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Reviewed by

Team Resolve

February 4, 2022

Rheumatoid Arthritis and Rehabilitation

Our body employs various cells and systems which are entrusted with keeping our body safe from any outside invader. However, at times, these cells which form our immune system attack our own body cells, leading to the development of Auto-immune diseases. One of the most common and debilitating autoimmune disease is Rheumatoid arthritis. In Rheumatoid arthritis, the defense cells of the bodies attack the cells of the bones, joints, and spaces around the joint, leading to pain and swelling in the affected joints. Considering that damage done by this disease is irreversible and the number of complications associated with Rheumatoid Arthritis, it becomes important to educate oneself about its symptoms, warning signs, treatment and management.

Table of Contents

Risk Factors for Developing Rheumatoid Arthritis

Anyone can be affected by Rheumatoid Arthritis but there are some factors which increase the risk of incidence like:
  • Age: Risk of developing Rheumatoid Arthritis increases with increase in age.
  • Sex: Females are three times more at risk as compared to their male counterparts.
  • Smoking: Smoking is a known aggravator of inflammation and increases risk of developing the disease as well.
  • Family history: Any known patients of Rheumatoid Arthritis in the close family can be translated into increased risk of developing the disease.
  • Obesity: BMI higher than normal signify a greater risk of being affected by this disease.

Symptoms of Rheumatoid Arthritis

  • Pain in multiple joints
  • Stiffness in movement of multiple joints. There is a significant reduction in range of movement of the affected joints.
  • Swelling around joints
  • Increased fatigue/tiredness in activities of daily life.
    • Fever 
    • Weight loss
  • Note: Rheumatoid arthritis involves multiple joints, and affects the smaller joints like that in fingers and toes first. Further it has a bilateral distribution, i.e., both hands are affected or joints of both legs are affected etc.

    When to see a doctor?

    As a disease, Rheumatoid arthritis is chronic and progressive, meaning that it damages and attacks the body for a long time and with time, the symptoms will only become worse. This damage is irreversible and hence timely diagnosis and treatment is of utmost priority. 

    The following warning signs of the disease should raise alarm and a doctor should be consulted at the earliest:

    • Pain and swelling around fingers and toes
    • Limitation and stiffness of movement
    • Progressive worsening of symptoms
    • Tiredness/fatigue on doing daily activities

    What can be done at home?

    Alongside medical treatment, rehabilitation and lifestyle changes are indispensable to battle a disease like Rheumatoid Arthritis and limit the damage to body as well as life. Small steps taken at home itself can work wonders in the treatment of this disease.

    Nutritional Changes

    • Decreased intake of oily foods, food with high salt content, sugar, butter etc. They are implicated in worsening of inflammation in the joints.
    • Increased intake of foods rich in minerals and vitamins which promote healing and repair of the body tissues.
    • Supplements of Cod liver oil, Omega-3 help reduce the inflammation of the joints as well.

    Adequate Rest

    • Inarguably the most important thing to keep in mind while undergoing treatment for Rheumatoid arthritis is to ensure adequate rest
    • Relaxing the joints and making a conscious effort to not exert the limbs helps prevent further damage to the body.

    Hot and Cold Therapy

    • Hot therapy: Application of heat on the affected joints for 10 minutes twice a day can help relieve pain and regain the agility in the movements.
    • Cold Therapy: Application of ice packs help reduce the swelling and the redness around the joints, preventing any further damage to the joints.

    Physical Therapy and Exercise

    The course of Rheumatoid Arthritis has two broad phases- an active phase (also called ‘flare up’) with all the symptoms and an inactive phase where for some while, there is a regression in the symptoms. It is important to customize and personalize therapy according to these phases to prevent worsening of the disease progression.

     

    • Proper rest should be encouraged during active phase to limit the damage to the joints. Further is needed, splints can be used to maintain proper posture for resting if needed.
    • Stretching: Stretch all the joints gently and move them in the entire range of motion. For example, wiggle your fingers, rotate your wrist, flex your elbow and rotate your shoulders. Repeat this cycle for the other limb. This helps in preventing stiffness and works on the mobility of the joints.
    • Massage: Massage the affected joints daily. This helps in stimulating the tissues and increases blood flow.
    • Strengthening exercises: This disease severely affects the strength of the muscles and compromises the quality of life. Strengthening exercised help restore the agility and builds up power in your tissues. For example- Squeeze a foam ball to strength the joints of the hand, make figure 8s in the air with wrist rotations etc.
    • Aerobic Exercises: These exercises require active participation and can include brisk walks around the neighbourhood, cycling, swimming etc.

    Note: Exercises should be discontinued if they cause severe pain and the condition of the patient worsens.

    Mental Health

    • Rheumatoid arthritis can severely reduce the functioning capacity of an individual. In such cases it becomes important to reassure and counsel the patient about various exercises, diet and treatment options available.
    • Encouraging indoor hobbies can help alleviate the anxiety and keeps the patient productive.
    • Various prosthesis and orthosis are available which aid in movement. If requirement is felt, use should be encouraged and the patient should be counselled on acceptance of these aids.
    • A professional psychiatrist can be approached if the patient has any worrisome symptoms like anxiety, palpitations, increased sweating, lack of interest in activities which were interesting earlier.
    • Educating the patient and the family about the disease and how to cope up with it is of paramount importance to ensure acceptance of the individual in society.

    Treatment options

    In the past few decades, treatment options for Rheumatoid arthritis have improved drastically. Even though there is no absolute cure for this disease; there are drugs which can relieve symptoms and prevent further damage to the joints.

    • Primary medical management starts with drugs called DMARDS- Disease Modifying Anti Rheumatic Drugs like Methotrexate, hydroxychloroquine, sulfasalazine etc. These drugs reduce symptoms, slow disease progression and improve the quality of life as well!
    • Along with primary DMARD therapy, NSAIDS like aspirin are prescribed for alleviating pain.
    • Apart from pharmacological management, physical and mental therapy is also recommended for Rheumatoid Arthritis.

     

    Complications

    Joint pain is a common problem which is usually ignored, considering it a normal part of ageing. Ignoring pain of Rheumatoid Arthritis can end up in various complications including but not limited to:

    • Diabetes
    • Obesity
    • Muscle atrophy and wasting
    • Increased risk of infections
    • Cancers of the gut
    • Damage to lung tissue
    • Chronic anemia

    It is rightly said that prevention is better than cure. For a disease like Rheumatoid Arthritis, delay in diagnosis and starting treatment can have drastic effects on any individual. 

    Rheumatoid Arthritis is a debilitating disease with no cure. However, with timely diagnosis and treatment, advancements in medical sciences can ensure that there is little compromise with the quality of life of an individual. Resolve360 is an endeavour, aimed at making sure that every individual in every corner of the world can access proper rehabilitation therapy for such diseases and, lead a normal and productive life. We employ a team of specialists to give personalized care at the convenience of your home. To book your first free session, register here! https://resolve360.app/

    Disclaimer

    This article is meant to guide and educate the patients. All medical treatment is to be undertaken under the guidance of expert medical service providers only.

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