcome to the Healing Room
What is it?
The word arthritis literally means joint inflammation, but is often used to refer to a group of more than 100 rheumatic diseases that can cause pain, stiffness and joint swelling. These diseases may affect not only the joints but also other body parts, including such important structures such as muscles, tendons, bones, ligaments and several internal organs.
How often:
Arthritis is a common disease and the prevalence may reach 1.5% of the population in some regions. It is more frequent in women and usually starts between 30 and 50 years of age, but also affects men and children. For the development of the disease are required some combination of genetic defects and the presence of one or more external factors.
Arthritis is a genetic predisposition and some genes have been identified. There is no known cause of Rheumatoid Arthritis and is thought to have several different causes, including genetic factors provoking defects in the immune system, triggering the inflammatory response. The persistence of stimuli or the inability of the immune system to control inflammation leading to chronic disease. The synovial membrane proliferates and releases enzymes produced by cells locally. Both the invasion of the synovial membrane and the action of enzymes cause the destruction of joint structures ,cartilage and adjacent bone, tendons and ligaments.
What do you feel?
The most frequent form of onset arthritis is symmetrical (for example, both wrists, the fingers of both hands) and additive (the first joints involved remain and others are added). Installation is usually slow and not aggressive, being located primarily in the small joints of the hands.
There are acute forms quickly and limiting. Less commonly, it starts in large joints or in an asymmetrical fashion. Can remain or evolve into classic symmetric polyarthritis. All peripheral joints may be involved and the damage to the cervical spine can be very serious.
Some patients with rheumatoid arthritis typically report that over months or years had outbreaks of arthritis in several or a few joints before the disease becomes chronic.
The most common clinical course is characterized by partial relief of the inflammatory activity. Less often, there is inactivity for varying periods of months or years. In severe cases the disease evolves progressively leading, over time, severe disability articulate.
How is it treated?
There is no single treatment that can be applied to all people with arthritis. It is for the professional who is providing assistance to develop a specific approach to minimize pain and improve the functioning of the joints. We list below some steps that can be used to relieve pain in the short term:
a) Medications: since people with osteoarthritis have an inflammation of small and discrete, is already able to relieve the pain with analgesics such as paracetamol. Patients with rheumatoid arthritis generally have pain caused by inflammation and often benefit more from the use of aspirin or other nonsteroidal antiinflammatory drugs, with such oibuprofeno, meloxicam, diclofenac and so on.
b) applying heat and ice: the decision to use heat or ice on arthritis depends on the type of arthritis should be discussed with the (a) doctor (a). Heat compresses on the sore spot for about 15 minutes to relieve pain. Ice compresses the same time reduce the swelling and pain. In the presence of circulatory problems, do not use cold compresses.
c) Protection of articulation: splints or slings can be helpful, always following the doctor's recommendation.
d) Massage: when applied properly and by authorized person, increases blood flow and relaxes the tense area. However, the inflamed joints are very painful, and the therapist should be very familiar with the underlying disease.
e) Acupuncture: this procedure should only be performed by a qualified professional. It is believed that acupuncture triggers the release of natural chemicals produced by the nervous system (endorphins), relieving pain.
What can be used to relieve pain in the long term?
a) Anti-inflammatory drugs (NSAIDs): this class of drugs that includes aspirin and diclofenac, are used to reduce inflammation and can be used to relieve pain in patients suffering from osteoarthritis or rheumatoid arthritis.
b) Anti-rheumatic: these medicines are used to treat patients with rheumatoid arthritis who have not obtained good results with the use of (NSAIDs). This group include: methotrexate, hydroxychloroquine, penicillamine and gold injections. It is believed that these drugs influence and correct abnormalities of the immune system responsible for diseases such as rheumatoid arthritis. Treatment with these medications requires close monitoring by a doctor because of side effects.
c) Corticosteroids: hormones are quite effective in the treatment of arthritis. Corticosteroids may be administered orally or by injection.
d) Reduction of weight: the excess pounds put extra stress on the joints that support the body, such with knees and hips. Research has shown that obese people who lost weight also experienced a substantial reduction in the development of osteoarthritis in the knees. Still, in the presence of osteoarthritis in one knee, weight reduction helps to reduce the chance of disease occurrence in the other knee.
e) Exercises: swimming, walking and exercising low-impact aerobics reduce stiffness and joint pain. Stretching exercises are useful.
f) Surgery: some patients with arthritis may require surgery to remove the synovium or realignment of the joint, or, in advanced cases, replacement of the affected joint with a prosthesis. Complete replacement of the joint not only provides a dramatic relief of pain but also has improved the mobility of many people with arthritis.
J. David, S. Townsend, R. Sathanathan, S. Kriss and C. J. Doré1 Author Affiliations Royal Berkshire & Battle Hospitals NHS Trust, Reading and 1Imperial College School of Medicine, London, UK J. David, Rheumatology Department, Battle Hospital, Oxford Road, Reading RG3 1AG, UK. Received December 1, 1998. Revision received April 6, 1999.
Last updated: 04/03/2012
